Below is a summary of Stewart’s electronic health record (EHR) activity during his 10-day stay in the hospital. As a physician, you are responsible for examining Stewart, ordering tests and procedures and diagnosing his condition. Using his EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Stewart’s healthcare team.

1. Review Stewart’s Inpatient EHR: You review the results of Stewart’s complete blood count (CBC) and notice that his white blood cell (WBC) count is high. What are his results?
   
   Internet Research: What causes high WBC counts?



2. Internet Research: You need to determine how much damage the ulcer on his leg has caused. You order an arteriogram and a CT scan of the leg. What is the purpose of these tests?
   
   Review Stewart’s Inpatient EHR: What do Stewart’s results indicate?



3. Internet Research: Stewart’s culture wound test is positive for a Methicillin-resistant Staphylococcus aureus (MRSA) infection. Why is it important to know these results in trying to treat the wound?



4. Internet Research: Based on the radiology tests and results of the culture wound, you determine that Stewart’s wound has progressed to wet gangrene; the underlying cause is diabetic neuropathy. What is wet gangrene?

Below is a summary of Stewart’s electronic health record (EHR) activity during his 10-day stay in the hospital. As a nurse, in addition to getting Stewart prepared for the tests and procedures ordered by the physician, you are responsible for obtaining, reading and monitoring his vital signs. Using his EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Stewart’s healthcare team.

1. Internet Research: Even though he has been prescribed Metformin and has an insulin pump, you notice that based on his Hgb A1c results, Stewart has not been regulating his blood glucose. Why is it dangerous that Stewart does not control his type 2 diabetes?



2. Review Stewart’s Inpatient EHR: You review Stewart’s Lipid Panel results. What do these results indicate?
   
   Internet Research: What are the possible effects of high cholesterol and high blood sugar on Stewart’s health?



3. Internet Research: Stewart will have a CT scan and arteriogram of his leg. You also prepare him for a Doppler ultrasound. What is this?

Review Stewart’s Inpatient EHR: What do the results of Stewart’s CT scan, arteriogram and Doppler ultrasound indicate?

Below is a summary of Stewart’s electronic health record (EHR) activity during his 10-day stay in the hospital. As a laboratory or radiology technologist, you are responsible for obtaining and providing test results to assist the physician in diagnosing Stewart’s condition. Using his EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Stewart’s healthcare team.

1. Internet Research: Stewart’s hospital physician believes that the ulcer on Stewart’s leg is gangrenous. As a lab technologist, you will run a culture on the ulcers to confirm the physician’s suspicions. Why is a deep infection with gangrene dangerous for a diabetic?



2. Internet Research: The physician orders a CT scan, an arteriogram and a Doppler ultrasound for Stewart’s leg. Explain what information the three procedures will provide.
   • CT scan
   • Arteriogram
   • Doppler ultrasound



3. Review Stewart’s Inpatient EHR: Stewart has several blood tests that provide important information. What are Stewart’s results for each of the tests listed below?
   • Complete blood count (CBC)
   • Lipid Panel
   • Coagulation test
   • Glucose A1c (glucose) test
   
   
   Internet Research: What does each test measure?
   • Complete blood count (CBC)
   • Lipid Panel
   • Coagulation test
   • Glucose A1c (glucose) test

Below is a summary of Stewart’s electronic health record (EHR) activity during his 10-day stay in the hospital. As a pharmacist, you are responsible for ensuring that Stewart receives the proper medications ordered by the physician. You are also responsible for reviewing any adverse interactions Stewart might have with his current medications. Using his EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of Stewart’s healthcare team.

1. Review Stewart’s Inpatient EHR: You review Stewart’s total cholesterol results, including his LDL, HDL and triglycerides. What are his Lipid Panel (cholesterol) results?
   
   Internet Research: What types of medication would you recommend to control his cholesterol? Provide a brief sentence regarding how each medication works.



2. Review the Video: Stewart has an insulin pump to help control his type 2 diabetes. Watch the video on insulin and explain how it works.
   
   
   Internet Research: In addition to the insulin pump, Stewart is also taking Metformin. What is Metformin and how does it work?
   
   Internet Research: Why are both medications beneficial in type 2 diabetes management?



3. Review Stewart’s Inpatient EHR: Stewart must continue to take his insulin and Metformin. In addition, three other medications are recommended by the physician. What are these medications?
   
   Internet Research: What is the purpose of these three medications?

Below is a summary of Stewart’s electronic health record (EHR) activity during his 10-day stay in the hospital. As a medical and health services manager, you are responsible for making sure he receives excellent care. You will also figure Stewart’s bills, consisting of his tests, procedures, room charges, supplies and medications. Using his EHRs, Virtual Physical Exam (VPE) and Internet research, fill out the billing statements and be prepared to share this information with the rest of Stewart’s healthcare team.

• MHSM – Bill; (includes both a PCP and Inpatient statement)
• MHSM – Bill Reference
• Stewart’s EHR – PCP Chart
• Virtual Physical Exam
• Stewart’s EHR – Inpatient Chart (link below)

1. Use the blank copies of Stewart’s PCP and Inpatient bills and the Bill Reference to calculate his costs. In his EHRs, look for the number of times a test is administered, number of days a cost is incurred or the units per day a medication is administered. You may need to do additional Internet research. Some helpful sites are www.healthcarebluebook.com, www.fairhealthconsumer.org and www.pharmacychecker.com.

Below is a summary of Stewart’s electronic health record (EHR) activity during his 10-day visit to the hospital. As a health coach, your job is to recommend lifestyle changes to alleviate symptoms, prevent symptoms from recurring and decrease the need for future emergency care or hospitalization. You will also provide the education Stewart needs to understand his diagnosis and the risk factors that may have caused his condition. Using Stewart’s EHR and Internet research, answer the questions and be prepared to discuss the responses with the rest of his healthcare team.

1. Review Stewart’s Inpatient EHR: You notice that Stewart’s blood pressure, Lipid Panel and BMI results are abnormal. What are Stewart’s results?
   
   Internet Research: What are the normal/healthy ranges for each test?



2. Internet Research: The most important part of Stewart’s recovery will be centered on education. What do you tell Stewart about each problem (listed below) and how reaching and maintaining healthy levels can affect his health?
   • Blood pressure
   • Cholesterol
   • Weight
   • Exercise
   • Glucose monitoring



3. Internet Research: You also want to reiterate to Stewart about the dangers of high blood glucose and not managing his type 2 diabetes. You explain that diabetes management is more than just taking medication, eating right and exercising. He must also monitor several areas of his health and body. What other areas will Stewart (and his physician) need to monitor?