This investigative case module was prepared as part of a BioQUEST faculty development workshop entitled NSF Chautauqua Short Course: Investigative Cases at Christian Brothers University in July 2004. The cases, resources, and implementation strategies were developed by participants for use with their own students. We invite you to adopt and adapt the following materials.

The BioQUEST Curriculum Consortium is committed to the reform of undergraduate biology instruction through an emphasis on engaging students in realistic scientific practices. This approach is sometimes characterized as an inquiry driven approach and is captured in BioQUEST's three P's (problem-posing, problem-solving, and peer-persuasion). As part of this workshop groups of faculty were encouraged to initiate innovative curricular projects. We are sharing these works in progress in the hope that they will stimulate further exploration, collaboration and development. Please see the following links for additional information:

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Investigative Cases
The Case: Respiratory Assessment

Part 1:

Rita is a triage nurse in the ER of a local hospital. Her patient presenting at the ER is a 57 year-old male with complaints of increased shortness of breath (SOB) and sputum production over the last few days.

Rita asked, "Who is your physician?"

The patient replied, "I have never needed a doctor until today. My breathing has gotten worse and the inhaler that I have been using isn't helping. The foreman at work sent me here."

Rita's first observation upon seeing the patient is that he is somewhat overweight with a ruddy complexion and coughing vigorously to get secretions up.

Rita begins to organize her thoughts about the assessement she needs to perform to get all the appropriate information from this patient.

Part 2:

The patient seen in ER has been admitted to the respiratory unit.
The health assessment and testing competed in the ER found the patient to be coughing up large amounts of thick yellow-tan sputum.
The CXR indentified an area of infiltrates in the RLL.
Arterial blood gas results were pH of 7.34, PCO2 49, HCO3 28, PO2 69 with the O2 saturation of 89%.
The patient was placed on 2 liters per nasal cannula and his pulse ox on 2 L was 91%.
Respiratory assessment included breath sounds of rhonchi on the right side which clears with cough.
Assessment is positive for egophony.
Continues to have barking cough with large amounts of sputum production.
History identified patient to have smoked 1 pack of cigarettes from age 15-20 and then 1 1/2 pack until present.
He has never been exposed to TB, works at Tyson foods for many years and enjoys woodworking projects.
The patient heats with wood, has no known allergies, takes motrin for pain occasionally and uses a proventil inhaler given to him by a co-worker, which he has been using every hour for relief of SOB.

Case Author:
Karen Hahn Cox College of Nursing and Health Sciences

Case Analysis

Option: Include a know / need to know chart like the one below:

What do you know?
What do you need to know?

Learning Goals


Part 1: Students will be able to indentify the need for a respiratory assessment and what should be included in a respiratory assessment.

Part 2:
Students will identify what is available in the given history and what is missing.
Students will develop a teaching/learning plan



Investigations and Activities

Part 1: Lecture on respiratory assessment includes:
Personal & Family history
Medical hx
Smoking hx
Medications present and hx
Travel and area of residence
Diet hx
Occupational hx
Current health problems
Physical assessment
Diagnostic assessment

Will continue on with lecture and give a follow up scenario giving assessment findings:

Part 2:
Have students problem solve patient diagnosis.
Have students work individually and identify the categories needed in a teaching/learning plan for this diagnosis.
Divide students into groups and give each group a category for the teaching/learning plan to develop.
Have students present teaching/learning plan to class.



Students will usually obtain additional references or resources
to help answer or explore their questions.

Special Data Items

1. healthcare.jpg


Student Products

Part 2: Each group of students will write on a specific category for the teaching/learning plan of a patient with COPD

Assessment and Evaluation Plan

Part 2:
Students will learn what teaching and nursing care needs to be provided to a patient with COPD.
Students will evaluate each other for group participation as well as presentation of topic.
Each student will have to present part of the teaching/learning plan.

Rubric will be established for the grading process and will replace a quiz grade of 5 points.



Course name:
Clinical Applications III
Likely sequence in syllabus:
Time during term:
Halfway through semester
Students in course:
ASN students-40-60 students
Collaborative elements:
Group work
Additional notes:


Credits html/healthcare.html

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