NRS-460 Benchmark - Case Study: Timothy Smith –
Intensive Care Unit (ICU)
Directions: Read the case study below. Evaluate the information and formulate a
conclusion based on your evaluation. Complete the critical thinking table and submit the
completed template to the assignment dropbox.
The purpose of this assignment is to evaluate patient data to navigate decision-making in
ambiguous situations, assist the patient and family in managing complex care needs, and perform
effectively in an interdisciplinary team.
PART I: Health History and Medical Information
Evaluate the health history and medical information for John Doe, presented below.
After his discharge from the ED, John was transferred to the Intensive Care Unit (ICU)
for specialized care and monitoring where you took over as his nurse. Upon arrival to the
ICU, John was identified as Timothy Smith. He arrives intubated on a ventilator and
requires continuous assessment for his TBI, multiple fractures, and underlying
psychological conditions. Specialty providers are considering the risks vs. benefits of a
hematoma evacuation. Upon entry to the ICU, Mr. Smith has been diagnosed with:
1. Severe Traumatic Brain Injury with a GCS score of 6, managed with an
external ventricular drain (EVD)
2. Respiratory instability managed with a ventilator
3. Femur fracture with open reduction and internal fixation (ORIF)
4. Hairline fracture of 3 left ribs
Laboratory Tests, Results, and Vitals:
1. EVD - Intracranial Pressure (ICP) - 12
2. Echocardiogram (EKG): Sinus Tachycardia Rate 128
3. Arterial Blood Gas (ABG):
a. PaCO2 Level - 51 mmHg,
b. HCO3 Level - 30 mEq/L
c. pH 7.39
d. PaO2 79 mmHg
e. SaO2 98% on ventilator
4. Respiratory Rate: mechanical ventilation rate 14 with no spontaneous respirations
© 2024. Grand Canyon University. All Rights Reserved.
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, 5. CBC -
a. White Blood Cells: 12.9
b. Hemoglobin: 13.6
c. Hematocrit: 38.7
d. Platelet Count: 310,000
6. CMP:
a. Potassium 4.5 mEq/L
b. Sodium 135 mEq/L
c. Bilirubin: 2.1 mg/dL
7. GCS 8 after placement of EVD and drainage of 10ml of sanguineous fluid from drain.
a. Deficit for only opening eyes to pain (2)
b. Verbal response is incomprehensible sounds (2)
c. Motor score of (4) withdraw from pain
PART II: Critical Thinking Activity
Use the findings from your evaluation to complete the following:
Power of Attorney
Upon arrival in the ICU, you discover Mr. Smith does not have a power of attorney.
Discuss how you would
determine who would make
decisions on his behalf. Your
response should be a minimum
of 150 words.
How can you utilize the
chaplain to assist in locating
the family? Your response
should be a minimum of 150
words.
Quality vs. Quantity of Life
Health care professionals often have to have difficult conversations with patients and families
in the intensive care unit (ICU) regarding prognosis and outcomes.
What resources are available to
have difficult discussion with
2
This study source was downloaded by 100000897898521 from CourseHero.com on 05-13-2025 05:10:42 GMT -05:00
https://www.coursehero.com/file/249327915/BTopp-BenchmarkCaseStudyTimothySmithICU-051825docx/
Intensive Care Unit (ICU)
Directions: Read the case study below. Evaluate the information and formulate a
conclusion based on your evaluation. Complete the critical thinking table and submit the
completed template to the assignment dropbox.
The purpose of this assignment is to evaluate patient data to navigate decision-making in
ambiguous situations, assist the patient and family in managing complex care needs, and perform
effectively in an interdisciplinary team.
PART I: Health History and Medical Information
Evaluate the health history and medical information for John Doe, presented below.
After his discharge from the ED, John was transferred to the Intensive Care Unit (ICU)
for specialized care and monitoring where you took over as his nurse. Upon arrival to the
ICU, John was identified as Timothy Smith. He arrives intubated on a ventilator and
requires continuous assessment for his TBI, multiple fractures, and underlying
psychological conditions. Specialty providers are considering the risks vs. benefits of a
hematoma evacuation. Upon entry to the ICU, Mr. Smith has been diagnosed with:
1. Severe Traumatic Brain Injury with a GCS score of 6, managed with an
external ventricular drain (EVD)
2. Respiratory instability managed with a ventilator
3. Femur fracture with open reduction and internal fixation (ORIF)
4. Hairline fracture of 3 left ribs
Laboratory Tests, Results, and Vitals:
1. EVD - Intracranial Pressure (ICP) - 12
2. Echocardiogram (EKG): Sinus Tachycardia Rate 128
3. Arterial Blood Gas (ABG):
a. PaCO2 Level - 51 mmHg,
b. HCO3 Level - 30 mEq/L
c. pH 7.39
d. PaO2 79 mmHg
e. SaO2 98% on ventilator
4. Respiratory Rate: mechanical ventilation rate 14 with no spontaneous respirations
© 2024. Grand Canyon University. All Rights Reserved.
This study source was downloaded by 100000897898521 from CourseHero.com on 05-13-2025 05:10:42 GMT -05:00
https://www.coursehero.com/file/249327915/BTopp-BenchmarkCaseStudyTimothySmithICU-051825docx/
, 5. CBC -
a. White Blood Cells: 12.9
b. Hemoglobin: 13.6
c. Hematocrit: 38.7
d. Platelet Count: 310,000
6. CMP:
a. Potassium 4.5 mEq/L
b. Sodium 135 mEq/L
c. Bilirubin: 2.1 mg/dL
7. GCS 8 after placement of EVD and drainage of 10ml of sanguineous fluid from drain.
a. Deficit for only opening eyes to pain (2)
b. Verbal response is incomprehensible sounds (2)
c. Motor score of (4) withdraw from pain
PART II: Critical Thinking Activity
Use the findings from your evaluation to complete the following:
Power of Attorney
Upon arrival in the ICU, you discover Mr. Smith does not have a power of attorney.
Discuss how you would
determine who would make
decisions on his behalf. Your
response should be a minimum
of 150 words.
How can you utilize the
chaplain to assist in locating
the family? Your response
should be a minimum of 150
words.
Quality vs. Quantity of Life
Health care professionals often have to have difficult conversations with patients and families
in the intensive care unit (ICU) regarding prognosis and outcomes.
What resources are available to
have difficult discussion with
2
This study source was downloaded by 100000897898521 from CourseHero.com on 05-13-2025 05:10:42 GMT -05:00
https://www.coursehero.com/file/249327915/BTopp-BenchmarkCaseStudyTimothySmithICU-051825docx/
