lOMoAR cPSD| 56342273
C. difficile/Sepsis
UNFOLDING Reasoning
Minnie Taylor, 62 years old
Primary Concept
Infection/Inflammation
Interrelated Concepts (In order of emphasis)
• Perfusion
• Clinical Judgment
• Patient Education
• Communication
• Collaboration
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%
, lOMoAR cPSD| 56342273
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
History of Present Problem:
Minnie Taylor is a 62-year-old African-American female with a history of diabetes mellitus type II, hypertension, and
peripheral arterial disease who had a left below the knee amputation (LBKA) three days ago. She had two small loose,
watery stools last night and a third large watery brown stool this afternoon that had a distinct foul odor. Minnie is now
complaining of generalized lower abdominal cramping that she rates 3/10. She does not have an appetite and does not feel
like drinking fluids. Minnie was awake and alert after lunch, but later that afternoon just before supper you note that Minnie
is sleepy and once aroused, falls right back to sleep.
Personal/Social History:
Minnie is a retired teacher who never married and has no close friends. She lives alone in her own apartment.
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:
• 62-year-old African American female • Patient may be on antibiotics due to LBKA
• Diabetes Mellitus type II • Distinct foul stool odor is an indication on C. Diff infection
• Hypertension • Changes in her physiological state may indicate a fluid imbalance
• Peripheral arterial disease related to fecal output and lack of thirst or appetite.
• Left below the knee amputation 3 days
ago
• Two small loose, watery stools last night
and a third large watery brown stool this
afternoon that had a distinct foul odor.
• Generalized lower abdominal cramping
rated 3/10
• No appetite and no thirst
• Sleepy and once aroused, falls right back
to sleep.
RELEVANT Data from Social History: Clinical Significance:
• Retired teacher • Patient will need help with daily life activities once discharge
• Never married • A social worker should be assigned to coordinate help for the
• No close friends patient
• Lives alone
C. difficile/Sepsis
UNFOLDING Reasoning
Minnie Taylor, 62 years old
Primary Concept
Infection/Inflammation
Interrelated Concepts (In order of emphasis)
• Perfusion
• Clinical Judgment
• Patient Education
• Communication
• Collaboration
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%
, lOMoAR cPSD| 56342273
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
History of Present Problem:
Minnie Taylor is a 62-year-old African-American female with a history of diabetes mellitus type II, hypertension, and
peripheral arterial disease who had a left below the knee amputation (LBKA) three days ago. She had two small loose,
watery stools last night and a third large watery brown stool this afternoon that had a distinct foul odor. Minnie is now
complaining of generalized lower abdominal cramping that she rates 3/10. She does not have an appetite and does not feel
like drinking fluids. Minnie was awake and alert after lunch, but later that afternoon just before supper you note that Minnie
is sleepy and once aroused, falls right back to sleep.
Personal/Social History:
Minnie is a retired teacher who never married and has no close friends. She lives alone in her own apartment.
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:
• 62-year-old African American female • Patient may be on antibiotics due to LBKA
• Diabetes Mellitus type II • Distinct foul stool odor is an indication on C. Diff infection
• Hypertension • Changes in her physiological state may indicate a fluid imbalance
• Peripheral arterial disease related to fecal output and lack of thirst or appetite.
• Left below the knee amputation 3 days
ago
• Two small loose, watery stools last night
and a third large watery brown stool this
afternoon that had a distinct foul odor.
• Generalized lower abdominal cramping
rated 3/10
• No appetite and no thirst
• Sleepy and once aroused, falls right back
to sleep.
RELEVANT Data from Social History: Clinical Significance:
• Retired teacher • Patient will need help with daily life activities once discharge
• Never married • A social worker should be assigned to coordinate help for the
• No close friends patient
• Lives alone
