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SMNET Case of the week 27/2/12

Discussion in 'Clinical Placements and Electives (Nursing)' started by iolaus, Feb 27, 2012.

  1. Mum of three

    Mum of three Well-Known Member Plus! Member

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    As most people have said, I would want to check her blood sugar because of the fainting and palpitations. Check her blood pressure, pulse, ECG, do bloods to check for iron levels and infection, ask if she could be pregnant, any history of fainting, any history of heart conditions in her family. Then take it from there. What time of year is it too, is it really hot? Has she eaten and drank recently? Get a next a kin if there is one and see if she wants us to call anyone. Actually bloods and EGC would probably be doctors call would they? So do the other obs and get a dr to review
  2. Mum of three

    Mum of three Well-Known Member Plus! Member

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    Any history of epilepsy?
  3. Beetle709k

    Beetle709k Well-Known Member

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    Full obs/bloods/neuro, enquire about medical history, including diabeties/epilepsy/heart problems/respiratory problems/other.

    Does she regularly take excersie, does she smoke, drink? Has she been out the night before ? Maybe she had her drink spiked?

    What is a regular daily routine? Is she on any medication or has a diagnosed medical condition, if yes who is her consultant/hospital?

    Refere to senior staff member/dr if you are at all concerned about any of her initial obs history.


    Most importantly as perviously stated get concent for any practices you need to perform, and explain through out what and why you are doing what you are. Be patient, polite and supportive. Offer a drink if she feels dehydrated. Importantly also offer her friend support and guidence as she may not know anything about what has happened to her friend prior to bringning her into the a&e.
  4. salzdoll

    salzdoll Member

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    Agree with all above, ask consent before doing anything. Sit her down, calm her, give her water incase she is dehydrated, do obs, ask if she is diabetic, oxygen if needed. Once she is more stable go through her full history. Do a urinalysis, bloods to check her blood chemistry etc, ECG for palpitations. Check if she has any cardiac conditions such as AF. Check if she is on any meds such as warfarin, digoxin etc.
  5. salzdoll

    salzdoll Member

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    Also check when she last ate or drank. Has she had any recent weight loss - does she have a very low/very high BMI?
  6. Mumtomidwife

    Mumtomidwife Member

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    what a fab idea - subscribing with interest to watch and learn x
  7. iolaus

    iolaus RM and Head of Clinical Practice Staff Member

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    Doctors tend to READ the ECGs but don't tend to be the one to actually do them
  8. salzdoll

    salzdoll Member

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    Yes, I've been doing them on the placement I'm on now, we do them and the doctor interprets them.
  9. tickleswife

    tickleswife Member

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    would your provided water and food???? What if she has internal problems and needs surgery?? Just and idea, havent a clue though!!
  10. Roo

    Roo Well-Known Member

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    I was going to say that about the drinking- I probably wouldn't offer water initially. I was also thinking- did she bang her head when she fell? Do they do some kind of head scan thing- CT scan?? Or is that for proper serious accidents etc? Lol. I worked in for a week on placement, everyone had one there but they were nearly all trauma type patients or elderly collapses.

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