Father of the Year Award – A true case study
Patient: Jessica Jones (this was her actual trip to the hospital in Jan. 2007)
Your group may use whatever resources are in the room. Mrs. Pardue and/or Mr.
Stratton may help you (after they make fun of you first – beware).
Presentation Notes: Pt presented to ER with hypoxia - O2 saturation at 84-86% (SaO2 –
84-86%) and decreased breath sounds on the right. Breathing was rapid and shallow (5055 breaths per min.),BP normal, slightly febrile at 100.9◦, HR was tachy at 142bpm, CBC
showed elevated white count. Blood culture was negative, UA showed no UTI. Pt.
showed obvious left arm pain at the shoulder (especially with anterior and posterior
movement) – which X-Ray later showed to be a complete oblique fracture of the
proximal humerus. Pt was admitted after CXR showed patchy areas in right lung lobes.
Once admitted, O2 was administered (initially 7L/min and subsequently decreased to
2L/min over the next 24hours) to maintain SaO2>96% and IV meds were given.
Morphine was administered for pain, and right arm immobilized in a sling to set. After
36 hours pt maintained SaO2 >96% in room air. After 48 hours pt was released to
continue medication at home.
1.
Define the underlined words or symbols above. For the broken bone – draw a
diagram.
2.
Based on the info above, why did my daughter have to be admitted to the
hospital (BTW – it wasn’t the broken arm)? Explain why this condition
would cause the hypoxia, tachycardia rapid breathing, elevated WBC count
and the other observations listed above.
3.
My daughter’s broken arm contributed to her respiratory system disorder.
Why would a broken left arm cause problems in the right chest? Morphine
helped not only pain control in the arm, but also dramatically improved
breathing – why?
4.
Assuming you have the right diagnosis, what IV medication was given to
Jessica? What does the negative blood culture and negative UA rule out.