Professional Practice Issues in Nursing: A Case Study Analysis

Running head: ASSESSMENT 2 1
Assessment 2
Student’s Name
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ASSESSMENT 2 2
Assessment 2
Criteria 1. Case Summary: Summarizes the case and presenting professional practice
issues.
This is a case of patient A, who is 81years and had come to the hospital on day one
complaining of feeling breathlessness for two nights when she lied flat. When examined she was
discovered to have fine creeps at the base of her lungs and an elevated jugular venous pressure.
She was immediately put on an oral Lasix dose to control the condition. The following day she
came back complaining of worsened symptoms where an x-ray and blood test were done. Since
the condition had worsened, she was admitted to the facility for further observation and
treatment. On the 4th day, a VMO reviewed the patient and observed that she was having
diarrhea and tenderness in the right abdomen. Her atrial fibrillation had also changed and she
reported feeling dizzy. She started refusing food where the VMO was forced to recommend for a
V/Q scan whose justification has not been given and the findings not justified. The following
day, 0830hrs the VMO assessed the patient and reported that she was depressed and anxious due
to failure to it which led to the need for the nurse to mobilize her. The patient continued
worsening where she became tachycardic, woozy, cold and feeling back pain. On the following
day, the patient became pale, grey, felt nausea, had a clammy skin and was unable to void. At
1330hrs on the sixth day, an assessment revealed that her white cell count had increased to 17.5
and no fever had been reported. When the registered nurse John reported on duty she reviewed
the medical notes and observed that the hospital was unequipped to take care of the condition of
the patient. Dizziness, low blood pressure and abdominal pain increased as time went on. During
1810hrs the RN reviewed the patient and performed an ECG on the patient although this was not
documented. An ISBAR form was filled at 2100hrs in preparation for the locum who came later

ASSESSMENT 2 3
and requested for a large IV cannula to be used to treat dehydration. Since the condition had
worsened the locum and RN started the process of referring the patient to the nearest rural
hospital where the patient died while being transported. The patient later died the following day
with the cause of death being septicemia.
Criteria 2. Contributory factors: Identify relevant professional errors that potentially
contributed to the incident happening?
The Nursing and Midwifery Board of Australia (2016) in standard five suggests that the
professional is supposed to develop a plan for practice that will be used in caring for the patient.
This means that there is a need to think critically and analyze information to use in nursing
practice. The challenge faced by patient A is the fact that most of the information collected from
the patient was not used in informing the care process that was done on the patient. This is why
there were delays in referring to the patient even after the registered nurse had clearly stated that
the hospital was not well equipped to handle the patient. Finnell, Thomas, Nehring, McLoughlin,
& Bickford (2015) addds that when standards are not followed, proffesionals are prone to make
mistakes and even risk the life of the pateint. The fourth standard also requires healthcare
professionals to comprehensively conduct an assessment on the patient to inform decision
making. This standard was not followed since errors were made as seen in the inconsistencies in
collecting and assessing patient information. Every sign and symptom that the patient showed
during the assessment was used not used in informing the care that the patient receives. This
means that the practitioners failed to observe the standards of practice and even the code of
ethics for practice.
From the case study, it is evident that the medical team failed to diagnose the changing
condition of the patient from the second day onwards. Furosemide (Lasix) as a drug has side