| Course | NUR 503 Advanced Health Assessment, Pathophysiology and Pharmacotherapeutics for Health Promotion II |
|---|---|
| Module | Module 6 |
| Paper type | Case study presentation, slides with speaker notes |
| Length | About 1,015 words, 6 pages |
| Format | APA 7 slide deck with speaker notes |
| School | Arizona State University |
| Program | MS in Nursing |
| Updated | October 2026 |
Free sample paper for NUR 503 Module 6
Thirteen Years on a Cushion: A Case Study Presentation of a Stage 3 Pressure Injury in a Man With T8 Paraplegia
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
NUR 503: Advanced Health Assessment, Pathophysiology and Pharmacotherapeutics for Health Promotion II
Instructor Name
Month Day, Year
Slide 1: The Patient
Mr. D., 38. Complete T8 paraplegia for 13 years after a motorcycle crash. Lives alone in Tucson, works part time from home. New wound over right ischial tuberosity found by home health nurse.
Speaker notes: Mr. D. is a 38-year-old man who has lived with complete T8 paraplegia for 13 years. He transfers independently, drives an adapted van and works part time from home doing accounting. He lives alone; his sister helps with skin checks on weekends. A home health nurse visiting for an unrelated catheter problem found an open wound over his right ischial tuberosity. He had not seen it, because he cannot see that area without a mirror, and he had not felt it.
Slide 2: How It Happened
Cushion more than five years old, compressed. Longer sitting hours with new remote job. Fewer pressure reliefs. Weekend-only skin checks.
Speaker notes: When we talked, a pattern emerged. His air-cell cushion was more than five years old and no longer held air evenly; a replacement had been ordered months earlier but was waiting on insurance approval. His new remote job kept him sitting longer, and he admitted doing fewer pressure reliefs. His sister checked his skin only on weekends. Habits that had protected him for years quietly slipped, which mirrors research showing that daily routines strongly affect pressure injury risk after spinal cord injury (Fogelberg et al., 2016).
Slide 3: Pathophysiology
Sustained pressure over bone compresses capillaries, causing ischemia and cell death. Shear distorts deeper tissue. After spinal cord injury: no sensation, no reflex shifting, muscle atrophy, altered circulation, moisture from neurogenic bladder.
Speaker notes: When pressure over a bony prominence exceeds capillary pressure for long enough, blood flow stops, cells become ischemic and tissue dies. Damage often starts in deeper tissue near the bone and spreads outward, which is why a small surface wound can hide a larger injury. Shear, from sliding or poor positioning, distorts tissue and worsens damage. After spinal cord injury, the usual protections fail: there is no pain to prompt movement and no automatic shifting, muscle over the ischium has atrophied so there is less padding, and changes in circulation and moisture from incontinence make skin more fragile.
Slide 4: Assessment and Staging
Wound: 3 cm by 2.5 cm, 0.8 cm deep, subcutaneous fat visible, no bone or tendon, no tunneling. Stage 3. Also assess: nutrition, continence, seating, mood, signs of infection or osteomyelitis.
Speaker notes: The wound shows full-thickness skin loss with visible fat but no exposed muscle, tendon or bone, which is stage 3 under the national staging system (Edsberg et al., 2016). A full assessment goes beyond the wound: nutrition, including protein intake and weight; continence and moisture; a seating evaluation of the chair and cushion; mood, since depression is common and undermines self-care; and signs of infection such as fever, increasing drainage or probe-to-bone, which would raise concern for osteomyelitis. Because his injury level is T8, below T6, autonomic dysreflexia is less likely, but nurses should still know his baseline blood pressure.
Slide 5: Pharmacology That Affects Skin and Healing
Baclofen for spasticity: sedation and fatigue can reduce pressure reliefs. Oxybutynin for neurogenic bladder: reduces leakage and moisture. Wound care: moisture-balancing dressing, no routine topical antibiotics. Nutrition supplements if intake is low.
Speaker notes: Several of Mr. D.'s medications affect his skin. Baclofen controls spasticity, which helps positioning, but drowsiness or fatigue can make him less likely to do reliefs, so timing and dose matter. His anticholinergic for neurogenic bladder reduces leakage, which protects skin from moisture, though it can cause constipation and dry mouth. For the wound itself, care focuses on pressure off-loading, cleansing and a moisture-balancing dressing; systemic antibiotics are reserved for signs of infection, and routine topical antibiotics are not recommended. If his protein intake is low, a supplement may support healing. The nurse reviews all medications for sedation and for anything that slows healing, such as systemic steroids.
Slide 6: Communication
Ask, do not lecture. Explore his routine and what changed. Use motivational interviewing to build his own plan. Involve his sister with his permission.
Speaker notes: Mr. D. knows the rules of pressure relief better than most nurses. Repeating education would feel insulting. Instead, the nurse asked open questions about his day, reflected his frustration about the insurance delay, and asked what he thought would work with his new job. He decided to set a timer on his work computer for reliefs every 30 minutes and to switch to side-lying for part of each afternoon. Motivational interviewing has been tested for skin care in spinal cord injury; in one trial it did not outperform education, and skin worsening was common in both groups (Guihan et al., 2014), so communication must be paired with practical changes such as equipment and visit frequency.
Slide 7: The Plan
Off-load: limit sitting to short periods until healing, side-lying for work breaks. Expedite cushion through case manager. Home health visits twice weekly for the first month. Daily skin checks with mirror and phone camera.
Speaker notes: The plan combines off-loading, equipment and support. Mr. D. will limit sitting time until the wound improves. The case manager will escalate the cushion authorization as urgent, documenting the wound. Home health will visit twice weekly for the first month, the period when worsening is most common, then reassess. He will check his skin daily using a mirror and his phone camera, sending a photo to the nurse if anything changes.
Slide 8: Takeaways
Pressure injury after spinal cord injury is a systems problem as much as a skin problem. Assess equipment, routine, mood and medications. Communicate to support his plan, not yours.
Speaker notes: The key lessons are that this wound was caused by a worn cushion, a changed routine and a delayed authorization as much as by pressure itself, and that nurses must assess all of those. Medications can help or hinder prevention. And communication works best when it builds on the patient's own expertise about his body and his life. I look forward to your peer reviews.
References
Edsberg, L. E., Black, J. M., Goldberg, M., McNichol, L., Moore, L., & Sieggreen, M. (2016). Revised National Pressure Ulcer Advisory Panel pressure injury staging system: Revised pressure injury staging system. Journal of Wound, Ostomy and Continence Nursing, 43(6), 585-597. https://doi.org/10.1097/WON.0000000000000281
Fogelberg, D. J., Powell, J. M., & Clark, F. A. (2016). The role of habit in recurrent pressure ulcers following spinal cord injury. Scandinavian Journal of Occupational Therapy, 23(6), 467-476. https://doi.org/10.3109/11038128.2015.1130170
Guihan, M., Bombardier, C. H., Ehde, D. M., Rapacki, L. M., Rogers, T. J., Bates-Jensen, B., Thomas, F. P., Parachuri, R., & Holmes, S. A. (2014). Comparing multicomponent interventions to improve skin care behaviors and prevent recurrence in veterans hospitalized for severe pressure ulcers. Archives of Physical Medicine and Rehabilitation, 95(7), 1246-1253. https://doi.org/10.1016/j.apmr.2014.01.012
What the NUR 503 Module 6 instructions ask for
Per the posted syllabus, the Case Study Presentation and peer review fall in Week 6, once case sign-ups close in Week 5, and the assignment carries 40 points with four peer reviews. The syllabus describes a recorded PowerPoint presentation of a case study focusing on pharmacology, pathophysiology, assessment and communication, and peer reviews in which students describe the information in classmates' case studies that had the biggest impact. Expect to present a patient, explain the disease process, describe assessment findings, discuss relevant medications and model how you would talk with the patient. Recording length, slide limit and peer review instructions are all set in Canvas.
Inside the NUR 503 Module 6 example
The deck has eight slides with full speaker notes. It introduces a composite patient and the circumstances that led to his wound, then explains the pathophysiology of pressure injury and why spinal cord injury removes normal protections. An assessment slide stages the wound with the national system and lists what else to assess. A pharmacology slide connects the patient's own medications to skin and healing. A communication slide shows motivational interviewing in practice and reports trial evidence honestly. The plan and takeaways slides close the case. Three sources are cited where used. Speaker notes are written to be read aloud in a recording, in plain sentences.
Where the marks sit in the NUR 503 Module 6 rubric
Case study presentations in NUR 503 are typically graded on accurate pathophysiology, thorough assessment, correct and relevant pharmacology, effective communication strategies, and presentation quality, plus completion of four substantive peer reviews. Graders look for a case in which each element connects to the patient rather than appearing as separate lectures. Pharmacology should go beyond listing drugs to explain their effects on this patient. Because the assignment carries 40 points, accuracy and completeness matter, and citations on slides or in narration are expected. Peer reviews are usually graded for specific, thoughtful comments rather than praise. Presentations that end with clear takeaways help reviewers write useful feedback.
NUR 503 Module 6 help: mistakes that cost marks
Students often spend most of the time on pathophysiology and treat communication in one line. Give communication its own slide with examples of what you would say. Another mistake is listing medications without explaining how they affect the problem in your case. Check staging and drug information against current sources. Keep the recording within the time limit. For peer reviews, say what in a classmate's case had the biggest impact on you and why, as the syllabus asks. If you want help with your own case presentation, send the case and the rubric to the desk. Keep each slide readable at a glance and practice the narration once before recording. Credit any images you use and avoid photos of real wounds unless they are licensed for reuse.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 503 Module 6 questions, answered
Where can I find a free NUR 503 Module 6 sample paper?
This page holds the full case study presentation, eight annotated slides on a stage 3 pressure injury after spinal cord injury, covering pathophysiology, assessment, pharmacology, communication and the plan.
What must the NUR 503 case study presentation cover?
The syllabus lists pharmacology, pathophysiology, assessment and communication, presented as a recorded PowerPoint.
How much is the NUR 503 case study worth?
The posted syllabus lists the case study presentation and peer review at 40 of the course's 100 points.
How many peer reviews does NUR 503 require?
The syllabus lists four peer reviews, describing the information in classmates' case studies that had the biggest impact.
How do I include communication in a NUR 503 case study?
Show what you would say to the patient, how you would involve family, and which approach, such as motivational interviewing, fits the situation.