Part I: Emergency Department (ED)
Unfolding Reasoning
m
er as
co
eH w
o.
rs e
ou urc
o
aC s
vi y re
John Taylor, 68 years old
Primary Concept
ed d
Infection/Immunity
ar stu
Interrelated Concepts (In order of emphasis)
Clinical judgment
Communication
is
NCLEX Client Need Categories Covered in NCSBN Clinical Covered in
Case Study Judgment Model Case Study
Th
Safe and Effective Care Environment Step 1: Recognize Cues
Management of Care Step 2: Analyze Cues
Safety and Infection Control Step 3: Prioritize Hypotheses
Health Promotion and Maintenance Step 4: Generate Solutions
sh
Psychosocial Integrity Step 5: Take Action
Physiological Integrity Step 6: Evaluate Outcomes
Basic Care and Comfort
Pharmacological and Parenteral
Therapies
Reduction of Risk Potential
Physiological Adaptation
© 2020 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
form
This or source
study by anywas
means, electronic,
downloaded mechanical,from
by 100000809733538 photocopying, recording
CourseHero.com or otherwise,
on 05-13-2021 without
18:48:10 GMT the prior written permission of KeithRN
-05:00
https://www.coursehero.com/file/70111555/COVID-19Clinical-Case-Study-UNFOLDING-Reasoning-Part-1-worddocx/
, Initial Triage Assessment in ED
Present Problem:
John Taylor is a 68-year-old African-American male with a history of type II diabetes and hypertension who came to the
emergency department (ED) triage window because he felt crummy; complaining of a headache, runny nose, feeling more
weak, “achy all over” and hot to the touch and sweaty the past two days. When he woke up this morning, he no longer felt
hot but began to develop a persistent “nagging cough” that continued to worsen throughout the day. He has difficulty
“catching his breath” when he gets up to go the bathroom. John is visibly anxious and asks, “Do I have that killer virus
that I hear about on the news?”
Personal/Social History:
John lives in a large metropolitan area that has had over three thousand confirmed cases of COVID-19. He has been
married to Maxine, his wife of 45 years and is retired police officer and active in his local church.
1. What data from the histories are RELEVANT and must be NOTICED as clinically significant by the nurse?
(NCSBN: Step 1 Recognize cues/NCLEX: Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
Age Higher risk for complication due to Covid19
m
Diabetes, HTN Comorbidities that increase complications from Covid19
er as
co
Headache and weakness Symptoms of Covid19
eH w
Nagging cough Symptom of Covid19
o.
Difficulty catching breath
rs e Symptom of Covid19
ou urc
RELEVANT Data from Social History: Clinical Significance:
Urban location with high positive cases of Covid19 Community spread of Covid19
o
aC s
vi y re
2. What additional clarifying questions does the triage nurse need to ask John to determine if his cluster of
physical symptoms are consistent with COVID-19?
ed d
ar stu
Have you had an elevated temp? Have you been exposed to anyone with known Covid19 infection? Have you had
any loss in your sense of taste or smell? Have you travelled anywhere with a high incidence of Covid19?
is
Th
3. Based on the clinical data collected, identify what measures need to be immediately implemented using
sh
the following clinical pathway.
Pt. needs Covid19 testing and should be wearing a mask – do not expose to other patients
This study source was downloaded by 100000809733538 from CourseHero.com on 05-13-2021 18:48:10 GMT -05:00
https://www.coursehero.com/file/70111555/COVID-19Clinical-Case-Study-UNFOLDING-Reasoning-Part-1-worddocx/
Unfolding Reasoning
m
er as
co
eH w
o.
rs e
ou urc
o
aC s
vi y re
John Taylor, 68 years old
Primary Concept
ed d
Infection/Immunity
ar stu
Interrelated Concepts (In order of emphasis)
Clinical judgment
Communication
is
NCLEX Client Need Categories Covered in NCSBN Clinical Covered in
Case Study Judgment Model Case Study
Th
Safe and Effective Care Environment Step 1: Recognize Cues
Management of Care Step 2: Analyze Cues
Safety and Infection Control Step 3: Prioritize Hypotheses
Health Promotion and Maintenance Step 4: Generate Solutions
sh
Psychosocial Integrity Step 5: Take Action
Physiological Integrity Step 6: Evaluate Outcomes
Basic Care and Comfort
Pharmacological and Parenteral
Therapies
Reduction of Risk Potential
Physiological Adaptation
© 2020 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any
form
This or source
study by anywas
means, electronic,
downloaded mechanical,from
by 100000809733538 photocopying, recording
CourseHero.com or otherwise,
on 05-13-2021 without
18:48:10 GMT the prior written permission of KeithRN
-05:00
https://www.coursehero.com/file/70111555/COVID-19Clinical-Case-Study-UNFOLDING-Reasoning-Part-1-worddocx/
, Initial Triage Assessment in ED
Present Problem:
John Taylor is a 68-year-old African-American male with a history of type II diabetes and hypertension who came to the
emergency department (ED) triage window because he felt crummy; complaining of a headache, runny nose, feeling more
weak, “achy all over” and hot to the touch and sweaty the past two days. When he woke up this morning, he no longer felt
hot but began to develop a persistent “nagging cough” that continued to worsen throughout the day. He has difficulty
“catching his breath” when he gets up to go the bathroom. John is visibly anxious and asks, “Do I have that killer virus
that I hear about on the news?”
Personal/Social History:
John lives in a large metropolitan area that has had over three thousand confirmed cases of COVID-19. He has been
married to Maxine, his wife of 45 years and is retired police officer and active in his local church.
1. What data from the histories are RELEVANT and must be NOTICED as clinically significant by the nurse?
(NCSBN: Step 1 Recognize cues/NCLEX: Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
Age Higher risk for complication due to Covid19
m
Diabetes, HTN Comorbidities that increase complications from Covid19
er as
co
Headache and weakness Symptoms of Covid19
eH w
Nagging cough Symptom of Covid19
o.
Difficulty catching breath
rs e Symptom of Covid19
ou urc
RELEVANT Data from Social History: Clinical Significance:
Urban location with high positive cases of Covid19 Community spread of Covid19
o
aC s
vi y re
2. What additional clarifying questions does the triage nurse need to ask John to determine if his cluster of
physical symptoms are consistent with COVID-19?
ed d
ar stu
Have you had an elevated temp? Have you been exposed to anyone with known Covid19 infection? Have you had
any loss in your sense of taste or smell? Have you travelled anywhere with a high incidence of Covid19?
is
Th
3. Based on the clinical data collected, identify what measures need to be immediately implemented using
sh
the following clinical pathway.
Pt. needs Covid19 testing and should be wearing a mask – do not expose to other patients
This study source was downloaded by 100000809733538 from CourseHero.com on 05-13-2021 18:48:10 GMT -05:00
https://www.coursehero.com/file/70111555/COVID-19Clinical-Case-Study-UNFOLDING-Reasoning-Part-1-worddocx/
