Case Discussion Pulmonary

Case Discussion Pulmonary – Part 2 Follow up Visit

Purpose

The purpose of this assignment is for students to:

1. Improve their ability to formulate diagnoses based on clinical presentation of patients

2. Improve their ability to understand and apply National Guidelines for the diagnosis and treatment of Pulmonary disorders

3. Design a relevant treatment plan

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Utilize healthcare delivery system resources in a fiscally responsible manner in the diagnosis and treatment of patients and families across the lifespan. (PO 5)

2. Develop management plans based on current scientific evidence and national guidelines. (PO 5)

3. Educate patients on treatment decisions (WO1)

4. Select an evidence-based article to support the plan of care for the case study patient. (WO2)

5. Analyze national guidelines and apply them to specific case study situations. (WO3)

6. Review appropriate antibiotic prescribing guidelines. (WO4)

Requirements:

Michelle continues to work in the bakery and her asthma has been well controlled on a low-dose inhaled corticosteroid inhaler, Singular 10mg daily, and Albuterol prn which she uses 1-2 times per week. Michelle presents to the clinic with an acute illness that developed 2 days ago and has a respiratory rate of 24, mild SOB with exertion, O2 saturation of 94%, and complaint of inspiratory and expiratory wheezing. She is able to speak and states her temperature over the last 2 days has been 101 to 102 F. Cough is productive of white sputum. Influenza A is going around the bakery. Exam findings show a woman who appears her stated age and is alert and oriented and though calm, is having mild work of breathing. AR 110 BPM, BP is 150/85, RR: 24, Temp 101.4. She has a nonproductive, dry cough, is mildly short of breath, fair chest expansion, + inspiratory/expiratory wheezes, no rales, no rhonchi. Auscultation reveals no thrills, gallops or extra heart sounds. Apical rate is elevated at 110. Physical exam is otherwise unremarkable. The MA has swabbed her for Influenza A- test is positive.

Discussion Questions Part Two:

1. Determine appropriate treatment plan for Michelle. Discuss medications, doses, Durable Medical Equipment, and any testing, and apply these directly to her case. Provide your rationale with evidence.

2. Decide whether she is safe to return home, include any prescriptions, or if a referral to a higher level of care is required. Discuss the criteria used to make your decision, how a referral is made and defend your position.

3. Discuss relevant education and follow up plan.

 

DISCUSSION CONTENT
Category Points % Description
Application of Course Knowledge  20 50% Post contributes clinically accurate perspectives/insights applicable to the results from the physical exam and new diagnoses. Initial post includes the most likely diagnosis/specific treatment plan given case study information supported by rationale and answers all questions presented in the case. Demonstrates course knowledge/assigned readings by: linking tests/interventions accurately to diagnoses, applies learned knowledge specifically to the symptoms and patient information using original dialogue i.e., little to no direct quotes. 
Evidence Based resources 10 25% Discussion post supported by evidence from appropriate sources published within the last five years. Focus of journal articles represents a logical link between the article content and the case study information.  In-text citations and full references are provided.
  30 75% Total CONTENT Points= 30 pts
DISCUSSION FORMAT
Category Points % Description
Organization  5 12.5% Discussion post presented in a logical, meaningful, and understandable sequence. Headings reflect separation of criterion outlined in assignment guidelines. 

**Direct quote should not exceed 15 words & must add substantively to the discussion

APA/Grammar/Spelling 5 12.5% Discussion post has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post. 

* APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

  10 25% Total FORMAT Points= 10 pts
      DISCUSSION TOTAL= 40 Pts
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDiscussion Content Possible Points = 30 Points

Application of Course Knowledge  Post contributes clinically accurate perspectives/insights applicable to the results from the physical exam and diagnoses. Initial post includes the most likely diagnosis/specific treatment plan given case study information supported by rationale and answers all questions presented in the case. Demonstrates course knowledge/assigned readings by: linking tests/interventions accurately to diagnoses, applies learned knowledge specifically to the symptoms and patient information using original dialogue i.e., little to no direct quotes.

20 pts

Excellent

Post contributes clinically accurate perspectives/insights applicable to the results from the physical exam and diagnoses. Treatment plan reflects National Guidelines given case study information supported by rationale and answers all questions presented in the case. Demonstrates course knowledge/assigned readings by: linking tests/interventions accurately to diagnoses, applies learned knowledge specifically to the symptoms and patient information using original dialogue i.e., little to no direct quotes.

18 pts

V. Good

Post contributes clinically accurate perspectives or insights and original dialogue with little or no direct quotes, but lacks some applicability/specificity to the assigned case study in one content area or does not incorporate National guidelines into treatment plan. Partially demonstrates course knowledge/assigned readings by: linking tests/interventions accurately to diagnoses, applies learned knowledge specifically to the symptoms and patient information using original dialogue i.e., little to no direct quotes.

17 pts

Satisfactory

Post has limited clinical perspective, insights and/or applicability to assigned case study in more than one content area.

10 pts

Needs Improvement

Post has limited clinically relevant perspective, insights and/or applicability to case study or is vague without specificity and attention to detail

0 pts

Unsatisfactory

Post contributes unique perspectives or insights and original dialogue with little or no direct quotes, but lacks applicability/specificity to the case study.

 

20 pts
This criterion is linked to a Learning OutcomeEvidence Based Resources
10 pts

Excellent

Follow up visit documentation fully supported by evidence from appropriate sources published within the last five years including National Guidelines. Content of journal articles represents a logical link between the article content and the assigned topics/case study information. In-text citations and complete references are provided.

9 pts

V. Good

Follow up visit documentation is partially supported by evidence from appropriate sources published within the last five years. In-text citations and complete references are provided. Evidence-based reference(s) used but may not fully demonstrate National guidelines or fully support treatment recommendations.

8 pts

Satisfactory

Follow up visit documentation is supported by evidence from appropriate resources however National Guidelines are not referenced in regard to diagnostic testing and treatment planning OR Journal articles do not represent logical link between the article content and assigned topics/ case study.

5 pts

Needs Improvement

Follow up visit not fully supported by evidence from appropriate sources published within the last five years including National Guidelines. Content of journal articles represents a weak logical link between the article content and the assigned topics/case study information. In-text citations and complete references are provided.

0 pts

Unsatisfactory

Follow up visit is not supported by evidence from appropriate sources published within the last five years. In-text citations and complete references are provided. National guidelines do not fully support treatment recommendations.

 

10 pts
This criterion is linked to a Learning OutcomeDiscussion Format Possible Points = 10 Points

Organization  Discussion post presented in a logical, meaningful, and understandable sequence. Headings reflect separation of criterion outlined in assignment guidelines.

5 pts

Excellent

Discussion post presented in a logical, meaningful, and understandable sequence. Organization of topics and transitions among ideas lends clarity to the discussion. Headings and paragraph spacing are used logically and contribute to evidence of the assigned diseases being compared and contrasted.

4 pts

V. Good

Discussion post presented in a logical, meaningful, and understandable sequence, However minimal transitions, headings and spacing used to organize thoughts.

3 pts

Satisfactory

May be unclear or difficult to follow in places. Headings, paragraphs and spacing minimal.

1 pts

Needs Improvement

May be unclear or difficult to follow in places. Lack of organization significantly impacts understanding of clinical picture.

0 pts

Unsatisfactory

Follow up visit not linked through organization of thoughts, paragraph, spacing or headings. Unable to clearly follow thought process.

 

5 pts
This criterion is linked to a Learning OutcomeGrammar/APA/Spelling

(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

5 pts

Excellent

Zero errors in grammar/spelling. Strong ability to communicate thoughts and ideas concisely.

4 pts

V. Good

Zero to 2 errors in grammar/spelling but no effect on ability to communicate thoughts and ideas.

3 pts

Satisfactory

3-6 errors in grammar/spelling with no effect on ability to communicate thoughts and ideas.