Question

S. S., a 75-year-old man who lived alone, was cutting vegetables and accidentally cut his finger. He casually washed the bleeding site, put a Band-Aid on the deep cut and continued cooking. Two days later, he removed the Band-Aid but the cut appeared open and oozing. Later that day, he replaced the Band-Aid with a fresh one and washed the wound with soap and water. A few days later he noticed that his finger had become very red and swollen and he could see a small amount of pus at the site. He had also developed a low grade fever and malaise. The following day he went to see his physician who cleaned the cut and gave him Cephalexin. However, S. S did not follow the dosing instructions and stopped taking the antibiotic when he felt better after 3 days. A few days later, he developed a high fever, chills, severe fatigue, tachycardia, and growing mental confusion. A relative visiting S. S called 911 and he was taken to the local emergency room. On admission, his temperature was 35.4 C, his blood pressurewas 88/60 mm Hg,his respiratoryrate was 22, hispulsewas 111. Blood chemistry revealed a BUN of 55 mg/dland creatinine of1.8 mg/dl

Questions:

1. What disorder do you think Sam has?

2. What was its etiology?

3. What additional diagnostic studies do you need to order?

4. What are you initial treatment interventions? Explain the rationale for each.

5. What are your initial treatment goals?

6. What is causing the abnormal assessment findings? (be specific-think patho here)

Answer 1

1. The disorder Sam might be having is Infection due to Diabetes

2. Etiology is diabetes

3. Additional diagnostic studies to be ordered is Glusoce tolerance test , HBA1C

4. According to the vitals ,first the patient has to be made stabilized by IV fluids and other supportive care then uncontrollable diabetes,and infection .