NUR 450: Advanced Pathophysiology

Assessment 3 – Clinical Case Study Analysis

Word Count: 1500–2000 words (±10%)
Weight: 35% of final grade
Submission Format: Typed, double-spaced, Times New Roman 12pt, APA 7th Edition
Due Date: Week 9, Sunday 11:59 PM (EST)

Task Description

Analyze a detailed clinical case study that demonstrates the link between disease mechanisms and patient outcomes. Apply advanced pathophysiological reasoning to identify underlying dysfunctions, interpret clinical data, and justify nursing interventions. The case must reflect a condition affecting multiple systems or complex comorbidities. Your discussion should demonstrate clinical judgment grounded in current evidence (2018–2025).

Case Scenario Example

Patient: Mr. L., 62-year-old male with a history of Type 2 Diabetes Mellitus, chronic kidney disease (Stage 3), and newly diagnosed congestive heart failure. He presents with dyspnea, bilateral lower limb edema, and orthopnea. Lab results indicate elevated BNP, creatinine, and HbA1c of 9.1%.

Assessment Requirements

1. Introduction (10%)
   • Briefly introduce the patient and the primary health conditions.
   • State the purpose of the analysis and its relevance to advanced pathophysiology and nursing practice.
2. Pathophysiological Discussion (40%)
   • Explain the interconnected pathophysiology of the patient’s comorbid conditions.
   • Describe molecular, cellular, and systemic changes driving clinical manifestations.
   • Support with peer-reviewed literature and clinical guidelines.
3. Clinical Manifestations and Diagnostics (25%)
   • Interpret the patient’s clinical findings and diagnostic results.
   • Correlate findings to disease mechanisms and compensatory responses.
4. Nursing Interventions and Rationales (20%)
   • Outline prioritized nursing interventions addressing the identified pathophysiological issues.
   • Justify each intervention using evidence-based reasoning and clinical practice standards.
5. Conclusion (5%)
   • Summarize key pathophysiological insights and their implications for advanced nursing decision-making.

Assessment Rubric

Criteria	Excellent (90–100%)	Proficient (80–89%)	Satisfactory (70–79%)	Needs Improvement (<70%)
Pathophysiological Integration	Deep, accurate linkage of disease mechanisms to patient presentation; demonstrates advanced synthesis.	Clear understanding with minor gaps in systemic correlation.	Basic description with limited integration across systems.	Superficial or inaccurate discussion of mechanisms.
Clinical Reasoning and Diagnostics	Insightful interpretation of findings with precise linkage to pathophysiology.	Appropriate interpretation with some logical inconsistencies.	Limited interpretation; partial accuracy.	Minimal or incorrect diagnostic analysis.
Nursing Interventions and Evidence	Interventions fully justified by research and aligned with advanced nursing standards.	Relevant interventions with adequate evidence support.	Basic interventions with minimal justification.	Inadequate or unsupported interventions.
Writing Quality and Structure	Clear, cohesive, and scholarly writing adhering to APA 7th edition.	Generally well-written; minor issues in flow or citation.	Acceptable but uneven structure and referencing.	Disorganized, unclear, or frequent APA errors.

Submission Instructions

• Submit via the university LMS in Word or PDF format.
• Similarity report must not exceed 15% on Turnitin.
• All sources must be from peer-reviewed journals (2018–2025).

Learning Outcomes Assessed

• Integrate complex pathophysiological mechanisms with clinical manifestations.
• Apply critical reasoning to interpret patient data and prioritize care.
• Design evidence-based nursing interventions informed by advanced pathophysiological understanding.

Understanding how diabetes mellitus and heart failure interact on a cellular and systemic level is critical to advanced nursing practice. In this case, chronic hyperglycemia contributes to vascular inflammation and renal impairment, worsening fluid overload and myocardial dysfunction. Effective nursing interventions focus on optimizing oxygenation, glycemic control, diuretic management, and patient education, each grounded in the underlying pathophysiology driving the patient’s symptoms.

This case study analysis task for Miami Regional University’s NUR 450: Advanced Pathophysiology requires students to interpret a complex patient case, analyze disease mechanisms, and apply evidence-based nursing interventions. The assessment integrates clinical reasoning, pathophysiological synthesis, and nursing care planning within a 1500–2000-word analytical paper.

Peer-Reviewed References

Hall, J. E., & Hall, M. E. (2020). Guyton and Hall Textbook of Medical Physiology (14th ed.). Elsevier. https://doi.org/10.1016/C2017-0-03876-5

Brown, A. M., & Edwards, H. (2021). Integrating pathophysiological reasoning in nursing assessment. Nurse Education Today, 98, 104749. https://doi.org/10.1016/j.nedt.2020.104749

McCance, K. L., & Huether, S. E. (2023). Pathophysiology: The Biologic Basis for Disease in Adults and Children (9th ed.). Elsevier. https://doi.org/10.1016/C2020-0-01748-7

Ponikowski, P., et al. (2021). 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 42(36), 3599–3726. https://doi.org/10.1093/eurheartj/ehab368

American Diabetes Association. (2024). Standards of Medical Care in Diabetes—2024. Diabetes Care, 47(Suppl. 1), S1–S164. https://doi.org/10.2337/dc24-Sint