Case Study Analysis Assignment 2022

Running head: CASE STUDY ANALYSIS
CASE STUDY ANALYSIS
Name of the Student
Name of the University
Author Note

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CASE STUDY ANALYSIS
Criteria 1
Patient A is an 81 year old woman and diagnosed with shortness breath at the GP
clinic with the complaint of breathing issues when lying flat. After examination it has been
found that the patient have crepes in both the lungs along with the elevated venous pressure
in the neck. Primarily her renal function and vital signs excluding the respiratory condition
was normal and thus the GP recommended oral administration of Lasix. However, the patient
was again admitted to the hospital as her condition had not been improved by the
implementation of the medicine. As time proceeds the patient showed no improvement and
the visiting medical officer (VMO) planned an X-ray and blood test. The VMO found that the
patient is having diarrhea and tenderness in the right abdomen. Hence, the VMO organized a
ventilation/perfusion (V/Q) after which the patient found to be in dizzy condition and also
having an atrial fibrillation. At this moment the VMO stated that the V/Q scan was inter-
determinate. On the other hand the patient at this point was refusing food or liquid intake and
complaining that she is feeling week and having abdominal pain. Next day the VMO stated
that the patient is depressed and anxious and needs mobilization. After which the patient’s
discharge planning was done however, the nursing note stated that the patient was feeling
unwell, having a 28-30 respiration rate whereas other vital signs were normal. With time it
has been seen that the patient was deteriorating with times and she was getting immobile with
time and also having back pain. The patient was not diagnosed by her responsible doctor as
the doctor gone away and was not contactable. With time her respiratory rate reached to 40
and she found to have a tachycardia and her skin was pale and feeling woozy. Hence, the RN
engaged for the investigation for the case. The RN organized a locum who can be able to
attend the patient. Her dizziness increased along with the abdominal pain (8/10). Her blood
pressure was getting low up to 89/53 and the respiratory rate was 40 to 44. The patient was
reviewed by the locum, RN and the RN provided an En for the patient. This observation

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CASE STUDY ANALYSIS
found that the patient have increasing diarrhea and the vital signs were not normal as well.
After this condition the clinical nursing manager came and advised to take medication from
the drug safe of another patient. The RN conducted an ISBAR in next observation however,
the condition of the patient has been deteriorating and it should be observed and reviewed as
soon as possible (Kitney et al., 2016). After this the on call doctor came and reviewed the
patient and inserted a large bore IV cannula to treat the dehydration of the patient. At night a
transport facility has been organized to transfer the patient to a rural referral hospital. Next
morning the patient tragically died due to septicemia when the evaluation of the patient done
by the air evacuation team.
Criteria 2
In this case there has been seen many ethical breaches which can be highlighted as the
cause of the tragic outcome. Firstly the improper observation process and the absence of the
doctor leads to the deterioration of the patient in a severe condition. There has been no
indication of the oxygen supplementation or medication providence to the patient for
addressing the breathlessness or dehydration of the patient (Sanford et al., 2015). On the
other hand the abdominal or back pain of the patient was not properly evaluated by the VMO
as well. When the RN was involved for the investigation it was already very late for the
patient (Dehghani, Mosalanejad & Dehghan-Nayeri, 2015). Secondly it has been seen that the
clinical nursing manager provided medication to the patient without the doctor’s prescription
and the medication was taken from another patient’s drug safe. Thus it can be stated that the
patient’s medication management process has been breached and the nursing care has not
followed the NMBA standards which includes the patient centered care, common good for
the patient and the nursing ethics of the beneficence, non-malificence have also been
breached in this case (Nursingmidwiferyboard.gov.au, 2019). Hence, it can be stated that the
process of the care was not adequate and also the patient was attended by the doctor and also