Read the following case study and answer the prompt: Please review the rubric for case studies before submitting your assignment. Your response should be written in paper format in APA style. Included the necessary number of references.
A 77-year-old man is admitted to the intensive care unit (ICU) of a university hospital from the operating room. Earlier the same day, he had presented to the emergency department with abdominal pain. His medical history included treated hypertension and hypercholesterolemia, previous heavy alcohol intake, and mild cognitive impairment. In the emergency department, he was drowsy and confused when roused and was peripherally cold with cyanosis. The systemic arterial blood pressure was 75/50 mm Hg, and the heart rate was 125 beats per minute. The abdomen was tense and distended. After the administration of 1 liter of intravenous crystalloid to restore the blood pressure, a computed tomographic scan of the abdomen showed extraluminal gas and suspected extraluminal feces consistent with a perforated sigmoid colon. He was treated with intravenous antibiotics and taken to the operating room for laparotomy. During this procedure, gross fecal peritonitis from a perforated sigmoid colon was confirmed; resection of the sigmoid colon with closure of the rectal stump and creation of an end colostomy (Hartmann’s procedure) was performed with extensive peritoneal toilet and washout.
On arrival in the ICU, he is still anesthetized, and remains intubated. the arterial blood pressure is supported with a norepinephrine infusion. When the patient was in the operating room, he received a total of 4 liters of crystalloid. On his arrival in the ICU, the vital signs are a blood pressure of 88/52 mm Hg, heart rate of 120 beats per minute in sinus rhythm, central venous pressure of 6 mm Hg, and temperature of 35.6°C. An analysis of arterial blood shows a pH of 7.32, a partial pressure of carbon dioxide of 28 mm Hg, a partial pressure of oxygen of 85 mm Hg, and a lactate level of 3.0 mmol per liter.
Please use the following questions to help you formulate a response to this case study:
1. What is your suspected diagnosis of the patient (other than the listed surgical diagnosis)
2. What are the treatment options for this diagnosis?
3. What are the risks to the patient?
4. What nursing interventions and orders would you expect to be a part of this patient's care?
Case Study Rubric
Case study response must be 250 words with the question being thoroughly answered. At least 4 references in APA format utilized.
1. Summarized problem, question, or issue -Clearly identifies the challenge and subsidiary, embedded, or implicit aspects of the issue. Identifies integral relationships essential to analyzing the issue
2. Considers context and assumptions-Analyzes the issue with a clear sense of scope and context, including an assessment of audience. Identifies influence of context. Questions assumptions, addressing ethical dimensions underlying the issue.
3. Communicates own perspective, hypothesis, or position.-Position demonstrates ownership. Appropriately identifies own position, drawing support from experience and information not from assigned sources. Justifies own view while integrating contrary interpretations. Hypothesis demonstrates sophisticated thought.
4. Analyzes supporting data and evidence -Evidence of source evaluation skills. Examines evidence and questions accuracy and relevance. Recognizes bias. Sequence of presentation reflectsclear organization of ideas, subordinating for importance and impact.
5. Uses other perspectives and positions-Addresses diverse perspectives from a variety of sources to qualify analysis. Any analogies are used effectively. Clearly justifies own view while respecting views of others. Analysis of other positions is accurate and respectful. Evidence of reflection and self-assessment
6. Assesses conclusions, implications, and consequences -Identifies and discusses conclusions, implications, and consequences. Considers context, assumptions, and evidence. Qualifies own assertions. Consequences are considered and integrated. Implications are developed and consider ambiguities.
7. Communicates effectively-Language clearly and effectively communicates ideas. May at times be nuanced and eloquent. Errors are minimal. Style is appropriate for audience. Organization is clear; transitions between ideas enhance presentation. Consistent use of appropriate format. Few problems with other components ofpresentation. All sources are cited and used correctly, demonstrating understanding or economic, legal, and social issues involved with the use of the information.