Category: Surgery

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  • 74. Case: Compulsive Hoarding – Mary

    Mary is a 72 year old woman who has been a compulsive hoarder for the last 10 years.  She can only move from room to room through pathways. She would like to move closer to her daughter and grandchildren, but she feels overwhelmed by the amount of stuff she has in her house. Despite the…

    View Case Study: 74. Case: Compulsive Hoarding – Mary

  • 48. Case: Shared Experience

    You have recently started working as an RN in cardiology at the local pediatric health centre. One of the first cases you are involved with hits a little close to home. It involves a 2-year old patient named Kira who has a congenital cardiac abnormality. The clinical circumstances are similar to what you experienced with…

    View Case Study: 48. Case: Shared Experience

  • 34. Case: To Tell or Not to Tell

    The head pathologist of the regional hospital informs the head pathologist of the tertiary care centre that the post-mortem examination of a former patient, Mrs. Dempsey, has revealed that she suffered from a neurological infection called CJD (Creutzfeldt-Jakob Disease). The tertiary centre pathologist reports this to the VP of Acute Care who determines through investigation…

    View Case Study: 34. Case: To Tell or Not to Tell

  • 28. Case: Mind the Gap!

    Mrs. Hardriver is admitted through ER to a general surgery unit for emergency surgical management of an acute small bowel obstruction secondary to her advanced colorectal cancer. After surgery, Palliative Care is consulted and they agree to admit Mrs. Hardriver to their service. As there is no palliative care bed available at the time of…

    View Case Study: 28. Case: Mind the Gap!

  • 27. Case: Withdrawal of Life-Sustaining Treatment

    Mr. Windown, age 82, is admitted to a cardiology clinical unit with unstable angina. In addition to his coronary artery disease, Mr. Windown suffers from disabling generalized osteoarthritis, chronic and progressive obstructive lung disease, and diabetes with associated compromise of his vision and kidney function. The coronary angiography reveals significant blockages of Mr. Windown’s coronary…

    View Case Study: 27. Case: Withdrawal of Life-Sustaining Treatment

  • 20. Case: To Treat or Not to Treat

    Stan Miller, a retired widower, sustains severe burns covering 80% of his body surface in a house fire secondary to a propane gas leak. He is initially assessed in the ED of the local hospital where he is sedated and intubated without any pre-resuscitation discussion about the seriousness of his thermal injuries and his care…

    View Case Study: 20. Case: To Treat or Not to Treat

  • 19. Case: Craig’s Right to Choose?

    Craig Renaldo is a 14-year old boy who was recently diagnosed with a right lower leg malignant vascular tumour. Staging investigations have been negative for distant metastases. Craig’s attending medical oncologist, Dr. Purvis, consults a pediatric orthopedic surgeon, Dr. Mendes, who recommends a below-knee amputation. Dr. Purvis concurs with this recommendation given the aggressive nature…

    View Case Study: 19. Case: Craig’s Right to Choose?

  • 18. Case: When the “Truth” is Painful

    Mrs. Sally Parrot, a 73-year old widow, has mild dementia of a presumed neurovascular type. She resides in her own small apartment in Serenity, a private continuing care community in Bedford, where she receives some assistance with housekeeping, meal preparation and organization of her medications. Sally is actively engaged in Serenity’s structured activities and, in…

    View Case Study: 18. Case: When the “Truth” is Painful

  • 8. Case: Who Should Decide?

    This case concerns a 35-year-old developmentally delayed female patient (functional age about 5 years old); her mother is her legal guardian. The patient tested positive for a BRCA gene mutation. Her mother is concerned that her daughter may develop ovarian cancer and wants her to have preventive surgery. Her physician does not believe this is…

    View Case Study: 8. Case: Who Should Decide?

  • 4. Case: Expectations for Care

    Ned is an elderly patient with relatively advanced dementia who is recovering from surgery to repair a hip fracture. He spends most of every 24-hour period screaming unless someone familiar sits with him. Staff members on the unit are becoming increasingly frustrated and stressed. The unit manager has received numerous complaints, verbal and written, from…

    View Case Study: 4. Case: Expectations for Care

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