NR 536 Week 5 Assignment  Develop an Evolving Case Study

NR 536 Week 5 Assignment  Develop an Evolving Case Study

NR 536 Week 5 Assignment  Develop an Evolving Case Study

The Developing an Evolving Case Study assignment is due on Sunday of Week 5 at 11:59 p.m. MT. The guidelines and rubric are listed below, as well as in the downloadable document.

Developing an Evolving Case Study Guidelines and RubricPreview the document

Developing an Evolving Case Study Template (Links to an external site.)


This assignment provides the opportunity for the student to develop an evolving case study that would be useful as part of a small group activity in the clinical setting. It should not be written for a simulation learning activity. Using a concept presented in Weeks 2, 3, and 4, the student incorporates the elements expected of an evolving case study, as well as pathophysiology, pharmacology, and physical assessment.

Course Outcomes

Through this assignment, the student will demonstrate the ability to do the following.

CO 1: Synthesize educational theories and knowledge from nursing and health sciences to foster experiential learning strategies and positive healthcare outcomes. (PO 1)

CO 2: Integrate pathophysiologic mechanisms with advanced assessment and pharmacologic concepts to maximize holistic, person-centered outcomes in complex disease states. (POs 1, 2, 3, 5)

CO 3: Integrate caring and person-centered concepts within diverse practice settings to maximize healthcare and learner outcomes. (PO 2)

CO 4: Employ a spirit of inquiry to foster professional development to facilitate the achievement of educational outcomes. (PO 3)

CO 6: Promote positive health and education outcomes by fostering the use of evidence-based and interprofessional strategies in experiential settings. (PO 5)


Description of the Assignment

This assignment requires the student to develop an evolving case study that would be useful in either the clinical or classroom setting. It is not written for a simulation learning activity. The evolving case study must focus on a concept assigned from Giddens (2017) required textbook during Weeks 2, 3, and 4. In addition, the student must identify Socratic questions related to the pathophysiology, pharmacology, and health assessment used in the evolving case study. The study demonstrates the following.

Initial presentation (i.e., Stage 1) regarding the health status of the patient

Progress to Stage 2 with the occurrence of event that requires the identification of the appropriate response from learners

Ends with Stage 3 that is based upon the action identified by learners

Development of Socratic questions useful for debriefing following completion of the evolving case study are required.

Criteria for Content

Overview of the assignment:

The evolving case study starts with background information that provides an overview; description of the patient; and the report provided to the participants using the format of situation, background, assessment, and recommendation (SBAR). Progressing over time with a fictional patient’s health status changing, this evolving case study presents the situation in three stages. Stage 1 is the initial stage where the patient’s healthcare situation is presented, followed by a trigger that represents a health challenge, or worsening of the health. Participants identify the appropriate interventions to maintain a stable health status, as well as recognize via assessment the deterioration in the fictional patient’s health. Stage 2 continues the presentation of the patient with progressive decline in health status requiring the identification of appropriate actions by participants. A trigger for Stage 3 will be identified based on the stabilization of the fictional patient. Outcome of the evolving case study is suggested as part of Stage 3. Preparation for debriefing of participants is considered by the identification of Socratic questions.

Required content for the assignment is the following.

Part 1: Overview of evolving case study

Description of the evolving case study

Identify the purpose

Identify the type of learner that the case study is developed for

Identify the concept to be demonstrated by the fictional patient

Description of the setting

Part 2: Description of fictional patient by identifying each of the following elements




Past medical history

History of present illness

Social history

Primary medical diagnosis

Surgeries and/or procedures with dates

Part 3: Develop the report that learners receive prior to the start of the evolving case study using SBAR

Time of report

Identify person providing the report

Identify each of the following for SBAR





Part 4: Stage 1: Start of the healthcare situation with required elements

Evolving case study information to be presented to the learner

One action that a learner SHOULD identify and is APPROPRIATE for the situation

Socratic question for each area to ask learner at end of Stage 1


Physical assessment


Trigger for Stage 2

Part 5: Stage 2: Deterioration in fictional patient’s health status with required elements

Evolving case study information to be presented to the learner

One action that a learner SHOULD identify and is APPROPRIATE for the situation

Socratic question for each area to ask learner at end of Stage 2


Physical assessment


Trigger for Stage 3

Part 6: Stage 3: Stabilization of fictional patient with required elements

Evolving case study information to be presented to the learner

One action that a learner SHOULD identify and is APPROPRIATE for the situation

Socratic question for each area to ask learner at end of Stage 3


Physical assessment


Expected ending for case study if learner’s actions are APPROPRIATE for the situation

Part 7: Debriefing

Socratic Question 1 (focusing on overall Stage 1)

Socratic Question 2 (focusing on overall Stage 2)

Socratic Question 3 (focusing on overall Stage 3)

Socratic Question 4 (focusing on the overall case study)

Preparing the Assignment

Criteria for Format and Special Instructions

The assignment should not exceed eight pages in length, excluding the title page and reference page.

The use of the template for Week 5 Assignment is required.

Expectations regarding graduate level include all of the following elements.

Correct spelling, grammar, and punctuation

Exceptional writing style with clarity, flow, and organization of information throughout the paper

Congruence with APA mechanics of style\

Template for Week 5’s Assignment:  Development of an Evolving Case Study for Clinical or Classroom Setting

Overview of Evolving Case Study
Learning Objectives  
Description of the Evolving Case Study:

·         Purpose

·         Identify type learner

·         Concept to be presented


The purpose of this case study is to use an actual case in a clinical setting to engage all the clinical skills such as psychomotor, cognitive, and communication to facilitate learning. The type of learner that will benefit from this case study will be a will be a student on internship or apprenticeship. The concept that will be used for the demonstration is involving the student the evaluation an actual case in a clinical environment and in making decisions concerning therapeutic strategy. .

Description of the Setting: The setting takes place in a healthcare facility which the access to various departments such as the consultation room, wards, and theatre room.


Description of Patient
Name Ms. Elena Atieno
Gender/Age/Weight/Height Caucasian female /age 35/weight65Kg
Allergies Spring season (seasonal allergy)
Past medical history Infertility (for 15 years) and hypertension
History of present illness Deterioration of nutritional status and severe continuous vomiting
Social history Drinks hard-drinks on Saturdays
Primary medical diagnosis Change in behaviors, confusion, and drowsiness (Gasalberti et al. 2017)
Surgeries and/or procedures with dates Urgent operation for brain decompression


Report that Learners receive to prior start of the Evolving Case Study using SBAR Format
Time of report 8 am
Person providing the report The patient, nurses in charge of the patient, student, and physician monitoring the patient pregnancy.
Situation Ms. Atieno woke up with so much nausea and vomiting continuously despite the fact that her pregnancy was almost 31 weeks. She prepared herself to go to the hospital because she had been instructed to do so in case of any changes since her pregnancy was a high risk one. On the way she experience some seizure and lost her way to the hospital. A motorist found her and rushed her to the hospital. She was emaciated and vomiting. The neuro surgery team decided for urgent operation
Background The patient has had problems with her pregnancy since the first month. She normally uses fexofenadine for her seasonal allergies. She had to seek doctor’s advice whether to continue with her normal medication for the allergies or not. Doctors evaluated her situation and concluded that fexofenadine was not fatal to her and the baby but she had to avoid pollen grains by closing windows, staying indoors, and using air conditioning whenever necessary (Presa et al., 2016). She had been keeping weekly check-ups with her physician. For the last two days, her condition was unstable, she was dizzy, drowsy, frequent nausea, and kept getting confused. That morning she kept vomiting and decided to go for medical checkup
Assessment The patient struggles to vomit but nothing in coming out. She is not speaking but when asked questions she gives answers which make no sense. Her doctor is reporting that she is thin and her weight has been reducing. She is hypertensive 150/90 and has a normal kidney function. Her Hb. is 6,5gm/dl and the baby is nearly mature though underweight.  Liver enzymes were 2 fold, 2,5, albumin, and 65% prothrombin
Recommendation Blood transfusion for 4 units of human albumin, 4 units of packed RBCs, and 4 units of fresh plasma two days prior to surgery. Obstetric preparation for an emergency cesarean section. Pediatric on standby in case of an urgent cesarean section.


Evolving Case Study Progression
  Evolving Case Study Information to be presented to the Learner


Actions Learners SHOULD Demonstrate Socratic Question for each area to ask learner at end of stage
Stage One (Start of the case study) The patient is struggling to vomit. Her mother and her nurse is trying to get her to stop but she cannot. The nurse is asking her how she got to the hospital but says she does not know.

At some point, she said she trekked to the hospital.

The student should demonstrate the knowledge of Anesthesia examination Pathophysiology:


Physical Assessment:







Trigger for Stage Two:
Stage Two:




The patient is hypertensive 150/90. Her Hb. is 6,5gm/dl.  Liver enzymes were 2 fold, 2,5, albumin, and 65% prothrombin. She is losing awareness of her present situation The student demonstrate the parameters involved in the Anesthesia examination are measured and recorded. Pathophysiology:


Physical Assessment:





Trigger for Stage Three:
Stage Three:




The patients has passed out again. The student should demonstrate the knowledge of Preoperative preparation Pathophysiology:


Physical Assessment:





Expected ending for case study if learner’s actions are APPROPRIATE:



Socratic Question #1 (focusing on Stage 1) Which concept did you apply during the demonstration?

How did the concept enhance learning?

Socratic Question #2 (focusing on Stage 2) What can you remember about your patient?
Socratic Question #3 (focusing on Stage 3) What indicative signs did the patient present on arrival?
Socratic Question #4 (focusing on the overall case study) What tests would you recommend?

What were the alternative medications?





Gasalberti, D., Reiff, J., Lambert, K., Emrich, J., & Poli, J. (2017). Pregnancy discovered during radiation of an atypical meningioma. Practical radiation oncology, 7(6), e427-e430.

McKinney, E. S., & Murray, S. S. (2017). Study Guide for Maternal-Child Nursing-E-Book. Elsevier Health Sciences.

Presa, I. J., Rodríguez, B. N., Bareño, B. R., Setién, P. M. G., Etxebarria, I. U., & Ercoreca, I. A. (2016). Chronic Urticaria in Special Populations: Children, Pregnancy, Lactation and Elderly People. Current Treatment Options in Allergy, 3(4), 423-438.

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Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.

Read Also: NR 536 Week 7 Assignment Designing an Experiential Learning Activity

Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.

One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.

I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.

In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.

Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).

Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).

Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.

I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.

As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.

It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.


Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.