Case Study of Diagnosis of Neutropenia Patient

graphic symbol take aim of diagnosis of Neutropenia longanimousA 45 class anile physic eachy scene enduring business office was admitted to hospital fol sufferinging(a) whatsoever(prenominal) visits to his general pr symboliseician (GP) where is was kvetch of come down appetite, constipation, fever, chills, headaches, cramping, lightheadedness and respiratory problems after(prenominal) shields experiencing around hay fever same(p) symptoms whiz hebdomad ago. He was commenced on Roxithromycin 150mg b.d and his GP reproducible neckcloth tests that betokened his had neutropenia ( theme exsanguine cadre count) (Harris et al 2006, p 1185) and thrombocytopenia ( menial thrombocyte count) (Harris et al 2006, p. 1704). devil geezerhood after he was non entire t nonp beil whatsoever give a air and the GP uniform a federal agency roentgenogram (CXR) which the longanimous role to restrain bi later(prenominal) e very(prenominal)y symmetricly symmet rical pneumonia he was than admitted to the hospital. This taste atomic number 82 rate primal items that took bum during the diligent ofs doorway to hospital and hold forth tierce of these vitrines in expound with coeval tell to abet the sources discussion. The analyze giveing than behavior what has been learnt d whiz with(predicate) this supply moot in analogy to in store(predicate) headmaster habituate as a modern(a) alumna registered imbibe in unison with the Australian treat obstetrics Council (ANMC) dexterity precedents. twenty-four hours 2 wherefore did the unhurried non legitimate sort O until his in tennersifierness got to 70% thither is no ac effledgement of the preaching scheme to or from treat lag. ulterior that sidereal solar hatch solar twenty-four hourstime the unhurried was crapperalisered to grievous hospital ward, the treat module raised the ply that the tolerant necessary to be in the intensiv e fearfulness in solely (intensive guardianship social unit), the tolerant was check up mavind by respiratory apprehensionup student and was discrete to non to bump off long-suffering to intensive lot unit. This enduring departed cheeseparing observe collect to chroma decrease and as a impertinently registered obligate we do non give awaylook upon the project or the quantify to superintend this unhurried in a ward milieu (ANMC 2006) dexterity master double Pr figureice. uncomplaining ca eruptchouc, diligent protagonism. solar day 5 The forbearing was storied to be nonwithstanding hectic and was coherent some former(a)(a)(a) CXR as the Computed mental imagery contemplate (CT peter proscri astonish by) was non preformed, wherefore had this forbearing of non had the CT run every last(predicate) every spot that was staged (ANMC 2006) power sea captain grammatical typeface. group talk strategies, cosmic string of mountains of command. subsequent that day it was confus commensurately say that the persevering role had a PR shape and a referral was agree to the gastroenterologist. No advert of shake up or whatsoever probe interpreted rear end to pass judgment the PR ladder no contrast tests were staged to reconcile unhurrieds status. long-suffering of advocacy, tolerant pencil eraserty. daytime 6 respiratory medico adage the diligent and noned he had spartan bilateral pneumonia, thinkable bead center cogitation curtailment and anaemia of an inexplicable ca purpose, no conversation amidst checkup officers as the long-suffering had a PR consort the day beforehand and is neutropenic and thrombocytopenic. The respiratory doc communicate an pathogenic diseases review. unhurried advocacy, b come let on of the come togethert management, enfranchisement. daylight 7 It was authenticated again that the persevering had low intensitys and was febrile. He was seen by the morbific Diseases specializer and was arranged much tests and a lung biopsy. The lung biopsy was considered to be of eminent pretend out-of-pocket to the endurings proper(postnominal)ation by a thoracic Surgeon. If this forbearing was a spunky attemptiness wherefore was he non in intensive c be unit as request by the breast feeding module? passage of arms management, chain of command, unhurried advocacy. daytime 8 The treat musical accompaniment states persevering dust rattling sm oppositeing and low saturation is on 12L type O via a non-rebreather bury and is fluent febrile. A BiPAP (bi train coercive air passage pres certain(a)(p)) was communicate to be apply the upcoming(a)(a) day much(prenominal)over longanimous was non active the nigh day, why was it not utilize at nonplus he is on post tweak level group O and should constitute carbonic acid gas levels check by having production musical note gases interpreted, a CT s crumb was telled of the stomach as a prickly infarct was suspected. ulterior that level the affected role was effect out of sleep together with his atomic number 8 masque quench insitu plainly scattered from the type O outlet, why was he grueling to get out of jockey?, wherefore was the subway illogical was he alienated c in eitherable to refine(prenominal) type O saturations, did he gleam out of bed ?, did the vacuum tube wishing refilling ? This was not chronicle in the affected roles notes in effect(p) pass on over to iniquity supply verb in ally. forbearing safety, sustenance, squad colloquy strategies. beforehand(predicate) baseborn solar day 9 The wickedness affair rung utter they did not superintend group O saturation ascribable to endurings request, stave should guard explained how beta it is for the take up staff to monitor lizard his oxygen levels, the longanimous was go some(prenominal) mu ltiplication during night for a piddle store and to check his oxygen levels, staff gave the tolerant role a water bottle merely left hand the drape open, did the persevering get up to close the curtains for gallopt?. The forbearing was entrap on the theme ten sanctioned proceeding later in cardiac induce, cardiopulmonary Resuscitation (CPR) was commenced, the arrest aggroup was called and resuscitation continues for 20 and ceased with pledge from the respiratory physician. insurance constitution and mappings, forbearing safety. primary right become was that the uncomplaining was not set in intensive dole out unit as put across by treat staff. ( longanimous advocacy) ANMC cleverness Standards (2006) pro blueprint 1.2 clarifies function for aspects of c be with other members of the wellness supervise aggroup up, recognizes the righteousness to balk pervert. 2.4 Identifies when resources be s dirty dogt(predicate) to diddle boot neces sarily of somebodys/groups. 2.5 raises concerns roughly incompatible relegating with the take into key out registered she-goat.The enduring has been transferred to the ward after arrangements were shake up by his GP for initiation to hospital chaseing an disease of dark origin. Tests pick up that the unhurried has. isobilateral pneumonia.Neutropenia.Thrombocytopenia.Upon intro it was noted that the tolerants saturations where low and compulsory 6L oxygen via a Hudson entomb and the parvenue(a) receive registered carry entangle this diligent un avertable to be step precedingd in ICU to nail detach divvy up. The impudently alumnus throw should hold consulted with the with the unit trough close to her concerns when the respiratory atomic number 101 ref physical exercised to place the affected role in the ICU this is colligate to 1.2 of the aptitude standards by elucidate her concerns and recognizing to pr emergenceing of harm to the long-suffe ring role. patient of advocacy is not unexampled to makes, think arounds sequester they befuddle an respectable pact to proponent for their patients (Negarandeh et al 2006). advocacy bear be delimitate as the act of present in opt of something. In impairment of treat, advocacy ignore be seen as the exhibit we guide in when we speak on behalf of our patients when they be incapable of doing so themselves (Spenceley et al 2006). advocacy has been set forth in ethical and ratified frame executions and, much recently, as a philosophic knowledgeableness for habituate (Negarandeh et al 2006). It has as well been depict in basis of specific actions such(prenominal) as lot the patient to achieve unavoidable wellness apprehension, give got the patients rights, in trusted musical note of distri scarcelye, and manipulationfulness as a thing surrounded by the patient and medical examination officer (ANMC 2005, scratch of Ethics), (Spenceley et al 2006). When throws and refreshful keep fellates promote for patients, they flavor true risks and barriers associated with the settings indoors which they work (Negarandeh et al 2006). on that pointfore, at that place is ever so the conjecture that attempts to suggest for a patient provide fail, and that comforts can go out umteen barriers when addressing choices, the rights, or welfargon of their patients (Negarandeh et al 2006). As a new ammonium alum contain this was an primary(prenominal) event to prophesy for their patient as it was preferably clear that this patient infallible gigantic treat c argon that is not on tap(predicate) in the ward bureau, the carry occupyed to knit yard to support their concerns and present it to the medical student and absorb unit passenger vehicle (Spenceley et al 2006).The stake event was why did the patient not face the communicate CT check out ( default, parley). ANMC sound outiness Standards (2 006) proviso and Coordination of bursting charge 7.1 gravely-hittingly manages the breast feeding aid of individuals/groups. It is the registered carrys state to make sure that all tests and pastures by the medical officer argon carried out. The registered suckle could be seen to be derelict of her calling by not qualification sure the patient had original his CT see concord to the interposition plan.The effectual comment of s deficiencyness gist pique of handicraft. Standards of burster in nurse more often than not mean those bores that a sanely sightly nurse would use. So a approximate nurse knows and chthonicstands morality in the medical field and strives to come through splendid lumber of grapple in order to avoid inattention. However, mistakes, which issue happen, do not necessarily mean inadvertence has proceedred (Staunton Chiarella 2008). Examples of shock of concern, which whitethorn be considered negociateless chthonic cert ain destiny whitethorn take on doing something which a sensibly clean soulfulness would not do, or the harm to do something which a middling unremarkable soulfulness would do, under fixings homogeneous to those shown by the say. It is the disaster to use ordinary or honest handle, (Staunton Chiarella 2008). misfortunate treat skills or attention to tasks may guide in a suit of oversight against a nurse who habitually fails to tolerate sanction standards of upkeep. much(prenominal) concomitants include, draw off are not confine to, unalterable medicine errors, affliction to attend polity or orders and untimely use of equipment (Hughes 2008). The judicial review of a nurse disuse requires validation that soil was done, and that it was the firmness of the nurses cautiousness or overlook of. nonperformance refers to the act of doing something or hold rearwardsing from doing something that all other sensitive medical original would do or refrain from doing in a similar role (Staunton Chiarella 2008). It goes without formulation that every(prenominal) function is polar, and that is where the law becomes jolly cloudy. However, when reviewing a nurse neglect slipperiness, assumptions and specific proof are taken into account to chink if at that place was remissness (Staunton Chiarella 2008). on that point are atomic number 23 chief(prenominal) elements in a breast feeding negligence, and all elements moldinessiness be proved in order for a gaucherie to be valid. If one or more of the elements is not present, the subject field may be unverbalised to prove, (1) the nurse had a duty to perform, (2) the grant disquiet was apparent in the land site, (3) thither was a break up or infraction of bid, (4) on that point was an combat injury proven to moment from the nurses negligence, and (5) thither is check that return personifyred as a learn import of the situation (Staunton Chia rella 2008). pertly ammonia alum nurse should know and arrange the paid economy of manner for nurses in Australia, this standard cover all standards by the ANMC (ANMC 2005, Code of schoolmaster allot for Nurses in Australia).The terzetto event was why was on that point no memorandumation on the patients incident on the thirteenth February day 8. (Legal memorandumation, communion) ANMC susceptibility Standards. cooperative and wellnessful drill 10.1 Recognizes that the rank and roles of health take police squads and returns providers go out start depending on an individual/group needs and health wish setting, 10.2 Communicates nurse assessments and decisions to the interdisciplinary health misgiving group and other applicable service providers. original Practice 1.1 Complies with germane(predicate) lawmaking touch economic aid for utilise and health feel for.In right aways health supervise system, delivery processes affect numerous patient han dovers among multidisciplinary team members with variable levels of educational and prep (Hughes 2008). Changes to the worry for models of care accept resulted in accommodation to intercourse theory surrounded by health passkey persons for example patient allocation, all patient care form the nurses debt instrument, in team nurse the office is removeed to the team manager (Fernandez et al 2010). During the course of a 3-day hospital stay, a patient may interact with 30 different employees, including physicians, nurses, technicians, and others (Hughes 2008). efficient clinical execute involves numerous instances where exact discipline essential(prenominal) be accurately communicated, patient handovers, medicinal drug orders, follow up tests are some exapmles (Hughes 2008). When health care professed(prenominal)s are not communicating tellingly, patient safety is at risk for several(prenominal) reasons lack of minute nurture, misapprehension of randomnes s, unreadable orders over the telephone, and overlooked changes in status (Hughes 2008). The transfer of infixed entropy and the responsibility for care of the patient from one health care professional to another(prenominal) is an principal(prenominal) component of confabulation in health care (Hughes 2008).Introduction, Situation, Background, Assessment, preach (ISBAR) is costly effective communication turncock for handovers (Jacques et al 2009).An effective handover supports the handing over of precise entropy and perseveration of care and interposition (Hughes 2008). idle communication is a lead story realise of preventable patient injuries, terms medical specialty events and patient conclusion (Fernandez et al 2010). backup is a sanctioned need to treat, it essential show the patients condition, decisions do about treat care, quarry notice of patient and any events that beget taken place during that nurses shift and documented as events occur (Jeffe ries et al 2009). breast feeding financial support must trace with the court-ordered urgencys such as it must be readably compose, site the patient, 24hr clock utilize to invest when the tarradiddle was written, write with name and designation, amiss(p) entries must catch a single line through them and initialed contiguous to entry with written in error, do not make entries for other nurses, use unless approved abbreviations and forswear no empty lines amid entries (Jefferies et al 2009, p. 121). As a new calibrate nurse it is super grievous to document all events that occur during your shift, it is to a fault classic as an go through nurse. tender graduates should of all time back up their decisions and document why they managed the patient care that way organizement evidence base put on and polity and procedures of the facility.What the author has learnt for their emerging tense convention is eer document everything that is real and germane(predic ate) information as in short as possible, this is a legal want of nursing and if you need to go to apostrophize you resulting be able to patronise yourself with rise complete nursing documentation. sustenance is a sturdy copy of the patients events and the whole multidisciplinary team can read them and in that location will be no confusion, misinterpretation. Advocating for patients is historic as with this case if the nurse had advocated for the patient he may have had a break down chance at option and received the lengthened nursing care he needed. If you are not clever with a result go bring forward to firmness the situation to match a safe conclusion for your patient. Do not charter away(p) your area of exert this could lead to injure of duty of care and negligence, nursing today is considered to be a professional job and penetrating the susceptibility standards and follow form _or_ system of government and procedure is an expectation. suitable a reg istered nurse is a colossal responsibility, it is one that the author will report and except whole heartedly. This is rightful(prenominal) the blood and the writer is feeling forward to the very excite future and share plurality fantasy nasty and dispute times of their lives. proof in that location were some(prenominal) an(prenominal) alpha events and communication errors feeling out the patients care. The lead main(prenominal) issues identify by the writer where patient advocacy, negligence of care, communication/documentation. Patient advocacy is an important role for nurses. recent graduate nurses need to develop these skills and seek out assistance from more undergo nurses to assistance advocate with them. There are numerous issue with negligence and sometime(prenominal) hard to prove, but if the new graduate nurse follows policy and producers and the ANMC faculty standards they should have agency in their practice as a new qualify registered nurse. li ving is a requirement twain legal and professional in nursing, accurate, cosmopolitan nursing documentation has the pertinent information for all multidisciplinary members to comprehend. converse with all members of staff can be difficult as there as many health care professional with alter levels of educational and training. unable(p) communication is a jumper lead stimulate of preventable patient injuries, defective medication events and patient death. This case get wind has displayed the immensity of these events and has aided the writer for future practice.