LEARN MORE...

Home
Documents
June 2021
3
Learning Activity 7 2 (2)

Learning Activity 7 2 (2)

Content type

User Generated

Uploaded By

funzf1981

Pages

Showing Page:

1/3

Case study

Abdul

Abdul arrives in your four-stretcher ED at shift change. He is 24 years old

and a paraplegic as a result of a MVC which occurred several years earlier.

He is a frequent visitor to the hospital. Abdul has moderate use of his hands,

no feeling below mid trunk, and he self-catheterizes routinely. He lives with

his family and has some personal care assistance provided through the

community. As a result, he has thrived at home. He has come to your ED

many times for GU-related issues. He is thinner than you remember, but he

states that he has been doing well until this week. Abdul explains to you

that two days ago he started to experience a fever, increased malaise, muscle

aches, a loss of appetite, and he has noticed a foul odor to his urine. He

thought that these symptoms were typical of a UTI so he took an

“antibiotic” at home yesterday. Today he felt worse, so he decided to come

to the ED.

You observe a thin male, waiting in his wheelchair with his mother at his

side. His skin is flushed, hot, and dry. His vital signs are: radial pulse 118,

blood pressure 100/60, temperature 39.2, respiration rate 20/minute, and

oxygen saturation of 99% on room air. He is speaking to you in full

sentences and there are no signs of airway obstruction. You are about to

give report for shift change, so you let him know that the department is full

at the moment, but you will be with him as soon as there is a space

available.

At 2015 you are able to place Abdul in an assessment bay. He remains alert

and oriented. He does not appear to have any increased work of breathing.

RR is 20. When you assess his radial pulse, you find it rapid and his blood

pressure is 100/60. His skin remains flushed hot and dry, and his

temperature is now 39.6. You do an ECG for Abdul.

Showing Page:

2/3

At 21:15 Abdul remains alert and oriented. His skin is warm to touch. His

general condition is unchanged. You were proactive and inserted an

intravenous and started infusing NS TKVO. Lab results are back.

Normal

Abdul’s Results

135-145

141 mmol/l

95-110

109 mmol/l

K+

3.5-5.0

5.0 mmol/l

Glucose

4-8

3.9 mmol/l

Creatine

35-115

122 mmol

WBC

4.5-11 x 10

Hgb

Men 140-180 g/l

Women 120-160 g/l

129

Hct

Men 0.42-0.521

Women 0.37-0.471

0.662

Based on the assessment data and the results of the blood work, the EP

orders the following:

1 L of NS wide open followed by 1 L at 500 cc per hour

Tylenol 1 g PO

Ceftriaxone 2 g IV

Showing Page:

3/3

Unformatted Attachment Preview

Case study Abdul Abdul arrives in your four-stretcher ED at shift change. He is 24 years old and a paraplegic as a result of a MVC which occurred several years earlier. He is a frequent visitor to the hospital. Abdul has moderate use of his hands, no feeling below mid trunk, and he self-catheterizes routinely. He lives with his family and has some personal care assistance provided through the community. As a result, he has thrived at home. He has come to your ED many times for GU-related issues. He is thinner than you remember, but he states that he has been doing well until this week. Abdul explains to you that two days ago he started to experience a fever, increased malaise, muscle aches, a loss of appetite, and he has noticed a foul odor to his urine. He thought that these symptoms were typical of a UTI so he took an “antibiotic” at home yesterday. Today he felt worse, so he deci ...
Purchase document to see full attachment