Setting: You are a junior doctor based on a surgical firm.
Patient: Kane White (DOB 22/03/1972, Hospital number 723111, Address: 12 Smith Street, Wareham, WR22 2HD) has come in this afternoon for admission prior to his Whipple’s procedure tomorrow.
He has a history of pancreatic cancer, hypertension and peripheral vascular disease.
He does not have any allergies and weighs 81kg.
He brought a list of his medications (click to enlarge):
The patient says he stopped aspirin 6 days ago as advised by an anaesthetist he saw in clinic.
Blood results: Hb 103 g/L (130-180), WCC 4.5 x10^9/L (4-11), Plt 266 x10^9/L (150-500), Na+ 137 mmol/L (133-146), K+ 4.5 mmol/L (3.5-5.4), Ur 4.5 mmol/L (2.5-7.8), Cr 92 mmol/L (59-104), Mg 0.4 mmol/L (0.8-1.0), INR 1.0 (0.8-1.2)
Task: Please complete the patients drug and fluid prescription charts. You have clarified with your consultant and she has specified:
- The patient should have venous thromboembolism prophylaxis this evening but not on the day of the operation
- The patient should have maintenance intravenous fluids overnight as he will be nil by mouth from midnight (please prescribe 2L initially in case of delay in list)
- Aspirin can be resumed on day 5 post-op
- Any antihypertensives should not be given today or on the day of the operation
- Any electrolyte abnormalities must be corrected intravenously
Please also write up an antiemetic and paracetamol in case the patient needs them post-op.
You have 8 minutes and there will be no questions. Your national formulary (e.g. BNF in UK) is available if needed.
Drug chart can be printed here. Fluid chart can be printed here.
There is no patient present in this station.
An example of a correctly completed drug chart can be viewed here.
An example of a correctly completed fluid chart can be viewed here.
