medportal CDB | Adrian Scholtz Part 2

Adrian Scholtz Part 2

Activity
Tutorial

Adrian was admitted to the ICU 24 hours ago. Since that time, additional investigations and bloodwork has been ordered. Adrian underwent a CT chest to rule out pulmonary pathology and septic embolic in the lungs are confirmed. Blood cultures are positive for Methicillin-resistant Staphylococcus aureus (MSSA). After an infectious disease consult, Adrian is started on IV Ancef. The Cardiology team led by Dr. Sibbald and the Cardiac Surgery team led by Dr. Semelhago agrees that the patient requires a repeat heart valve replacement. In addition, the nurses observe Adrian to appear to be volume overloaded with worsening swelling. Despite copious IV fluids, Adrian is not making much urine (<200mL/day). A nasogastric tube was inserted for methadone administration. The nurse and dietician are requesting consideration for total parenteral nutrition based on recent laboratory results demonstrating malnutrition and hypoproteinemia. Ophthalmology is consulted for concerns of septic emboli following completion of an MRI of the brain. Nephrology consulted and believes dialysis may help the patient, but it is not the definitive treatment. They will only start dialysis if the patient is under consideration for repeat heart valve surgery.

Curriculum Block

Integration Foundation / Maternal Health Risks/Aging-Related Care / Part 5 / Week 4

- Indicates most relevant

Objectives

Global Objectives

Upon completion of this problem, students will be able to demonstrate the integration of cardiac, respiratory, hematology and renal core concepts in critical management of a patient with complex sepsis including ethical issues with social issues and chronic drug use.

Assessments

End-Unit Tutorial Assessment

Integration Foundation

Concept Application Exercise (CAE)

IF CAE 3

Tags

Curriculum Block

Integration Foundation Maternal Health Risks/Aging-Related Care Part 5 Week 4

Curriculum Week

Discipline

Cardiology Infectious Diseases Nephrology Nutritional Sciences Ophthalmology Surgery

MCC Presentations

Acute Kidney Injury (Anuria or Oliguria) Substance Use or Addictive Disorders Substance Withdrawal

McMaster Program Competencies

1.5 Develop and carry out patient management plans 1.9 Provide health care services to patients, families, and communities aimed at preventing health problems or maintaining health 2.2 Apply biomedical scientific principles fundamental to health care for patients and populations. 2.4 Apply principles of epidemiological sciences to the identification of health problems, risk factors, treatment strategies, resource allocation, and disease prevention/health promotion efforts for patients and populations 2.5 Apply principles of socio-behavioural sciences to the provision of patient care, including assessment of the impact of psychosocial and cultural influences on health, disease, care-seeking, care concordance, care adherence and barriers to and attitudes toward care. 4.3 Demonstrate sensitivity, honesty, and compassion in difficult conversations, including those about death, end of life, adverse events, bad news, disclosure of errors, and other sensitive topics 5.7 Demonstrate the application of ethical principles to commonly encountered ethical issues such as the provision or withholding of care, confidentiality, informed consent, and including compliance with relevant laws, policies, and regulations 7.1 Work with other health professionals to establish and maintain a climate of mutual respect, dignity, inclusion, ethical integrity, and trust

MeSH

Cardiovascular Infections [C01.190] Cardiovascular Infections [C14.260] Critical Care [E02.760.190] Critical Care [N02.421.585.190] Critical Illness [C23.550.291.625] Drug Users [M01.169] Endocarditis [C14.280.282] Endocarditis, Bacterial [C01.190.249] Endocarditis, Bacterial [C14.260.249] Endocarditis, Bacterial [C14.280.282.407] Heart Valve Prosthesis [E07.695.310] Heart Valves [A07.541.510] Intensive Care [E02.760.190.400] Intensive Care [N02.421.585.190.400] Kidney Failure [C12.777.419.780.500] Kidney Failure, Acute [C12.777.419.780.500.205] Methadone [D02.522.675] Methicillin-Resistant Staphylococcus aureus [B03.300.390.400.800.750.100.500] Opioid-Related Disorders [C25.775.675] Parenteral Nutrition [E02.421.505] Patient Care Team [N04.590.715] Patient Care [E02.760] Pulmonary Embolism [C08.381.746] Renal Dialysis [E02.870.300] Renal Dialysis [E02.912.800] Renal Replacement Therapy [E02.870] Social Work [N02.421.849] Substance Withdrawal Syndrome [C25.775.835] Substance-Related Disorders [C25.775]

Related Activities