The Case of the Missionary Health Care Worker in Africa
Jenny, a twenty-two year old college graduate, has recently decided to spend two years as a missionary in a coastal African village. As part of her duties, she will work in the missionary clinic that has recently been established in the village. This clinic will provide routine medical care and a traveling physician and nurse will visit once each week. Jenny feels fortunate to have the opportunity to use the information that was presented to her in various classes she completed while in college. After completing a 4-month intensive training period (language classes, medical preparation for work in the clinic, and cultural enrichment), she departed for Africa.
Upon her arrival, Jenny found that she would be spending most of her time in the clinic since the village had been without routine medical care for the past 2 years. The previous clinic was closed due to flooding and insufficient funds to rebuild. Initially, Jenny found that she was very dependent upon the physician’s weekly visits since her training was limited. Gradually, she found that she was beginning to call upon her training (both clinical and classroom) and she felt comfortable diagnosing and treating some of the more routine cases. One morning, a mother came in with her five-year-old child. The mother reported that the child had been unable to eat or drink anything for the past day because of vomiting. In addition, her child was experiencing severe diarrhea. Jenny asked the mother if any other family members were exhibiting similar symptoms, to which the mother replied that a few other members of the family had similar symptoms, however, not as severe. Jenny’s first thought was that the symptoms were very similar to those she had exhibited following a bout of food poisoning while in college. Since the villagers had no refrigeration and poor sanitation, Jenny gave the mother an electrolyte solution containing glucose similar to Gatorade® and told the mother to have the affected children consume this solution and nothing else for the next 24 hours. After that time, if the children were no longer vomiting, she could start feeding them tea and broth. Jenny also cautioned the mother that if the children did not seem to be getting better after 24 hours to bring the children back to the clinic.
The next morning Jenny opened the clinic to find the mother, and not just the child she had seen the previous day, but three more of the woman’s children. All of the children were exhibiting similar symptoms that now included muscle cramping and excessive thirst in addition to diarrhea and vomiting. When checking the vital signs of the children, Jenny noticed increases in both the pulse and respiratory rates accompanied by decreased blood pressures. Uncertain as to the appropriate course of action, Jenny contacted the physician by radio. Upon conveying the histories and information to the physician, Jenny received instructions to keep the children at the clinic, start intravenous (IV) infusion with lactated Ringer’s solution, and allow the children to drink as much of the electrolyte solution with glucose as they would like. The physician also gave Jenny a list of laboratory tests to run on the blood, urine and stool samples that she should collect. Jenny started the IV infusions and gave each child some of the electrolyte solution. After this, she obtained stool, blood and urine samples from each child and asked the mother to leave the children with her for care and observation. The mother agreed and said she would return later that night to help with the children.
The results of the tests run indicated severe metabolic acidosis, an increased hematocrit, hypokalemia, and the presence of Vibrio cholerae bacteria in the stool samples. Based on the results of these tests, the physician and Jenny diagnosed the children with cholera and obtained a more detailed history in an attempt to determine whether these individuals were the only ones exposed or whether these cases were the first of a possible epidemic. Jenny and the physician found that the family had recently visited relatives in a distant village where similar symptoms had been present in a number of families that had all celebrated a recent shellfish harvest.
The physician prescribed continued IV infusions with lactated Ringer’s solution and electrolyte fluid replacement by mouth. The children were not allowed to consume other foods or drinks, especially coffee or any other beverages containing caffeine. The children were also told that once the vomiting stopped they could start consuming solid foods. The children were all treated with antibiotics and stool samples were taken from other family members to determine whether or not they were infected with Vibrio cholerae. Infected, asymptomatic individuals were treated with antibiotics. The physician later explained to Jenny that caffeine was prohibited because the toxin produced by the bacteria (termed choleragen) binds to the surface of the epithelial cells of the small intestine and activates adenylate cyclase. In addition, the toxin interferes with the active transport of sodium ions in the intestinal lumen.
Why did Jenny initially suspect that the child and other family members were experiencing food poisoning? Upon further evaluation on the second day why would the child present an increased pulse and respiratory rate but decreased blood pressure?
Here are the discussion board requirements.
Why Work with Us
Top Quality and Well-Researched Papers
We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university or professional, and we will assign a writer who has a respective degree.
Professional and Experienced Academic Writers
We have a team of professional writers with experience in academic and business writing. Many are native speakers and able to perform any task for which you need help.
Free Unlimited Revisions
If you think we missed something, send your order for a free revision. You have 10 days to submit the order for review after you have received the final document. You can do this yourself after logging into your personal account or by contacting our support.
Prompt Delivery and 100% Money-Back-Guarantee
All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.
Original & Confidential
We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.
24/7 Customer Support
Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.
Try it now!
How it works?
Follow these simple steps to get your paper done
Place your order
Fill in the order form and provide all details of your assignment.
Proceed with the payment
Choose the payment system that suits you most.
Receive the final file
Once your paper is ready, we will email it to you.
No need to work on your paper at night. Sleep tight, we will cover your back. We offer all kinds of writing services.
No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.
Admission Essays & Business Writing Help
An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.
Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.
If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.