Case Study #1 Mrs. Smith, 74 y.o. female, was admitted last night to the medical/surgical unit for exploratory bowel surgery this a.m. Yesterday, she presented.

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Presentation transcript:

Case Study #1 Mrs. Smith, 74 y.o. female, was admitted last night to the medical/surgical unit for exploratory bowel surgery this a.m. Yesterday, she presented to the ED with abdominal pain and diarrhea. Her abdomen is large, hard and swollen. PMH: Mild dementia, HTN, DM. Social History: Resident in an assisted living facility. Drinks 1-2 glasses wine/day. The assisted living facility is experiencing an outbreak of diarrheal illness. CT Scan: Complete blockage of large intestine with mass measuring 10 x 7 x 5 cm. AM Labs: Glucose 168, BUN 22, Cr 1.5, Albumin 2.7 What infection prevention actions should you take?

Case Study #2 Mr. Jones, 65 y.o. male, is scheduled for a repeat I & D of the right lower leg. Mr. Jones has chronic ulcers to BLE for over 6 months. He has been hospitalized several times. Since his last discharge, he has been treated at a wound clinic with outpatient IV antibiotics and wound treatments by a wound specialist. PMH: Recurring MRSA cellulitis to BLE, HTN, DM. Social History: Janitor at a local middle school. Lives with his wife and children. Culture results: Gram positive cocci in clusters. Physical exam: Moderate amount of purulent drainage RLE wound. PreOp Labs: Glucose 209, BUN 18, Cr 1.7, Albumin 3.0 What infection prevention actions should you take?

Case Study #3 Mr. Lee, 69 y.o. male, is scheduled for a 3 vessel CABG this a.m. with a saphenous vein harvest. He developed shingles 2 weeks ago. He has two days of acyclovir treatment left to complete. The lesions are dried and crusted over but still slightly painful. PMH: HTN, angina with moderate exertion. Social History: Retired businessman. Lives alone. PreOp Labs: MRSA screen negative 5 days ago. Chemistry and CBC all WNL. What infection prevention actions should you take?