Question

Scenario

The emergency medical services (EMS) team has brought a 54­-year-old female patient to the emergency department where you are working. The EMS personnel state that the patient was found wandering in a nearby park by a jogger, who called 911 from her cell phone after the woman screamed obscenities at her and then fell, seriously scraping her arm and face. The woman is bleeding, disoriented, combative, and accusing the EMS team of stealing her purse. Her hands are shaking severely, and she is shouting at the doctors and nurses that she needs a bottle. The woman’s clothing is dirty, and you can smell stale body odor and urine.

Critical thinking Questions

1. Based on your first impressions of this patient’s actions and appearance, what do you suspect she is suffering from?

2. What short­ and long-term health risks would you suspect this patient faces?

3. Why do you think the patient’s hands are shaking, and what do you think causes her confusion and combativeness?

4. What assessments do you think are needed for this patient?

Answer 1

1.The patient is suffering from a mental disorder which can be understood from the actions and appearance. This could be possibly a substance abuse as she was asking for a bottle from the healthcare professionals

2.The short term risk are

• Hygienic problems due to lack of proper personal care
• Starvation or anorexia due to inadequate access to proper food
• Risk for urinary tract infections, skin infections due to wandering

The long term risk are

• Substance abuse or drug abuse
• Delirium, Depression, anxiety

3.The shaking of hand could be possibly because of loss of energy, weakness,abuse,lack of food affecting her musculoskeletal system

4.The assessment needed are

• Mental status examination
• Physical examination
• Laboratories tests like basic CBC,random blood sugar,urine routine, liver and renal function test ,chest X ray to find botany disease

2.