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 Case Scenario 
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 Case Scenario 

Patient Presentation:
A patient is 27 years old. He was infected with a bacteria V. cholerae (Cholera is caused by the bacterium V. cholerae. (This
bacterium is Gram stain-negative), by eating contaminated food and water or uncooked food and fruits. After a 24 to 48 hours, some
symptoms begin with the sudden onset of painless watery diarrhea that quickly become voluminous and is often followed by
vomiting. Its main symptoms are vomiting and diarrhea, because of these, severe dehydration can occur.
He vomits every time he eats and drinks anything. After a day, his color become pale yellow, and he became weak due to
dehydration by loose motions and vomiting. In the first day of infection, he drank some rehydration solutions, but no improvement
observed. He also felt severe abdominal pain.
He experienced accompanying abdominal cramps, probably from distention of loops of small bowel as a result of the large
volume of intestinal secretions. Fever is typically absent.
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Diagnosis:
He went to a hospital where proper check-ups were performed. The physician advised him for few tests (CBC +
ESR, Rapid stool test to identify cholera bacteria). Thus, confirms cholera by identifying bacteria in a stool sample. He
was then admitted for treatment and management.
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History:
Two Days Ago – Symptoms began with abdominal cramps and an intense urge to pass stool after every meal. His symptoms
started to appear after eating his dinner bought in the Carinderia and rapidly worsened with passage of stool
becoming more frequent. Within two days he was passing persistently watery diarrhea.
Two Days Ago – Symptoms persisted, and he experienced diarrhea and vomiting after eating or drinking, which lasted for 48
hours. He was admitted to hospital for rehydration and further investigations.
Two Days Ago – patient is passing 8 – 10 liquid stools per day. Diarrhea is watery. Occurs day and night. Patient complains of
malaise, lethargy and anorexia. He has lost 5 kg in the past 2 – 3 days.
No past surgical history, and No significant medical history.
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Family History:
Mother – Type 2 Diabetes Mellitus
No other family members with chronic disease
No known allergies
Foods are brought in the Carinderia nearby and water supply from water pump being used by the whole Barangay.
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Examination/ Assessment:
Thin ill-looking male patient, conscious and alert, in obvious discomfort.
The nurse weighed him and recorded 48 kgs only at that time. He became bluish and weak due to loss of water causing
dehydration.
Other findings include:
Vital Signs:
Blood Pressure 90/50 mmHg
Cardiac Rate: 122 bpm
Respiratory Rate: 28 cpm
Temperature: 36.1 celcius
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Examination/ Assessment:
General Appearance:
Weak, and pale looking. Eyes were sunken and with observable discomfort. Lack of sweat production, shriveled skin
with dark urine.
Neurological:
Verbalized stress and worrying at time.
Cardiovascular:
Slight Tachycardia. Complaining of heart beats faster, increasing heart rate and causing to feel palpitations at times.
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Examination/ Assessment:
Abdominal examination:
Guarding and tenderness noted in the left iliac fossa and hypogastrium.
Abdominal X-ray:
No toxic megacolon
Gastroscopy Report:
Esophagus and gastroesophageal junction were normal. Stomach mucosa was intact and normal. No gastritis,
ulceration or blood was noted. Cardia was normal. Pylorus and duodenum normal.
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Management:
After checking all aspects, the physician ordered the following:
 Dimenhydrinate tablets for vomiting twice-a-day before the meal.
 Antibacterial medication: gramicidin, neomycin sulfate, ciprofloxacin 500 mg twice-a-day, and Flagyl (Metronidazole)
400 mg twice-a-day and a rehydration solution (ORS).
 Intravenous Fluid to treat dehydration (Volume per volume).
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Guide questions:
Note: analyze well the case scenario given. Incorporate additional relevant data pertaining to the disease.
1. identify and discuss briefly the disease being described.
2. describe the current situation of the patient. Nursing diagnosis should be prioritized based on your assessment data.
3. make use of your critical thinking through expanding your knowledge focusing on the clinical manifestations/ presentations you
observed to your patient.
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In the scenario create:
 Daily PA ------- as a group (please refer to the handbook for PA tool format)
 (1) Sample FDAR Charting ------- per student
 (1) NCP ------- per student (please refer to the handbook for NCP format)
 (1) Drug Study ------- per student (please refer to the handbook for Drug Study format)
 Patient Education (contents: Lifestyle, Activity/ Exercise, Diet, Follow-up check, Psychological or Emotional or spiritual Aspect
of teaching needs ------- per student
 Case Study ------- as a group
 Journal Reading ------- per student