Case Scenario 1 Jeremy Kayton

Case Scenario 1
Jeremy Kayton is an 18 year old male student who has presented to the Emergency Department at 2130 post ingestion of an unknown quantity of Panadol Osteo tablets, with an unknown quantity of bourbon at approximately 1900. On arrival Jeremy was withdrawn, teary and not making eye contact, he stated to the Triage nurse that he had taken the tablets for a headache that would not go away.
# Past Medical History- Jeremy has recently been diagnosed as a Type 1 Diabetic. Regular medications: NovoRapid, Lantus. Jeremy has had difficulty adjusting to his diagnosis of diabetes and has on occasions missed his dose of insulin when out socialising. Nil other significant history noted.
Jeremy was born in Canada but moved to Australia when he was 17, to pursue his studies. He has no immediate family in Australia. A concerned friend who brought him to the hospital advised the Emergency Nurse that Jeremy has been very stressed lately due to a relationship breakdown. His grades at university have suffered and he has been working long hours to support himself.
The Emergency RMO who has come to review Jeremy has ordered a paracetamol level to be taken within 4-8 hours after the initial ingestion of the Panadol Osteo. He has been commenced on intravenous therapy Normal Saline over 4 hours (1000/4). The doctor will review the Paracetamol level and will determine if further treatment (e.g. N-acetylcysteine infusion) is required for the paracetamol ingestion according to the Guidelines for the management of paracetamol overdose Nomogram. The emergency team have discussed the case with the psychiatric team who will come and review Jeremy shortly. BGL 12mmol.
Case Scenario 2
Rose Haughton is a 45 year old female, single mother of a four year boy. Rose has presented to the Emergency Department this morning via ambulance after being awake all night with abdominal pain, nausea and vomiting. The pain started suddenly last night at about 2100, her last oral intake was take-away fish and chips at approximately 1930. The pain is constant and is mainly in her right upper quadrant (RUQ); she is also complaining of intermittent pain in her shoulders, she grades her pain as an eight out of ten.
#Past Surgical History: Recent surgery noted- Total hysterectomy with bilateral salpingoopherectomy under general anaesthesia (TAH+BSO) 6/52, complicated by intra-abdominal abscess. Discharged 4/52 ago under GP care and oral antibiotics.
#Past Medical History includes painful and heavy periods, fatigue and anaemia and depression.
Regular medications: Sertraline (Zoloft) 100mg daily.
Rose works three days a week as a bank teller in a local shopping centre. Her Italian mother lives nearby and assists with childcare, however; this is sometimes difficult due to limited English and no drivers licence.
Rose weighs approximately 86kg. Height 169 cms
The emergency team have ordered intravenous therapy Normal Saline over 6 hours (1000/6) and have written her up for: Morphine S/C 5-7.5mg 2 hrly PRN and Ondansetron 4mg IV. Full Blood workup has been sent including septic screen. Referral has been made to the surgical team please keep fasted until then. Abdominal Ultrasound has been booked. # Provisional diagnosis-Cholecystitis.
Roses mother and son are currently waiting in the visitors room.
Assessment 1 Case Scenario Report planning
This document will help you plan and prepare your Report using Inquiry Based Learning (IBL) Approach
Inquiry Based Learning stage
What you need to do to critically analyse and demonstrate your critical thinking about the Case Scenario
Learning Outcomes Section Notes/planning for your Report
Demonstrate your learning in each section by presenting the information that you have examined to improve your knowledge and understanding of selected Case Scenario
STEP 1 - CONNECT
Select and Analyse one of the case scenarios
Think about what are some of the key issues or information that you consider are important in this case scenario
Notes for the Introduction section of your report
Introduce the context of your selected case scenario. Do not repeat the scenario synopsis but rather document what you consider are the key issues in this Case Scenario here.
STEP 2 QUESTION
Think about some of the broader questions about this case scenario that you want to know more information about
Identify the additional information you need to know to understand the case better (remember this is about your learning)
It may help you to formulate your questions in a list format here.
Notes for Critical Questions and Rationale section of your report
Briefly identify and discuss why these questions are relevant to your learning about this case scenario (ie. how will these questions help you understand the case better?)