Anita is a 10-year-old girl attending a rural elementary school. Anita has asthma, complicated by allergies to ragweed and cedar elm. Her asthma symptoms increase dramatically on days in which the pollution count is particularly high and she becomes very ill on days in which there is an ozone alert. Anita’s mother has been very […]

A 65-year-old man DH with liver cirrhosis is admitted to the medical-surgical unit with nausea and vomiting. He also has a diagnosis of heart failure. You note that his serum albumin (protein) level is low. The physician has written admission orders, and you are trying to make the patient comfortable. He is to take nothing […]

Marilyn Mullins, 62, said she was shocked when she received a note from a chaplain at Sentara Martha Jefferson Hospital that said she had died. A hospital chaplain called Mullins with an apology and explained that a technical error caused the mistake. The hospital said a secretary accidentally checked the box for the deceased patient […]

Maria Hernandez is a 6-year-old female who came into the emergency department about 10 minutes ago. Maria’s caregiver reports the child is in a sickle cell crisis. The child reports their “stomach and legs hurt” and rates their pain as 6 on FACES pain scale. Maria’s knees are swollen, red, and warm to touch. The […]

Shawn Jackson is a 13-year-old transgender male whose name on the EHR for billing purposes is Shetona Jackson. Shawn was brought to the emergency department by his parent. The parent states, “Shawn has been having flu-like symptoms for the past week. He had a fever last week, but not this week. I am so concerned; […]

Hayden is a 6-year-old child who was seen wandering outside on the street at 0400 this morning and brought to the emergency department by police. The child was found wearing pajamas, no coat, and no shoes. The outdoor temperature this morning was 0˚ C (32˚ F). Vital signs on arrival were temperature 34.1˚ C (93.4˚ […]

A 28-year-old male patient presented to the Emergency Department (ED) for suicidal ideation. The patient was not medically cleared; therefore, was admitted to the Medical Surgical Unit for management of acute medical conditions. The provider ordered suicide precautions. The patient was unmonitored by a safety attendant or virtual sitter. The patient was found during hourly […]

28-year-old male patient presented to the Emergency Department (ED) for suicidal ideation. The patient was not medically cleared; therefore, was admitted to the Medical Surgical Unit for management of acute medical conditions. The provider ordered suicide precautions. The patient was unmonitored by a safety attendant or virtual sitter. The patient was found during hourly rounds […]

Paired Case Studies 1 A: A 12-year-old boy was admitted as an emergency due to swelling over much of his body, particularly his face and torso. A week previously he had complained of a sore throat. He had low urine output and is hypertensive. His urine showed proteinuria and hematuria. He was anemic with a […]

A 42-year-old single white male went to his physician with complaints of fatigue, abdominal pain and loss of appetite. Past medical history: He had no history of hepatitis, CMV, Varicella, Rubella vaccinations. He reported being sexually active on a recent vacation and eating many of the local foods. Physical examination: The whites of his eyes […]