A.A. a 75-year-old man who lived alone, was cutting plants in his garden and accidentally cut his finger. He casually wa
Posted: Tue Mar 15, 2022 2:43 pm
A.A. a 75-year-old man who lived alone, was cutting plants in
his garden and accidentally cut his finger. He casually washed the
bleeding site and saw that it was fairly deep, so he put a finger
bandage and continued working. Two days later, he removed the
bandage but the cut was still open and now oozing. Later that day,
he replaced the finger bandage with a fresh one after he had washed
the wound with soap and water. Two days later he noticed that his
finger had become warm, red, and saw a small amount of pus at the
site. He had also had a low grade fever. The following day he went
to see his physician who cleaned the cut and gave him a
prescription for Cephalexin. However, A.A stopped taking the
antibiotic in a few short days once he felt better. Now a few days
later, he has developed severe fatigue, fever, chills, tachycardia,
and increasing mental confusion. A neighbor witnessed A.A. on the
porch in his underclothes and called 911 who took him to the local
emergency room. On admission, his temperature was 35.4
C, his blood pressure was 88/60 mm
Hg, his respiratory rate
was 28 (deep and
rapid), and his pulse
was 113. Blood chemistry revealed a BUN
of 57 mg/dl and creatinine
of 1.9 mg/dl.
You order fluids, cultures, and start broad spectrum
antibiotics. While awaiting the full CBC, A.A. continues to
decline. His pulse is
now 133/min, BP is 78/58 Respirations are
30/min. You are approaching the 2 hour mark from his
initial presentation to your facility. His additional labs are as
follows: Hemoglobin 17.8, Hematocrit 48, WBC
39,606, Neutrophils 52, Lymphocytes 8, Monocytes 3,
Eosinophils 0, Basophils 0, Band forms 11, Platelets
42,000, MCV 92, Red Cell morphology 1+schistocytes, PT
15.4, aPTT 37.2, D-Dimer 372, Fibrinogen 189, FDP 32, ESR 60, PaCO2
28, PaO2 68.
In a minimum of 2 full pages, excluding title and
reference pages, answer the following:
Include an abbreviated version of the case (in your own words)
in the introduction of your journal. Based on the above case study,
address each section of the Journal rubric (found in the Grading
Rubrics section under Course Resources) and use it to guide your
completion.
his garden and accidentally cut his finger. He casually washed the
bleeding site and saw that it was fairly deep, so he put a finger
bandage and continued working. Two days later, he removed the
bandage but the cut was still open and now oozing. Later that day,
he replaced the finger bandage with a fresh one after he had washed
the wound with soap and water. Two days later he noticed that his
finger had become warm, red, and saw a small amount of pus at the
site. He had also had a low grade fever. The following day he went
to see his physician who cleaned the cut and gave him a
prescription for Cephalexin. However, A.A stopped taking the
antibiotic in a few short days once he felt better. Now a few days
later, he has developed severe fatigue, fever, chills, tachycardia,
and increasing mental confusion. A neighbor witnessed A.A. on the
porch in his underclothes and called 911 who took him to the local
emergency room. On admission, his temperature was 35.4
C, his blood pressure was 88/60 mm
Hg, his respiratory rate
was 28 (deep and
rapid), and his pulse
was 113. Blood chemistry revealed a BUN
of 57 mg/dl and creatinine
of 1.9 mg/dl.
You order fluids, cultures, and start broad spectrum
antibiotics. While awaiting the full CBC, A.A. continues to
decline. His pulse is
now 133/min, BP is 78/58 Respirations are
30/min. You are approaching the 2 hour mark from his
initial presentation to your facility. His additional labs are as
follows: Hemoglobin 17.8, Hematocrit 48, WBC
39,606, Neutrophils 52, Lymphocytes 8, Monocytes 3,
Eosinophils 0, Basophils 0, Band forms 11, Platelets
42,000, MCV 92, Red Cell morphology 1+schistocytes, PT
15.4, aPTT 37.2, D-Dimer 372, Fibrinogen 189, FDP 32, ESR 60, PaCO2
28, PaO2 68.
In a minimum of 2 full pages, excluding title and
reference pages, answer the following:
Include an abbreviated version of the case (in your own words)
in the introduction of your journal. Based on the above case study,
address each section of the Journal rubric (found in the Grading
Rubrics section under Course Resources) and use it to guide your
completion.