Evidence Based Nursing Research

Running head: EVIDENCE BASED NURSING RESEARCH 1
Evidence Based Nursing Research
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Author’s note

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Table of Contents
Introduction......................................................................................................................................3
Two signs and symptoms related to case study...............................................................................3
Relating it to the patho-physiology of the patient presenting problem...........................................3
The priority problem chosen............................................................................................................4
Justification of the problem chosen.................................................................................................5
Intervention chosen to address the problem....................................................................................6
Collaborative or pharmacological intervention:..........................................................................6
Nurse initiated intervention.........................................................................................................7
Evaluate efficacy of the chosen interventions.................................................................................7
One psycho social issue from the case study and ways to address it using patient centred
approach...........................................................................................................................................7
Conclusion.......................................................................................................................................8
Reference.........................................................................................................................................9
Appendix........................................................................................................................................11

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Introduction
The essay aims to discuss about the pathophysiological conditions related to Acute
lymphoblastic leukaemia, a type of cancer affecting the bone marrows and blood contributing
to risk of bleeding and frequent infections for patient. The current essay utilizes the NMBA
standards for critically assessing the case study of Elodie Greer, a 14 year old girl with a
previous diagnosis of Acute Lymphoblastic Leukaemia and providing the best care to patient. In
addition, the essay makes use of knowledge related to pathophysiology, physiology and
anatomy to support decision making based on evidence for provide suitable care plan.
Two signs and symptoms related to case study
The matter of concern in the mentioned case study can be as follows; Elodie is a lively
child. However, with the passage of time she exhibited episode of malaise making her parents
worried. In addition to that Elodie was additionally suspected to have sepsis secondary to an
infected Hickman’s line. The dryness of mouth and dark urine is critical health concern for
patient. However, the incident of allogeneic stem cell transplant is termed as a potential cause of
concern that may lead to severe series of co-morbid conditions.
Relating it to the patho-physiology of the patient presenting problem
The Hickman line is a catheter used for administrating drugs during the event of
chemotherapy. There remains no evidence that the Hickman line was flushed once a day with
heparin solution; that can be termed as one of the leading cause of sepsis. On the basis of
objective data, it can be easily stated there is a rise in level of white blood cells. According to the
study by Cicconi and Lo-Coco (2016, p. 1476), increase in the amount of WBC is not related to

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specific disease; rather it indicates problems such as stress, infection or trauma. A large count of
lymphocyte is likely to occur in presence of bacterial or even viral infection.
In addition to that the patient exhibits tachycardia which is a common feature associated
with sepsis. Tachycardia is termed as a common feature of sepsis which is indicative of response
to stress. The mentioned event is a systematic response towards stress leading to psychological
mechanism increasing i cardiac output coupled with high rates of oxygen delivery to tissues
(Cicconi et al. 2016, 1987). With onset of tissue hypoperfusion, there is a rise in rates of
respiration compensating for metabolic acidosis.
The dark yellow urine cannot be termed as a major clinical problem for patient; however,
currently it does not pose threats in relation to sepsis. The yellow colouration of urine is
generally due to presence of pigments such as urochrome or urobilin. The dark yellow urine in
the mentioned case is commonly due to dehydration. The mentioned case study gives clear
understanding that Elodie exhibits symptoms of dryness in mouth and no passing of urine.
The priority problem chosen
In regards to the series of chosen problem, it can be clearly stated sepsis is a problem that
demands immediate priority. Elodie was diagnosed with Acute Lymphoblastic Leukaemia,
corrected with chemotherapy. She additionally received allogenic stem cell transplant. The
allogenic stem cell transplant involves donation of healthy multipotent stem cells. Thus, it is very
likely that that Elodie’s body may reject the cells of the donor. In addition to that, it can be stated
there remains probable chances of sepsis in case of Elodie.
In case the sepsis along Hickman Line, prompt action must be undertaken. Sepsis is often
termed as a life threatening organ dysfunction initiated due to dysregulated host response