The Unfortunate Nurse Case Study

The Unfortunate Nurse

PART I

1. How does this story highlight the importance of taking a thorough medical and personal history of a patient? What sorts of questions are important to ask someone who is ill?

It is important to ask about any recent travel, accidents, changes in routine, or unusual happenings.

2. Why does the doctor want to take a “closer look” at Nancy? What sort of things might she look for?

Nancy might have dengue fever. By examining her labs, the doctor will have a better idea of what is making Nancy sick.

3. What exactly does “blood work” mean? What kind of tests is the doctor likely to order using the blood and why? What about the urine and/or sputum sample?

The doctor will examine Nancy’s blood to check for signs of the virus. The virus can be isolated in cell cultures and detected in PCR. Dengue can be detected in the urine or saliva using real time RT-PCR.

Further Questions

1. What is a leukocyte? Are leukocytes raised or depleted in Nancy’s blood? What is the usual significance of an elevated leukocyte count? What’s going on with the lymphocytes?

A leukocyte is a white blood cell. An elevated leukocyte count usually indicates an infection. Nancy’s leukocytes are slightly elevated.

2. ……. What do the results tell you? What new, complementary information is gained from the EIA report?

Nancy has dengue antibodies in her blood, which means she has been exposed to dengue fever. Nancy’s lymphocytes are low, which is indicative of dengue.

3. What is the significance of the RT-PCR results?

The PCR results show that the dengue virus is present in Nancy’s system.

4. What actions will Dr. Ghee take in treating Nancy?

(Side note, the journal articles listed were almost all unable to be found, either on the website listed or through Google Scholar).

I don’t know if the doctor would continue Nancy on acetaminophen, but she needs some kind of fever reducer. A painkiller a few notches above acetaminophen...