Case Study
( )اسم القسم
) ) الشهر
Student Name:
Group:
1
Case Study
Sociodemographic data
Special unit…………………..
Patient’s name:……………………………………… Hospital No……………
Date of admission……………………………….. Stay period:…………….
Age:………………. Sex…………………….
Level of education……………………….. Occupation…………….
Marital status………………………… Religious……………….
Present History:
-Diagnosis/ Present illness:……………………………………………………………….
-Chief complaints on admission:…………………………………………………………
-Associated signs and symptoms:………………………………………………………
-Onset / Duration / Frequency:……………………………………………………………
-Predisposing factors:…………………………………………………………………….
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-Reliving measures and its effect:………………………………………………………..
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Past History:
Medical:
-Diagnosis / Duration:………………………………………………………………….
-Diagnosis / Duration:………………………………………………………………….
-Diagnosis / Duration:………………………………………………………………….
Surgical:
-Name of surgery / Duration:…………………………………………………………..
-Name of surgery / Duration:…………………………………………………………..
Allergy history:………………………………………………………………………
Family history:
-Diagnosis / Relation:…………………………………………………………………
-Diagnosis / Relation:…………………………………………………………………
Life style habit--------------------------------------------------------------------------
Patient’s physical assessment
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Definition of disease--------------------------------------------------------------------
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Path physiology\ types----------------------------------------------------------------
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Etiology
According to patient According to literature
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Clinical manifestations
According to patient According to literature
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Complications
According to patient According to literature
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Diagnostic measures
Lab investigation:
According to literature According to patient
Lab Investigation Patient's Results Normal Range Nursing Considerations
4
Radiological examination:
According to literature According to patient
Check for
Type of examination Patient's Results Nursing Considerations
what done
Medical management according to patient
No. Drug name Route Dose / Frequency Side effect Nursing Consideration
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Surgical management
According to patient According to literature
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Nursing management
According to patient According to literature
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