Group 1 PBL 1st session

1.) Clarify the terms

 Fainting – “kakuyapon”
 Throwing Up – “Kasukaon”

2.) Define the problem

— Why did the patient feel she is about to faint and throw up?
— Why is the patient given 02 therapy
— What is the purpose of elevating the legs and the semi-fowler’s position
— Why is the patient having her 02 saturation and blood pressure taken?
— What is the purpose of the cold cloth?

3.) Brainstorming
— Patient has decreased in O2
— Patient is feeling tired and uneasy
— Elevating the leg to improve circulation, provide comfort, & increase blood pressure
— Giving of oxygen therapy to provide comfort and improve oxygenation
— BP cuff and Pulse Oximeter to monitor vital signs
— Low oxygen may have caused the feeling of fainting
— Problem in cardiovascular system may brought about the symptoms of patient
— Patient may be dehydrated
— Patient’s prescribed diet while hospitalized
— Is the patient given IV fluids

4.) Problem Analysis

— The patient’s symptoms may be caused by a cardiovascular problem
— Patient may be hypotensive
— What is the patient’s age (changes in age may brought about the symptoms of the patient) and
medical history (patient may have underlying conditions)
— What is the patient’s prior activity
— Vital signs of the patient
— Does the patient have a family history of heart/respiratory diseases
— Cardiovascular assessment, neurological assessment, respiratory assessment
— Laboratory Exams (ABG, CBC)
— Diagnostic exam (ECG)
— Flow rate of the oxygen

5.) Learning Goals

— What causes the feeling of fainting and throwing up
— What is the purpose of the cold cloth to the forehead
— Normal laboratory results in older adults
— Normal vital signs in older adults
— Normal assessment findings (cardiovascular, neurological, respiratory)

What we already know

— Patient has bloody stool
— Post endoscopy: patient has pain in epigastric area; rated 8 on a scale of 1-10
 — Doctor prescribed Morphine for pain
— Patient is taking OTC inflammatory medication, ibuprofen, Infliximab IV
— Patient eats unhealthy food when put under stress
— Active bleeding after endoscopy
— Patient is intaking alcohol
— Disease is not related to the cardiovascular, respiratory systems
— Patient’s Vital Signs are as follows: Temp – 98.8 deg celsius, PR – 114, RR – 22 , O2 Sat – 95%,
BP – 100/60mmHg
— Age of patient is 36
— Hgb is 7ml/dl, Hematocrit is 21%

To research — Possible diseases may be (1) Crohn’s Disease / (2) Gastric Ulcer / (3) Stress Related Ulcer
— Possible results of Endoscopy
— Manifestations of: Crohn’s Disease, Gastric Ulcer, Stress related Ulcer
— Medical/Surgical treatment for Crohn’s, Gastric Ulcer, Stress related Ulcer
— Complications IBD
— Fecal Diagnostic Test indicative of Crohn’s Disease (Fecal Calprotectin Test)