Judgment Case Study with Concept Map
Engage Fundamentals Stress and Coping Clinical
Case study
The nurse is caring for Madeline Moore, a 45-year-old woman who has come to the clinic seeking care for depression symptoms. Madeline indicates she has experienced depression in the past but is not currently taking any medications for depression. The client takes a multivitamin and calcium supplement each day. Madeline informs the nurse that she is going through a divorce and the relationship has been fraught with emotional and physical abuse; she currently feels safe. The client is no longer living with her husband as the divorce proceeds; she does not have children. After completing the Beck Depression Inventory, the nurse finds the client’s score to be 20, indicating borderline clinical depression. Additional symptoms Madeline reports is a 30-pound weight loss over 2 months, a loss of appetite, and difficulty coping due to a lack of social support. Madeline lost her job 3 months prior due to the company downsizing; she has only found part-time work since then. She is unable to pay rent to live on her own with her part-time job. The client’s main support comes from one friend who no longer lives in the area and her parents. Madeline is now living with her parents. Madeline denies thoughts of harming herself or others.
Assessment Questions
1. Identify the relevant subjective and objective assessment information related to the client’s condition and place the findings in the assessment data box below. (Recognizing Cues; Assessment)
2. Based upon assessment information, identify and prioritize the top 3 client problems. Write one client problem in each of the Client Problem boxes below. (Analyze Cues; Analysis and Prioritize Hypothesis; Planning)
3. Below each client problem, determine and enter the relevant assessment information that supports the identified client problem. (Analyze Cues; Analysis and Prioritize Hypothesis; Planning)
4. Identify important nursing interventions that should be taken to address each client problem and enter them in the related intervention box for the associated client problem. (Take Action; Implementation)
Discussion Questions
Educators may choose to instruct students to include relevant information identified during the discussion questions into the concept map.
1. Discuss special considerations to be made for clients from diverse backgrounds. (Recognize Cues; Assessment)
a. Elderly client with no family support.
b. Clients from diverse backgrounds (i.e. age, culture, socioeconomic status).
2. Identify potential client problems. (Analyze Cues; Analysis)
a. Instruct students to provide a rationale for their choices.
3. Discuss nursing interventions to address the identified potential client problems. (Generate Solutions; Planning)
a. Instruct students to provide a rationale for their choices.
4. Discuss the desired client outcomes related to the performed interventions identified in the concept map as well as for potential client problems. (Generate Solutions; Planning)
a. Discuss client responses that demonstrate an improvement of the client problem.
b. Identify client responses that indicate worsening of the client condition. (Generate Solutions; Planning)
5. Discuss safety considerations that should be included when planning care for this client (i.e. fall risk). (Generate Solutions; Planning)
6. Identify client education the nurse should provide for this client (i.e. diet, activity, ADLs). (Take Action; Implementation) Discuss client outcomes you would anticipate based on the performed nursing interventions (i.e. improved SPO2 with raising head of bed, increasing amount of oxygen being delivered). Identify how achievement of client outcomes would be evaluated. (Evaluate Outcomes; Evaluation)
7. Discuss ways to modify or revise the plan of care when client outcomes are not met. (Evaluate Outcomes; Evaluation)
