lOMoAR cPSD| 56342273
Appendicitis/Appendectomy
SKINNY Reasoning
John Washington, 14 years old
Primary Concept
Inflammation
Interrelated Concepts (In order of emphasis)
• Pain
• Stress
• Clinical Judgment
• Patient Education
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
, lOMoAR cPSD| 56342273
Physiological Adaptation 11-17%
0
SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
John Washington is a healthy 14-year-old African American male who weighs 150 lbs. (68.2 kg). He came to the
emergency department because he woke up this morning at about 2 am with "excruciating" generalized abdominal pain
around his belly button that has been progressively getting worse over the past several hours. It is now 2 pm. He took
ibuprofen 400 mg PO this morning, which decreased the pain some but is now more painful and uncomfortable. The pain
is now localized to his RLQ. The pain increases with walking and movement but he feels better when he lies down in a
fetal position. He vomited three times after he drank some orange juice for breakfast this morning and has had nothing to
drink since. He continues to feel nauseated but has not had an emesis since this morning.
Personal/Social History:
John lives with his mother and three younger brothers. He is active in athletics and has a strong social network of friends
and family in the inner-city neighborhood where he lives.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
RELEVANT Data from Social History: Clinical Significance:
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment:
T: 100.5 F/38.1 C (oral) Provoking/Palliative: Movement, palpation
P: 106 (regular) Quality: Sharp, cramping
R: 20 (regular) Region/Radiation: Mid abdomen, RLQ
BP: 142/76 Severity: 8/10
O2 sat: 99% RA Timing: Continuous
What VS data are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential/Health Promotion and Maintenance)
RELEVANT VS Data: Clinical Significance:
1
Appendicitis/Appendectomy
SKINNY Reasoning
John Washington, 14 years old
Primary Concept
Inflammation
Interrelated Concepts (In order of emphasis)
• Pain
• Stress
• Clinical Judgment
• Patient Education
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
, lOMoAR cPSD| 56342273
Physiological Adaptation 11-17%
0
SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
John Washington is a healthy 14-year-old African American male who weighs 150 lbs. (68.2 kg). He came to the
emergency department because he woke up this morning at about 2 am with "excruciating" generalized abdominal pain
around his belly button that has been progressively getting worse over the past several hours. It is now 2 pm. He took
ibuprofen 400 mg PO this morning, which decreased the pain some but is now more painful and uncomfortable. The pain
is now localized to his RLQ. The pain increases with walking and movement but he feels better when he lies down in a
fetal position. He vomited three times after he drank some orange juice for breakfast this morning and has had nothing to
drink since. He continues to feel nauseated but has not had an emesis since this morning.
Personal/Social History:
John lives with his mother and three younger brothers. He is active in athletics and has a strong social network of friends
and family in the inner-city neighborhood where he lives.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
RELEVANT Data from Social History: Clinical Significance:
Patient Care Begins:
Current VS: P-Q-R-S-T Pain Assessment:
T: 100.5 F/38.1 C (oral) Provoking/Palliative: Movement, palpation
P: 106 (regular) Quality: Sharp, cramping
R: 20 (regular) Region/Radiation: Mid abdomen, RLQ
BP: 142/76 Severity: 8/10
O2 sat: 99% RA Timing: Continuous
What VS data are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential/Health Promotion and Maintenance)
RELEVANT VS Data: Clinical Significance:
1
