CASE STUDY

Requirements:

  1. Read the case study below.
  2. In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference by Wed., 11:59 pm MT.
  3. Provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question using appropriate resources, before Sun., 11:59 pm MT.

Case Scenario:

A 72-year-old male presents to the primary care office with shortness of breath, leg swelling, and fatigue. He reports that he stopped engaging in his daily walk with friends three weeks ago because of shortness of breath that became worse with activity. He decided to come to the office today because he is now propping up on at least 3 pillows at night to sleep. He tells the NP that he sometimes sleeps better in his recliner chair. PMH includes hypertension, hyperlipidemia and Type 2 diabetes.

Physical Exam:

BP 106/74 mmHg, Heart rate 110 beats per minute (bpm)

HEENT: Unremarkable

Lungs: Fine inspiratory crackles bilateral bases

Cardiac: S1 and S2 regular, rate and rhythm; presence of 3rd heart sound; jugular venous distention. Bilateral pretibial and ankle 2+pitting edema noted

ECG: Sinus rhythm at 110 bpm

Echocardiogram: decreased wall motion of the anterior wall of the heart and an ejection fraction of 25%

Diagnosis: Heart failure, secondary to silent MI

Discussion Questions:

  • Differentiate between systolic and diastolic heart failure.
  • State whether the patient is in systolic or diastolic heart failure.
  • Explain the pathophysiology associated with each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and orthopnea.
  • Explain the significance of the presence of a 3rd heart sound and ejection fraction of 25%.
Category Points % Description
Application of Course Knowledge 30 30% The student:

  • Differentiates between systolic and diastolic heart failure.
  • States whether the patient is in systolic or diastolic heart failure.
  • Explains the pathophysiology associated for each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and orthopnea.
  • Explains the significance of the presence of a 3rd heart sound and an ejection fraction of 25%.
Support from Evidence-Based Practice 30 30%
  • Initial discussion post is supported with appropriate, scholarly sources; AND
  • Sources are published within the last 5 years (unless it is the most current CPG); AND
  • Reference list is provided and in-text citations match; AND
  • All answers are fully supported with an appropriate EBM argument
Interactive Dialogue 30 30% In addition to providing a response to the initial post due by Wednesday, 11:59 p.m. MT, student provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question. A response to faculty could include a question posed to a student or the entire class or a faculty question directed towards another student. AND

  • Evidence from appropriate scholarly sources are included; AND
  • Reference list is provided and in-text citations match
  90 90% Total CONTENT Points= 90 pts
Discussion Format
Category Points % Description
Organization 5 5% Organization: 

  • Case study responses are presented in a logical format; AND
  • Responses are in sequence with the numbered questions; AND
  • The case study response is understandable and easy to follow; AND
  • All responses are relevant to the case topic
Format 5 5% Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*

(*) 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 10% Total FORMAT Points= 10 pts
  100 100% DISCUSSION TOTAL=____ out of 100 points

(*) 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.