Case Study: Nurse Handover for Fred's Chemotherapy Side Effects, QAS

This case study presents the scenario of Fred, a patient experiencing adverse effects from chemotherapy, including nausea, vomiting, and pain. As a community general practice nurse, the author details Fred's medical history, which includes COPD, osteoarthritis, and type 1 diabetes. The assessment highlights the patient's declining vitals, including low blood pressure, high respiration rate, and low oxygen saturation. The nurse provides an ISBAR handover, detailing the situation, background, assessment, and recommendations, which include oxygen support, intravenous fluids, and further imaging. The case study emphasizes the need for immediate intervention to address the patient's fluid imbalance, pain, and respiratory distress, offering a comprehensive approach to patient care in a critical situation.

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

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CASE STUDY
INTRODUCTION
I am the general practice nurse in the community. I am responsible for taking care of
the patients under my charge. I have patient who has lately shown some symptoms for which
he needs better treatment.
SITUATION
I have a patient who is known by the name Fred. Lately he has been showing quite a
few symptoms of discomforts and ailments after the initiation of the chemotherapy treatment.
His condition was also deteriorating and his vitals were declining as well and that is the
reason I called you to admit him to the hospital. He underwent bowel resection 8 weeks ago
and his chemotherapy treatment initiated 2 weeks ago. However, he is showing symptoms,
which have raised my concerns, are his continuous vomiting since the last 3 days and his
decreased food intake because of the nausea.
BACKGROUND
The patient has a medical history of suffering from compulsive obstructive pulmonary
disorder (COPD) since the past 15 years, osteoarthritis, and diabetes mellitus type 1. He uses
salbutamol inhaler for easing his discomforts and smoke rarely. He also consumes over the
counter medication (OTC) and paracetamol PRN. He uses insulin with meal as well as per
requirement. The patient was diagnosed with bowel cancer and had to undergo bowel
removal resection 8 weeks ago at a local hospital. After they underwent the surgery the
doctors prescribed undergoing chemotherapy treatment, which initiated 2 weeks ago. It has
been 3 days since he started showing symptoms or side effects of chemotherapy such as
vomiting and nausea that further stopped him from uptaking food. His vomit quantity was

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CASE STUDY
about 350 ml however; his intake was 30 ml, which is also a reason for concern. He is also
facing a pain in their backs and legs, which showed result of 7/10 on the pain scale.
ASSESSMENT
The patient’s condition is serious. He is vomiting at an alarming rate and his nausea is
not allowing him any oral intake. This would result in fluid imbalance, as fluid intake is less
than fluid output. His blood pressure level is 110/60, which also means deficiency of
electrolytes (Collis & Mather, 2015). The pain assessment scale shows a 7/10, which
indicates severe pain and might be because of the osteoarthritis he already has (Rijkenberg et
al., 2015). His respiration rate is 26 breaths per minute, which is much higher than the normal
rate i.e., 20 breaths per minute and it indicates the relapse of (COPD). His SpO2 level is 91%,
which is quite low than normal (Khachaturian et al., 2018).
RECOMMENDATION
The patient requires oxygen support as soon as possible to support his breathing. He
should also be incorporated with intravenous fluid to replenish the fluid content of his body.
He should also undergo X-ray imaging to understand the reason for his back and leg pain.

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CASE STUDY
REFERENCE
Collis, E., & Mather, H. (2015). Nausea and vomiting in palliative care. Bmj, 351, h6249.
Rijkenberg, S., Stilma, W., Endeman, H., Bosman, R. J., & Oudemans-van Straaten, H. M.
(2015). Pain measurement in mechanically ventilated critically ill patients: behavioral
pain scale versus critical-care pain observation tool. Journal of critical care, 30(1),
167-172.
Khachaturian, Mark, Michael Smith, Irwin Gross, and Christine Tengler Cherepy. (2018)
Multi-Vital Sign Detector of SpO2 Blood Oxygenation and Heart Rate From a
Photoplethysmogram Sensor and Respiration Rate, Heart Rate Variability and Blood
Pressure from a Micro Dynamic Light Scattering Sensor in an Electronic Medical
Records System. Google Patents.