Wednesday, November 26, 2014

Thanksgiving activity for Nursing students - What's wrong with your patient?

We found some great examples of weird, unexpected and common problems that come into the E.R. around Thanksgiving. This activity is great for students to complete before holiday vacation when you're not ready to start a new lesson, but you still want students thinking. We like to give prizes (or snacks) to the student to solves all the cases first. For a printable/editable version of this sheet click here.

Can you figure out what’s wrong with these patients?
Bonus Question: What would your role as a Nurse be in their care?
All cases are taken from real examples.

Scenario 1: A soft spoken, 30 year old woman comes in to the hospital the morning of Thanksgiving complaining that she hasn’t slept for the last few days. She reports being slightly dizzy and has a headache. You notice that she’s sweating even though the room is chilly and upon taking her blood pressure you notice that it’s elevated. Her blood work is normal, her temperature is 98.7 and she has no signs of infection.
  • Answer: She’s suffering from anxiety! She married into a large, loud family and gets extremely nervous having a group of 20 raucous in laws in town for the holidays.

Scenario 2: A 35 year old male enters the emergency room complaining of a fluttering feeling in his chest at 11pm on Thanksgiving. He smells vaguely of alcohol and has spent the day with his family having dinner but has not done any strenuous or unusual activity. He does not have a history of any cardiac disease and is a non-smoker. The cardiac monitor shows atrial fibrillation, his pulse is 158 and slightly irregular, his blood pressure is 128/64 and his temperature is 97.3.
  • Answer: Holiday Heart!In 1978, Ettinger et al conducted a study evaluating 32 separate dysrhythmic episodes in 24 patients. These patients consumed alcohol heavily and regularly; in addition, they took part in a weekend or holiday drinking binge immediately prior to evaluation. Based on the results of this study, the term holiday heart syndrome was coined. It was defined as an acute cardiac rhythm and/or conduction disturbance, most commonly supraventricular tachyarrhythmia, associated with heavy ethanol consumption in a person without other clinical evidence of heart disease. In short - he drank too much at his family dinner!

Scenario 3: A 10 year old female is brought in to the hospital by her mother the day after Thanksgiving and complains of an upset stomach. She has been experiencing diarrhea for the last several hours and her mother mentions that the girl’s father has been feeling nauseous as well and vomited once this morning. The mother is showing no signs of illness. When you take the patient’s temperature she throws up on your scrubs and tells you her “belly hurts”. Her temperature is 101, her pulse is 94 and her blood pressure is 116/79.

  • Answer: This patient has salmonella poisoning! Undercooked turkey or poultry can cause salmonella poisoning. Unfortunately for her and her dad, they both ate a ton of turkey during Thanksgiving, the mom happens to be a vegetarian.