In the following three case scenarios determine if the patient has an increased risk for surgical complications based on their current health status and medical history.
Write a 1-2 paragraph response for each scenario and determine the following:
Case Scenario 1:
Mr. Rogers is a 51-year old male. During his pre-operative examination he tells the nurse I have an ache in my right foot. He offers an explanation suggesting I must have stepped on something or twisted my ankle. Maybe I got bitten by a bug when I was outside yesterday. The nurse notes that the patient’s ankle is reddened slightly swollen and warm to the touch. However his temperature is within normal limits. Mr. Roger’s ankle is x-rayed and there is no fracture noted. He has full range-of-motion of his right ankle. Mr. Rogers has a preexisting medical condition of gout. He is scheduled for outpatient surgery on his thyroid.
Case Scenario 2:
Mr. Sanders is a 61-year old male who presents with nausea and has been vomiting for two days. He is also experiencing mental confusion. His blood glucose is 796 mg/dL. He is a newly diagnosed diabetic and has not been getting medical treatment. Intravenous regular insulin is administered to Mr. Sanders in order to bring his blood glucose level down to a normal level. Further tests show that his Hemoglobin A1C is 10.3%. Mr. Sanders has a preexisting medical condition of coronary heart disease and hypertension. He is scheduled for outpatient surgery on his thyroid.
Case Scenario 3:
Mrs. Miller is an 88-year old woman who presents with nausea vomiting and severe abdominal pain. Further tests reveal that her white blood cell count is 13000/mm3. Her physical examination reveals that her abdomen is distended and very tender to the touch. Her doctor suspects that she has acute pancreatitis. Mrs. Miller has a preexisting medical condition of heart failure and gastroesophageal reflux disease (GERD). She is also scheduled for outpatient surgery on her thyroid.
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