Pretend Patient

[green34]

We need to make a pretend patient for a class. It can be over any adult patient we want or one we make up. Basically we would talk about the patient and see what course of treatment we would do. I was thinking about doing herpes encephalitis. Any other suggestions for diseases or conditions?

[DalekRN]

Do something that interests you, what's your area of interest?

[green34]

Wounds. But it is supposed to be a critical care scenario. So I am basically looking up other conditions that could be interesting to do. It's not really a presentation but a mock scenario. The class is heavily involved with human patient simulators, but due to the wide variety we're not using the human patient scenarios for our own scenarios.

[vanilla bean]

Would it be possible to combine your area of interest with a critical care scenario? Something like a necrotizing fasciitis, compartment syndrome (postop w/open wounds), or an infected/non healing sternotomy? There are lots of wounds to manage in critical care patients.

[green34]

Well, we did a compartment syndrome scenario and I think we're duing a burn this week in lab. Necrotizing fascitis might be interesting. I really don't want to do a wound-based scenario.

Like maybe I am looking for interesting stories where you think the person is going to die.

One I can think of is one where a patient had a GI bleed. She was stable when she came in but vomited once and started crashing fast.

[phuretrotr]

If you wanted to do wanted to do encephalitis due to herpes, there is a great case study on "patient H&M". Since they have to take out parts of the brain and hippocampus, it could work out for a scenario because you would also have to plan for other healthcare professional assistance such as various types of therapy while also monitoring and assessing the patient after surgery.

[KelRN215, BSN, RN]

Guillain Barre Syndrome can be an interesting one. Someone comes in with a little bit of weakness/numbness in their feet and before you know it, they're intubated in the ICU and can't move anything.

[nurseprnRN, BSN, RN]

We don't see it nearly as often as we used to, thank god, but how about something that gives you flash pulmonary failure, like pneumocystis or coccidiomycosis?

[green34]

Thanks! I'll look up the conditions.

Just to be safe, there is more than just naming a condition here. I have to come up with a scenario, pathophysiology, possible treatments/orders, lab values, possible outcomes dependent on what treatments were done, etc.

[Christy1019, ASN, RN]

What if you had an unstable septic patient and the sepsis source of infection was from a wound? A LOT of critical care is dealing with septic patients, you could talk about titrating multiple drips, multiple antibiotics, resulting organ failure etc...

[Cohiba]

Ebola or organophosphate poisoning are "interesting"... The organophosphates could come from a pesticide exposure and not necessarily a nerve gas attack if farm chemicals are around where you're at--they're far more common than you might think, even in non-farming communities if there are roads/rail lines anywhere near your location.

[calivianya, BSN, RN]

Sounds like a fun project. :)

I had a patient once who broke some bones and then had a massive MI in surgery to fix the bones. His kidneys failed due to low cardiac output and he went into ARDS as well. He was on a CRRT machine and an oscillator, and we had a lot of trouble maintaining his BP and O2 despite bumping his FiO2 on the vent up to 100% and titrating his vasoactive drips up. He was a really busy patient. It's really something what a fall and a few broken bones can do to you!