Witchcraft Escape Room

Witchcraft Escape room

Witchcraft Manual

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Instructions

Andreas Rosa presents to the ER on Halloween night. He is a 6 year old with a hx of type 1 DM since age 5. He has had a fever and cough for the past 2 days. He is not eating or drinking well. He will repond to your questions but is lethargic. He has been unable to keep OTC meds down d/t coughing. His glucometer is broken and his mom has been unble to afford to replace it. She has been only giving him 1/2 of his scheduled insulin to save money. His normal dose when they can afford it is: NPH: 5 units SQ daily in the am; 3 units SQ in the evening; Sliding scale Regular before meals and at bedtime. Andreas is up to date on his immuniztions. He has had no surgical procedures. His only reported allergy is a runny nose during ragweed season.

Complete each Lesson to help Andreas manage his type 1 DM.

Lesson 01

Haunted Forest: venture forth and reach the end of the path

Magical Progress

NS infusion at 20 mL/kg

Potassium 40 mEq IV in 50 mL

D50% 1-2 mL/kg IV

Regular Insulin continuous infusioin

Question 1/4

After completing your initial assessment which order would you initiate FIRST for Andreas?

Question 2/4

Andreas VS are: HR: 136, BP 75/55, RR 38, SaO2 90% on room air Temp 37.0. EKG shows Sinus Tach, he has fruity smelling breath, he is oriented to person, place and time ,but is lethargic. PERRLA is WNL. What intervention is your priority

Apply O2 to keep sat above 92%

Put him in a gown

Draw CBC

A warm blanket and a glass of water

Question 3/4

What lab would be priority?

Stat Glucose at bedside

CMP

UA with reflex to culture

Question 4/4

Watch the following video on DKA by clicking on the link. What type of respirations help to correct DKA by correcting acidosis?

Cheyne Stokes

Apneic

Biott

Kussmaul

Well done!

Lesson learned!

Continue

You fell!

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Lesson 02

Potions. Drag the circleover the potions tofind the missing letter.

Magical progress

Question 1/4

What lab value requires immediate attention?

K- 3.2

Na 140

Cr 0.8

Drag the circle and findthe lab.

Question 2/4

How many mLs bolus would you administer for Andreas based on the following: Wt 22 kg. Order: NS 20 mL/Kg

300

440

250

Drag the circle and findthe bolus.

Question 3/4

DKA presents as Metabolic Acidosis.

True or False

True

False

Drag the circle and findthe correct answer

Question 4/4

Which of the following orders should be done FIRST? You have already started an IV and completed a bolus of 440 mL NS. A: Start Regular Insulin gtt per order B: Verify Potassium Level and start ordered Potassium C: Order DM diet tray from the kitchen

Drag the circle and findthe letter.

Well done!

Lesson learned!

Continue

Oh no! You have added the wrong ingredient to the mixture and created poison, go back to correct the mixture.

It's poison!

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Lesson 03

Divination. Can you predict the future by looking at a single card?

Magical Progress

Question 1/4

These labs are consistent with what condition?

Clue

Hypothyroidism

Hyperglycemic hyperosmolar state (HHS)

00:10

DKA

Acute MI

Question 2/4

These labs are consistent with what condition?

Clue

Hypothyroidism

Hyperglycemic hyperosmolar state (HHS)

00:10

DKA

Acute MI

Question 3/4

What findings in Andreas history would not have contributed to his current status?

Clue

Allergy to Ragweed

Fever and cough for the last 2 days

00:10

Decrease in regular insulin dose

Not eating or drinking for the last 2 days

Question 4/4

What word is used in witchcraft to refer to the ability to see and communicate withthe dead?

Clue

Telepathy

Called back

00:10

Necromancy

Deathitis

Well done!

Lesson learned!

Continue

Bad omen!

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Lesson 04

Enchantments Which of these options is the best choice?

Magical progress

Question 1/4

Andreas becomes increasingly agitated and combative. The provider orders a head CT. What complication of DKA is the highest priority?

• Immediately give mannitol 0.5 to 1g/kg IV over 10-15 min. Mannitol can be repeated after 30 min. Effects generally are quickly apparent
• Adjust fluid administration as indicated to maintain normal BP
• Intubation may be necessary for pts with abnormal respirations or to protect the airway.

• Change IV Regular insulin to Sliding scale
• Start an IV of D51/2NS stat
• Call Lab to get a stat CMP
• Get a CT of the abdomen
• Start IV Dilantin to prevent seizure activity

Question 2/4

In a freak Halloween snow storm, Andreas can not be transferred out due to visbility and ice on the roads. What set of treatments would be appropriate to treat his suspected cerebral edema?

150-250

80-140

Question 3/4

Cerebral Edema has been ruled out for Andreas and he is being prepared to be admitted to the ICU until it is safe to transfer to PICU. What should his goal blood glucose range be?

False

True

Question 4/4

When Andreas blood sugar is 150 you should contact the provider. True or False

Manual completed

Congratulations!

Magical progress

Badchoice!

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You can nowpractice sorcery!

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Your progress will be lost and you will not learn witchcraft

Exit

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Become an expertin witchcraft!

To do this, you must complete the wizardry manual by overcoming each of the 4 lessons you will find: · Bewitched Forest· Potions· Divination· Enchantments. Test your magical skills and try not to fail or you will have to retakethe test.