Case Summary: Summarizes the case and presenting professional practice issues

Running head: BEING A PROFESSIONAL NURSE 1
401021 Being a Professional Nurse or Midwife – Assessment 2
Student’s Name
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BEING A PROFESSIONAL NURSE 2
Criteria 1. Case Summary: Summarizes the case and presenting professional practice
issues.
The case of 81year old patient A started with a complaint of breathlessness for two nights
when lying flat where the medical examination revealed that there were fine creeps at the base of
the lungs and elevated jugular venous pressure. This led to the commencement of Oral Lasix
treatment but the justification for the drug and the dosage have not been recommended. The
patient’s condition became worse where there was need for a chest x-ray and blood tests were
done. From the case study, one professional issue that was noted is the failure of the nurse to
observe the symptoms after being given Lasix. This drug has severe side effects that can affect a
patient and thus requires close observation to monitor the symptoms that develop as a result of
the side effects that arise from this drugs. Despite the fact that there were changes that were
observed on the patient, it is evident that this was not considered. The second professional issue
is the failure to document the changes in the patient especially after admission. It is evident in the
case study that the RN failed to document the observations that he was making on the patient
even when the condition was deteriorating. The role of documentation of vital signs and
symptoms is to determine the response of the patient towards the medication. This was
compromised thus affecting the care that the patient received. This means that the locum and
even the air evacuation team did not have complete notes on the patient that could assist them to
make clear decisions. The third professional issue is the admission of the patient in a critical
condition and yet there was no locum to attend to her. The patient stayed in the hospital for four
days before the locum came to see her. Even when the registered nurse indicated that the hospital
was not well equipped to handle the situation of the patient, this advice was ignored and the

BEING A PROFESSIONAL NURSE 3
patient was forced to wait for the locum which compromised the quality of care that she
received.
Criteria 2. Contributory factors: Identify relevant professional errors that potentially
contributed to the incident happening?
One professional error in the case study is the failure by the medical team to identify the
side effects of the drug (Lasix) that was administered to the patient. From the case study, the
medical team have not indicated if they stopped administering lasix to the patient when she was
admitted or not. According to Casu & Merella (2015) lasix can cause depletion of body water,
sodium, and chloride and thus the need for close examination of the patient when under this
medication. The ACSQHC under medication safety requires hospitals to define and verify the
scope of practice for prescribing, dispensing and administering medication. This was missing
since the side effects that the patient was experienced were ignored and not assessed to
determine the effect on the patient (Australian Commission on Safety and Quality in Health
Care, 2017). From the case study, it is noted that this was not done well since the patient was
treated and left to go home and only admitted after the condition failed to improve. Further, Won
& Sang (2015) adds that the threshold of the dose differs from patient to patient and from the
case study we have not seen where the dose was prescribed and specifically what the drug was
prescribed for in the case of the patient. In addition to that, the patient had difficulties to void
which was reported after the administration with Digoxin and Valium due to the increased heart
rate of 168/min.
Another error that was made by the medical team is the failure to document the
observations that were made on the patient properly. Oczkowski, Mazzetti, Meade, & Hamielec
(2014) argue that furosemide (Lasix) has several side effects that require monitoring and