CASE ANALYSIS PRESENTATION SCENARIO

Mrs. Inconsi Derate is a 50-year-old woman whose height is 5 feet, 7

inches, and weighs 155 pounds. Her routine mammogram showed a 2.3 ×
4.5 cm lobulated mass at the 3:00 position in her left breast. Mrs.I.D.
underwent a stereotactic needle biopsy and was diagnosed with infiltrating
ductal carcinoma that was both estrogen and progesterone receptor positive.
The staging workup was negative for distant metastasis. Her final staging
was stage IIB. She had a modified radical mastectomy with lymph node
dissection. The sentinel lymph node and 11 of 16 lymph nodes were positive
for tumor cells. An implanted port was placed during surgery. She is
prescribed a chemotherapy regimen of six cycles of CAF (cyclophosphamide
[Cytoxan], fluorouracil [5-FU], and doxorubicin [Adriamycin]).

CASE STUDY PROGRESS 1

Mrs. I.D. has now completed three cycles of CAF. Her last treatment
with doxorubicin, cyclophosphamide, and 5-fluorouracil was approximately
12 days ago. She comes to the emergency department with a 2-day history
of fever, chills, and shortness of breath. On arrival, she is disoriented and
agitated. Vital signs are 86/43, 119, 28, 103.6° F (39.8° C), Sa O2 85% on
room air. Chest x-ray demonstrates diffuse infiltrates in the left lower lung.
Her chemistry is within normal limits, with the exception of BUN 28 mg/dL,
creatinine 1.6 mg/dL, and lactic acid 2.4 mg/dL.
Chart View

Complete Blood Count

WBC 1200/mm 3
Neutrophils 34%
Segmented (Polys) 30%
Bands 4%
Lymphocytes 60%
Monocytes 3%
Eosinophils and basophils 2%
Hct 24.9%
Hgb 8.7 g/dL
Platelets 85,000/mm 3

CASE STUDY PROGRESS 2

The physician orders a 500-mL normal saline bolus now, with orders
to infuse over 2 hours. You decide to use Mrs. I.D.'s implanted port for IV
access. After accessing the port and connecting the fluid, the infusion pump
alarms that the line is occluded. What will you do? (Create a NCP)
CASE STUDY OUTCOME

Mrs. I.D. requires endotracheal intubation and spends 3 days in the

ICU receiving antibiotics and respiratory support. She is able to be
extubated and returns to the oncology unit, where she remains for a few
more days before being discharged to home.

INSTRUCTION:

Your case presentation will be based on the case scenario above.

Do not assume information that is not provided.

CASE PRESENTATION COMPONENTS

INVOCATION
PRAYER
NATIONAL ANTHEM
FSUU HYMN
INTRODUCTION
NURSING HEALTH HISTORY
ANATOMY AND PHYSIOLOGY
PATHOPHYSIOLOGY (CONCEPT MAP)
NURSING ASSESSMENT
LABORATORY EXAM ANALYSIS
DRUG STUDY
NURSING CARE PLAN (LIST 5 NCPS PRESENT ONLY TOP 3)
DISCHARGE PLAN
 GRADING CRITERIA

Criteria Percentage
Mastery 30%
Visual Aids 20%
Student Participation 30%
Overall Management 20%
Total: 100% Grade ___ x 40%
Content
Introduction 5%
Nursing Health Hx/Drug 20%
Study & Diagnostic/Lab
exam
Nursing Assessment 15%
Anatomy and Physiology 10%
Pathophysiology 15%
NCP 30%
Discharge Plan 5%
Total: 100% Grade ____ x 60%
Final Grade ____