Question

Reza is a 23-year-old male who was involved in a motor vehicle accident. After the accident, he told the paramedics he felt extreme pain under his rib cage. He was transported by ambulance to the hospital, and the attending physician determined Reza had ruptured his spleen during the accident. He was scheduled for emergency splenectomy. Due to the severity of the injury, Reza had to have “open surgery” to remove his spleen.

The surgery was a success. Reza was given prophylactic antibiotics to prevent a surgical site infection. Because Reza had an open surgery, the doctor told him he’d need to stay in the hospital up to 6 days, depending on his recovery.

By the fourth day, Reza, who was young and otherwise healthy, was looking forward to being discharged from the hospital. But that morning, he woke up experiencing severe abdominal cramps. He slowly tried to get up to go to the bathroom, but he quickly realized he wasn’t moving fast enough. Panicked, he immediately pressed the nurse call button. By the time, the nurse got to Reza, there was stool all over him, the bed, and the floor. Reza was horrified, but the nurse comforted him, helped him up, and got him into the shower. The hospital housekeeping staff was called to clean the room.

After he was cleaned up, the nurse assessed Reza. His vital signs were recorded as follows:

• Temperature = 39.4°C [102.9°F]
• Pulse = 118 bpm
• Respiration = 20 breaths/minute
• BP = 92/52 millimeter Hg

While taking Reza’s vital signs, the nurse noticed he was pale and appeared dehydrated. He also seemed confused and disoriented. Reza kept trying to leave his hospital room, and he had repeat episodes of profuse diarrhea that had to be cleaned off him, the linens, and the floor. The nurse noticed the stool appeared yellow in color, seemed to contain pus, and had an especially foul odor.

The type of infection and the causative pathogen must be identified based on the patient’s signs and symptoms and laboratory results. Then a treatment plan is developed.

1.Identify the signs, symptoms, and potential risk factors.

2.Determine the causative pathogen (make a diagnosis).

3.Evaluate diagnostic laboratory results.

4.Suggest treatment

Based on the case to this point, what would be helpful to evaluate your patient and aid in diagnosis?

• X-ray
• Cultures of blood and stool samples
• Check platelet levels
• Neurological exam
• Colonoscopy
• Move to intensive care unit
• Put patient on isolation precautions

In the choices, below what would not be helpful to evaluate the patient?

Group of answer choices

Put patient on isolation precautions

Move to intensive care unit

Colonoscopy

Cultures of blood and stool samples

Answer 1

according to the current situation of the patient. it looks like there is a problem is with the gastrointestinal tract.

in the treatment of surgical site infections, doctors use wide spectrum antibiotics.

long term use of such antibiotics(i.e ceftriaxone) causes superinfection. which means on the action of these

antibiotics along with pathogenic bacteria it also kills useful or symbiotics bacteria because in presence of these bacterial colony pathogenic bacteria cannot grow because of limited resources but if these bacteria get killed

by antibiotics body harbors new pathogenic bacteria which is very often seen in our gastrointestinal system.

SYMPTOMS OF GIT(gastrointestinal tract) INFECTION INCLUDE

-DIARRHEA(most common)

-DEHYDRATION

-TACHYCARDIA

-FEVER

-BLOOD AND PUS IN STOOL

-GASTROENTERITIS(inflammation of git).

AFTER SEEKING THE CONDITION

TESTS WHICH WILL BE  USEFULFOR DIAGNOSIS

INCLUDES

1.CULTURE OF BLOOD AND STOOL SAMPLE- it gives us an idea about the infective agent is which pathogen

so that we could perform sensitivity testing and effective treatment.

2. MOVE TO ICU- Because the patient is tachycardic and B.P IS also not normal and dehydrated too so to prevent from any organ failure or complications we should admit to ICU for continuous monitoring.

UNHELPFUL AID FOR DIAGNOSIS

1.COLONOSCOPY AND 2. X-RAY is not needed because the patient is stable from four days these tests have not so much significance.

3.PLATELET EXAMINATION

These do not seem necessary because not any sign of bleeding

4. ISOLATION - As per situation is also not necessary.