Bodhi Brown iHuman Case Scenario

Bodhi Brown iHuman Case Scenario

The patient is an 18 year /old male who presents to the clinic accompanied by his father after an exercise associated collapse with brief LOC on the football field during practice. He reports having headache, nausea, lightheadedness, cramps, excessive sweating, and decreased urination as well as admittedly not hydrating well. Physical exam shows tachycardia, orthostatic hypotension, dry mucous membranes, and capillary refill of 3 seconds. Risk factors include: antihistamine use, alcohol, wearing heavy equipment in high heat and humidity, and obesity.

Ken Fowler ihuman diagnosis

Primary Diagnosis

Heat Exhaustion:

The most likely diagnosis is heat exhaustion since the Pt has a heat index of 100F, inadequate hydration, high intensity exercise, and loss of consciousness. It is differentiated with simple dehydration by heat index (Mayo Clinic, 2021). His sweating, normal mentation and core body temp is below 104F and that disqualified the ruling of heat stroke.

Different Diagnosis

Bradycardia.

Bradycardia is one of the different diagnoses. The condition of having a slow heart rate is referred to as Bradycardia. Some of the signs for bradycardia include fatigue, fainting, lightheadedness, confusion or memory loss and chest pain (O’Connor and Casa, 2021). The Pt collapsed after the exercises and experienced lightheadedness meaning he might be suffering from bradycardia. The absence of chest pain and shortness of breath leading to ruling out of bradycardia condition.

Syncope.

Another diagnosis is Syncope. An alternative word for passing out or fainting is syncope.

A person is said to experience syncope if they pass out, go limp, and then quickly awaken. The symptoms for syncope include blacking out, falling for no reason, feeling lightheaded, dizziness, groggy, fainting and change in vision (O’Connor and Casa, 2021). After the exercise the Pt collapsed and fainted and awaked meaning that he could be experiencing syncope condition. Absence of symptoms such as feeling groggy leads to ruling out of syncope.

Dehydration.

Dehydration is another diagnosis possible for the Pt. When an individual does not drink enough water or loses more than they take in, they become dehydrated. Sweat, tears, vomiting, urination, and diarrhea all cause fluid loss (O’Connor and Casa, 2021) Bodhi Brown iHuman. The conditions developed after exercises meaning the Pt may have been dehydrated through sweating. Symptoms to dehydration include tiredness, headache, lightheadedness, dry mouth, and passing little urine infrequently. The patient was in possession of all these symptoms for dehydration.

Pharmacological Care

• No intervention is required if the patient is stable and asymptomatic, but will continue to monitor for patient safety and well-being
• Cardiac monitoring, IV access, with continuous assessment: VS: 5-15 min q 4-6 hours first 24 hours, including oxygen saturation when indicated
• Atropine 1 mg IV bolus. Repeat q3-5min prn: do not excess 3mg/total does

Supportive Care

• He should not return to play or engage in intense practice in heat for at least 24 hours
• He should develop an acclimatization plan and be free from the symptoms before returning to play.
• Change wet clothes and sheets, as needed.
• Stay hydrated as much as possible high in electrolytes
• Keep the room temperature moderate
• Loosen clothing

Additional Ancillary Test Needed

• 12 lead electrocardiograms (ECG).

Social Determinants of Health to Consider, Health Promotion and Pt Risk Factors

• Hyperglycemia can be as a result of his heavy fast-food diet.
• Obesity is a risk factor for heat related illness. An increase in weight or excess weight hinders the body from regulating body temperature effectively.
• A nutritionist can help the whole family.

Patient Education

• Explain the signs and symptoms to assist him in recognizing them early.
• Educate the patient to drink sports (Gatorade) drink or water (Buttaro et al., 2021).
• Educate the patient on diet to avoid weight gain.
• Educate the patient of signs and symptom of low blood pressure

Follow-Up/Disposition

• Referral to cardiac consult
• Follow up in 1 to 2 weeks
• Call 911 if symptom of bradycardia persists
• Activity as tolerate.
• Bodhi Brown iHuman
• Excuse from school sport workout for 5 days. May return back to school after 5 day if no symptoms

 

References

Buttaro, T. M., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2021). Primary care:             Interprofessional collaborative practice (6th ed.). Elsevier.

O’Connor F, Casa DJ. Exertion heat illness in Adolescents and adults: Epidemiology,             thermoregulation, risk factors, and diagnosis. Updated. 2021.

Mayo Clinic (2021). Heat exhaustion. Retrieved November 2021,             https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/diagnosis-treatment/drc-  20373253 Bodhi Brown iHuman

Bodhi Brown iHuman Case Scenario

The scenario involves an 18-year-old male who visits the clinic with his father after collapsing during football practice. He experienced a brief loss of consciousness (LOC) on the field. He reports symptoms like headache, nausea, lightheadedness, cramps, excessive sweating, and reduced urination. The patient admits not hydrating well. Physical examination reveals tachycardia, orthostatic hypotension, dry mucous membranes, and a capillary refill time of 3 seconds. Contributing factors include antihistamine use, alcohol consumption, wearing heavy equipment in hot and humid conditions, and obesity.

Primary Diagnosis

Heat Exhaustion:

The leading diagnosis is heat exhaustion, given the patient’s high heat index (100F), inadequate hydration, intense exercise, and loss of consciousness. It is differentiated from simple dehydration based on the heat index (Mayo Clinic, 2021). Notably, the patient’s sweating, normal mentation, and core body temperature below 104F eliminate the possibility of heat stroke.

Other Possible Diagnoses

Bradycardia.

Bradycardia is a potential diagnosis, characterized by a slow heart rate. Symptoms of bradycardia include fatigue, fainting, lightheadedness, confusion or memory loss, and chest pain (O’Connor and Casa, 2021). Given that the patient collapsed after exercise and experienced lightheadedness, bradycardia could be a consideration. However, the absence of chest pain and shortness of breath rules out this condition.

Syncope.

Syncope, another diagnosis, refers to passing out or fainting. A person experiences syncope when they momentarily lose consciousness and then quickly regain it. Symptoms of syncope include blacking out, falling without reason, feeling lightheaded, experiencing dizziness, grogginess, fainting, and changes in vision (O’Connor and Casa, 2021). Since the patient collapsed and regained consciousness after exercise, syncope is a possibility. The absence of grogginess-related symptoms leads to ruling out syncope.

Dehydration.

Dehydration is another possible diagnosis. Dehydration occurs when the body loses more fluids than it takes in. Fluid loss can result from sweating, tears, vomiting, urination, and diarrhea (O’Connor and Casa, 2021). Given that the patient’s symptoms developed after exercise, dehydration due to sweating is a potential cause. Symptoms of dehydration encompass tiredness, headache, lightheadedness, dry mouth, and infrequent urination. The patient displayed all these symptoms of dehydration.

Pharmacological Care

No intervention needed if the patient is stable and symptom-free, but continuous monitoring for safety and well-being is required.
Cardiac monitoring, IV access, and ongoing assessment: Vital signs checked every 5-15 minutes every 4-6 hours within the first 24 hours, including oxygen saturation when necessary.
Administer Atropine 1 mg IV bolus. Repeat every 3-5 minutes if needed, but do not exceed a total dose of 3 mg.

Supportive Care

The patient should abstain from intense exercise or play in heat for at least 24 hours.
A plan for acclimatization should be developed, and the patient should be symptom-free before resuming play.
Change wet clothing and sheets as required.
Maintain hydration with electrolyte-rich fluids.
Keep room temperature moderate.
Loosen clothing.

Additional Ancillary Test Needed

Perform a 12-lead electrocardiogram (ECG).

Social Determinants of Health, Health Promotion, and Patient Risk Factors

Hyperglycemia could be due to the patient’s fast-food-heavy diet.
Obesity is a risk factor for heat-related illnesses, as excess weight impairs the body’s temperature regulation.
A nutritionist can provide guidance to the whole family.

Patient Education

Explain signs and symptoms to aid in early recognition.
Educate the patient on drinking sports drinks (like Gatorade) or water (Buttaro et al., 2021).
Provide guidance on a diet to prevent weight gain.
Educate the patient about signs and symptoms of low blood pressure.

Follow-Up/Disposition

Refer for a cardiac consultation.
Schedule a follow-up in 1 to 2 weeks.
Advise calling 911 if bradycardia symptoms persist.
Encourage activity as tolerated.
Excuse the patient from school sports workouts for 5 days. Return to school after 5 days if symptoms have subsided.

References

Buttaro, T. M., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2021). Primary care: Interprofessional collaborative practice (6th ed.). Elsevier.

O’Connor F, Casa DJ. Exertion heat illness in Adolescents and adults: Epidemiology, thermoregulation, risk factors, and diagnosis. Updated. 2021.

Mayo Clinic (2021). Heat exhaustion. Retrieved November 2021, https://www.mayoclinic.org/diseases-conditions/heat-exhaustion/diagnosis-treatment/drc- 20373253 Bodhi Brown iHuman