PL - Caso Clinico

USO DE LA IA EN LA EDUCACIÓN
PRACTICA DE LABORATORIO
INSTRUCCIONES:
* Lee el siguiente caso clínico; puedes usar alguna herramienta de traducción automática
vista en la sesión anterior.
Equipo 1
1. Crea una presentación electrónica usando alguna herramienta de IA para facilitar su

realización en donde expliques de manera general el caso clínico. (Usa el inglés
para su redacción)
Equipo 2
1. Subraya con un color los conceptos teóricos que no comprendes.

2. Escribe en inglés y francés las definiciones de los conceptos teóricos identificados
en el paso anterior.
3. Redacta una conclusión en tus propias palabras de las razones por las que es útil
investigar por tu cuenta temas o conceptos nuevos.
Equipo 3
1. ¿Cuál es la talla del Px?

2. Escribe los signos vitales que se tomaron al inicio, en la sala de operaciones y en
cuidados intensivos.
3. Escribe la relación que existe entre las tomas de signos vitales y las razones de su
variación. (Usa el inglés para su redacción)
Equipo 4
1. Investiga asistentes virtuales del área de la salud (WhatsApp)

2. Chatea con ellos para conocer sus funcionalidades
3. Redacta una conclusión en Ingles de tu experiencia usando estos asistentes
virtuales
LICENCIATURA EN ENFERMERÍA
Equipo 5
Crear un material de estudio para repasar los conceptos de Caso Clínico (Usa una
herramienta de IA)
CASO CLÍNICO
Female patient, 31 years old, originally from San Marcos, resident of Guatemala,
Christian, literate. She was referred from the hospital unit due to a fall of 5 steps.
Non-surgical medical history denied, surgical medical history denied, allergic history
denied, toxicological history denied.
On physical examination, signs of admission P/A 120/60 mmHg, HR 78 x min, Fr 16

x min, T° 37. Physical examination within normal limits, right foot shows palmar
ecchymosis, decreased range of motion due to pain, crepitus and pain on palpation,
preserved superficial and deep sensitivity, distal capillary refill less than 3 seconds.
Upon admission on 8/8/2017 14:21:16 with the diagnosis of:
● Displaced fx of the base of the right 2nd metatarsal

● Displaced fx of the base of the right 3rd metatarsal
● Right 2nd metatarsal neck fx
On August 9, the pre-medication interview was conducted with the patient, where it
was explained that the anesthetic plan would consist of regional anesthesia, it was
documented that there was no significant medical history, blood count and
coagulation times were within normal limits.
Dosing with tinzaparin 3500 U SC in pm, Ranitidine 50mg PO HS and AM,

Metoclopramide 10mg PO HS and AM.
Patient is scheduled for surgery on August 10th.
Previous antibiotic?
The patient was admitted to the operating room A4 at 12:30 p.m., where the
patient was seen oriented in time, space and person. Basic monitoring was started,
where P/A 108/67 mmHg, Fc 88 x min, SO2 98% were documented.
Patient is classified as ASA I with 60kg weight, BMI: 25
Equipment is prepared for a regional anesthesia of the spinal type, where the patient
is placed in a sitting position, spaces are palpated appropriately; syringes are loaded
with 80 mg lidocaine without epinephrine and another syringe with 25 mcg of
fentanyl plus 10 mg bupivacaine. With sterile technique, asepsis and antisepsis are
performed, local anesthetic is injected waiting for the necessary time for the effect, a
number 26 spinal needle trocar is introduced; the subarachnoid space cannot be
located in the first attempt, so the trocar is repositioned and the subarachnoid space
is located, observing rock water without the presence of erythrocytes, anesthetic is
injected (isobaric bupivacaine plus fentanyl), the procedure ends without
complications.
The patient is placed in a supine position, monitoring continues without changes.
Sedation is administered 3 mg midazolam
15 minutes after the block the patient suddenly begins to have difficulty breathing,
mandibular rigidity with inability to place oropharyngeal cannula, since the patient
cannot be ventilated, 100 mg of succinylcholine is administered and the patient is
intubated with a number 7 orotracheal tube, 3 mg of midazolam is administered, no
lung sounds are auscultated so 2 puffs of salbutamol are administered with which
there is slight improvement, wheezing and basal rales are auscultated in both lung
fields, the patient is hemodynamically unstable with severe hypotension 60/40
mmHg so 10 mg of ephedrine is administered intravenously, dexamethasone 8 mg is
administered, the patient does not recover oxygen saturation which remains at 80%,
two more doses of ephedrine 10 mg are administered and the patient is transferred
to recovery in charge of intensive care, he leaves the operating room with P/A 62/30
mmHg Fc. 123 x min and SO2 85%.
Patient is admitted to the intensive care unit under critical care with mechanical
ventilation and management of vasoactive amines, however the patient remains with
saturation below 90%.
Later, at 6:00 p.m., she was transferred to the adult intensive care unit, bed #6,
where she was sedated with midazolam at 10 cc/hr and tramadol at 10 cc/h; she
continued with norepinephrine at 25 cc/hr (0.4 gammas), her vital signs were 93/52
mmHg, Fc 160 x min, SO2 88%, under mechanical ventilation. The patient presented
an episode of supraventricular tachycardia, therefore the decision was made to
cardiovert and start an amiodarone infusion; an infusion of “lipids” was started,
thinking of “local anesthetic poisoning” at 1.5 mg/kg.
The admission diagnoses were:
● State of shock
● Drug reaction anesthesia
1. Toxicity
● Fracture of the metatarsal of the right foot.
The dose of norepinephrine is increased, which improves P/A. It is decided to

evaluate neurological status, so 0.1 mg of Flumazenil is administered, which shows
that the patient's state of consciousness improves. Laboratory tests taken in the
UCPA are received:
Showing ultrasensitive troponin T at 61.33 , BNP 222.50, CPK 370, CK-MB 156,
LDH 230, D-dimer 5.43, Ammonium 131, WBC 19.26.
It is decided to start anti-ischemic therapy with aspirin, clopidogrel, atorvastatin,

beta-blocker.
Arterial blood gas with pH 7.21, pCO2 41.50, SO2 91%, Lactate 3.50, HCO3 16.70,
EB -10.20
Subsequently, he presents other episodes of supraventricular tachycardia, which is

why he is cardioverted again.
Patient is diagnosed with ventilator-associated pneumonia, antibiotic coverage:

Meropenem, Linezolid, Ampicillin Sulbactam.
The patient's sedation is withdrawn and neurological deficit is evident, so she is

scheduled for an electroencephalogram.
The patient is scheduled for an electroencephalogram, however the patient has

hypernatremia, so it is expected to correct sodium values.
Patient died on 8/20/17 at 1:00 am with a diagnosis of refractory shock.

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USO DE LA IA EN LA EDUCACIÓN

1. Crea una presentación electrónica usando alguna herramienta de IA para facilitar su

1. Subraya con un color los conceptos teóricos que no comprendes.

1. ¿Cuál es la talla del Px?

1. Investiga asistentes virtuales del área de la salud (WhatsApp)

On physical examination, signs of admission P/A 120/60 mmHg, HR 78 x min, Fr 16

Upon admission on 8/8/2017 14:21:16 with the diagnosis of:

● Displaced fx of the base of the right 2nd metatarsal

Dosing with tinzaparin 3500 U SC in pm, Ranitidine 50mg PO HS and AM,

Patient is scheduled for surgery on August 10th.

Patient is classified as ASA I with 60kg weight, BMI: 25

The patient is placed in a supine position, monitoring continues without changes.

Sedation is administered 3 mg midazolam

The admission diagnoses were:

The dose of norepinephrine is increased, which improves P/A. It is decided to

It is decided to start anti-ischemic therapy with aspirin, clopidogrel, atorvastatin,

Subsequently, he presents other episodes of supraventricular tachycardia, which is

Patient is diagnosed with ventilator-associated pneumonia, antibiotic coverage:

The patient's sedation is withdrawn and neurological deficit is evident, so she is

The patient is scheduled for an electroencephalogram, however the patient has

Patient died on 8/20/17 at 1:00 am with a diagnosis of refractory shock.

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