UNIVERSITY OF SANTO TOMAS

COLLEGE OF NURSING
COMPETENCY APPRAISAL 2
MS CASE # 3
FOCUS OF STUDY:
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Care of Client with CVA

Care of Client with Spinal Cord Injury
Care of Client with Autonomic Dysreflexia
Care of Client on complications of immobility
Care of Client undergoing Spinal SX
Care of Client with Spinal Shock
Principles of Rehabilitation for CVA clients & SCI
Principles of Emergency nursing

PRE-REQUISITE LEARNINGS:
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9.

Review of anatomy and physiology of organs involved

Pathophysiology of CVA
Pathophysiology of SCI
Review of modifiable and non-modifiable risk factors (CVA)
Pre-operative Nursing Management
Intra-operative Nursing Management
Post-operative Nursing Management
Bioethical Principles involved
Rehabilitation principles (PT, OT, SLP, Nursing)

INSTRUCTIONS:
1. All Class secretaries will provide the facilitator the CLASS LIST for grading
purposes.
2. The facilitator will provide the class with Case Scenario/ Case Study a week
before the discussion with corresponding focus of study and guidelines.
3. Each RLE group will submit their written output before the case presentation in
class. This will be graded and counted as part of their presentation grade
4. Each student must be ready for learning issues and discussion during the class.
This will be graded and counted as part of their participation grade.
5. There will be a post test after the class discussion.

Learning outcomes:
After studying the case scenario, the student should be able to:
1. Identify learning issues
2. Utilize the Nursing Process in the plan of care for this client
3. Integrate bioethical concepts in the care of your client
4. Integrate psychosocial aspects of care

Case Scenario #3
PART I - A 26 years old male was brought into the ER by EMTs and paramedics via
ambulance after being involved in a MVA 2hours ago. EMTs stated that patient was noted to
be intoxicated at the scene of the accident and with DUI. The patient was noted to be
lethargic, knows own name only, does not know where he is and does not know the current
date and not able to able to follow simple commands. VS 100/60, PR 90/min, RR 22/min,
temperature 37 degrees Centigrade axillary, complained of throbbing generalized pain with
numerical scale 7/10. Further assessment yielded rib fractures of right ribs 3rd to 5th and
open fracture at right tibia and comminuted fractures at right hip ; burned areas all
described as white dry leathery areas at right side of the face, right shoulder, front abdomen
and right lateral thigh. Pulse oximetry reads at 91%. The patient also has multiple
lacerations on his arms and legs namely: left forearm measuring 7cm X 4cm X less than
0.1cm; left upper arm measuring 3cm X 3cm X 5cm; left shin measuring 5cm X
2cm X 1cm ; right medial thigh measuring 8cm X 1cm X 0.5cm. All the lacerated areas
described as with red wound bed 100% with sanguinous drainage, non-foul. Additionally, the
patient also sustained a SCI T6 to T8 Fracture ASIA C . The patient is 56 with ABW of 165
lbs. The patient is directly admitted to the ICU.

PART II- CASE SCENARIO ON CVA WILL BE GIVEN IN THE CLASSROOM

CA-2 2015