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:

An 84- year-old -female who has a history of diverticular disease presents to the clinic with left lower quadrant (LLQ) pain of the abdomen that is accompanied by with constipation, nausea, vomiting and a low-grade fever (100.20 F) for 1 day.

On physical exam the patient appears unwell. She has signs of dehydration (pale mucosa, poor skin turgor with mild hypotension [90/60 mm Hg] and tachycardia [101 bpm]). The remainder of her exam is normal except for her abdomen where the NP notes a distended, round contour. Bowel sounds a faint and very hypoactive. She is tender to light palpation of the LLQ but without rebound tenderness. There is hyper-resonance of her abdomen to percussion.

The following diagnostics reveal:  

Stool for occult blood is positive.

Flat plate abdominal x-ray demonstrates a bowel-gas pattern consistent with an ileus.

Abdominal CT scan with contrast shows no evidence of a mass or abscess. Small bowel in distended.

Based on the clinical presentation, physical exam and diagnostic findings, the patient is diagnosed with acute diverticulitis and she is admitted to the hospital. She is prescribed intravenous antibiotics and fluids (IVF). Her symptoms improved and she could tolerate a regular diet before she was discharged to home.

Discussion Questions:

  1. Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
  2. Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis.
  3. List 3 risk factors for acute diverticulitis.
  4. Discuss why antibiotics and IV fluids are indicated in this case.
Category Points % Description
Application of Course Knowledge 30 30% The student:

  • Compares and contrasts the pathophysiology between diverticular disease (diverticulosis) and acute diverticulitis.
  • Identifies the clinical findings from the case that supports a diagnosis of acute diverticulitis.
  • Lists 3 risk factors for acute diverticulitis.
  • Discusses why antibiotics and IV fluids are indicated in this case.
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