Patient: M.T., 44-year-old warehouse supervisor
Chief concern (Day 1): “Bad low-back pain after lifting a box.”
Home AI tool: Patient uses the health system’s portal symptom-checker chatbot. After entering “low back pain,”
“both legs tingling,” “can’t feel when wiping,” and “peeing less than usual,” the bot outputs “likely muscular
strain home care; clinic visit in 3–5 days.” No red-flag alert is displayed.
Course:
• Day 2–3: Pain worsens; bilateral sciatica, saddle numbness, and urinary retention (“I haven’t peed since
last night unless I strain”). The bot again recommends home care.
• Day 4 (ED): Patient febrile, hypotensive, confused. Bladder scan >1200 mL; purulent urine after
catheterization. MRI lumbar: massive central L4–L5 disc herniation compressing cauda equina.
• Labs: Leukocytosis, lactate 5.2 mmol/L, creatinine bump.
• Outcome: Despite urgent decompression and broad-spectrum antibiotics/ICU care, the patient develops
uroseptic shock with multi-organ failure and dies on Day 6.
Studies show online/AI symptom-checkers vary widely in diagnostic/triage accuracy and may miss
emergencies; WHO and AHRQ urge caution and human oversight for clinical AI
Clinical reasoning.
Competency Evaluate factors integral to clinical reasoning. Student Success Criteria View the grading rubric for this deliverable by selecting the “This item is graded with a rubric” link, which is located in the Details & Information pane. Scenario You recently started a new position as a nurse manager in a