NURS 1101 ETHICS AND LAW FOR NURSES

NURS 1101 Ethics and law for Nurses Legal Implications

The patient was suffering from Septicaemia which means the blood contains numerous bacteria, actively dividing, which results in organ dysfunction. It is a severe illness and must not be considered only an infection. Septicaemia can be complicated by increased metabolic rate, circulatory collapse, vasoregulatory perfusion abnormalities and myocardial depression. The following derangements may involve. (Matthews. M, 2001)

Abnormal coagulation.

Excessive tumour necrosis factor may present.

Cell apoptosis

Poor glycaemic control.

Lack of steroid hormones.

Endothelial injury.

Neutrophile hyperactivity (Remick. D. G, 2007).

Cause of Septicaemia

Factors for developing sepsis in this case may include the following:Surgery of emergency appendectomy took place in unhygienic circumstances.The Days passed undiagnosed the infection, and the situation become critical.Patient was deteriorated rapidly regardless of having the appropriate oral antibiotics.Symptoms of abdominal pain were obvious (Matthews. M, 2001).

Investigation of Septicaemia

''If'', the officer diagnosis that the patient had an operation and post operation, his condition got severe. To investigate the case following tests are required to examine Septica.

Urine sample to find out the sensitivity, culture and microscopy.

FBC test report to find out - anaemia, thrombocytopenia, neutropenia may be present. In a viral infection lymphocytosis predominates may be present.

Renal function - to check dehydration or failure of organ.

Glucose test to find out the hyperglycemia may be present.

Liver function tests to find out hypoalbuminemia may be present.

Clotting screening to find out disseminated intravascular coagulation may be present.

CT scan to catch the source

CXR, abdominal ultrasound

Investigate Metabolic acidosis

Measures of lactate and oxygen saturation of venous blood (SvO2) (Patel GP, Elpern EH, & Balk RA, 2007).

Ideally blood culture should be sent before antibiotics are given

Should not delay Antibiotics when the patient is very ill.

Invasive investigations to find out the source of infection such as the lumbar puncture, bronchoscopy, laparoscopy, lymph node biopsy, etc (Matthews. M, 2001).

Nursing Care

The patient needs the following nursing care during and after the investigation

Intubation for the patients may require recovery.

Also, recovery by ventilation.

If the patient is shocked, requires Intravenous rehydration.

Insulin may be required until the septicaemia resolves.

Urinary output with a catheter.

Patients may have adrenal dysfunction

Monitoring the patient for central venous pressure.

The Specific therapy for Septicaemia

Surgery may also be required in this case abscess drainage, wound debridement but it was too late.

The Intravenous antibiotics should include broad-spectrum antibiotics given intravenously.

The regimen can be tailored for the patient when an organism is isolated.

The Microbiologist may be required for the patient may have fungi.

These therapies are important to avoid complications of disseminated intravascular coagulation (DIC), Waterhouse-Friderichsen syndrome, Multiorgan failure such as cardio-respiratory failure or renal failure. (Matthews. M, 2001)

Negligence

The officer and all the nurses involved in the case neglected the patient, and they are responsible for the patient's death. The officer who checked Mr. John, the nurse on duty when patient was in pain after the operation, and the nurse on duty when the blood test results were out neglected the patient's condition. When Mr. John was complaining about abdominal pain and the medical officer who reviewed ...