NURS 4580 Module 2 DQ
Student Name
Lamar University
NURS 4580: Synthesis in Professional Nursing
Prof. Name
Date
Discussion Question
The Lewis Blackman Case: (Section A)
Why does Helen Haskell begin by discussing Lewis?
Helen Haskell opens her narrative by highlighting her son, Lewis Blackman, who tragically died at the age of 15 due to preventable medical errors. His untimely death became the driving force behind her advocacy for improved patient safety measures. By starting with Lewis’s story, Haskell aims to personalize the issue, underscore the gravity of medical errors, and stress the urgency of reform in healthcare practices to safeguard future patients.
Understanding Ketorolac: Indications, Dosage, Side Effects, and Risks
What is Ketorolac (indications, side effects, normal dosages for 15-year-olds, risks and benefits)?
Ketorolac is classified as a nonsteroidal anti-inflammatory drug (NSAID) used primarily for short-term management of moderate to severe pain. It is often administered after surgeries to control discomfort without relying on opioids. Common adverse effects include gastrointestinal issues such as stomach pain and nausea, along with dizziness and fever (Ziesenitz et al., 2022). For adolescents around 15 years of age, the standard dosage ranges from 10 to 30 mg every six hours, not exceeding a total of 120 mg daily. While Ketorolac is effective in reducing pain and avoiding opioid-related complications, it carries risks such as increased bleeding, renal impairment, and gastrointestinal distress, especially when used for prolonged periods or in high doses (Cooney, 2021).
Decreased Urine Output: Clinical Relevance
What was the significance of the lack of urine output (to the underlying problem, amount of Ketorolac, and need for fluids)?
A marked reduction or absence of urine output is a critical indicator of renal dysfunction. In Lewis’s case, this symptom likely signaled early kidney injury potentially induced by Ketorolac. NSAIDs like Ketorolac can impair renal perfusion and filtration (Chang et al., 2020). The absence of urine highlighted the necessity for immediate hydration through intravenous fluids to minimize nephrotoxic effects and support renal function.
Misinterpretation of Vital Signs
Why do healthcare providers dismiss the implications of undetectable blood pressure? Why would they think it was equipment failure?
Healthcare providers may sometimes attribute abnormal or absent vital signs to technical faults rather than clinical deterioration. In Lewis’s case, undetectable blood pressure may have been misread as an equipment malfunction rather than an emergent clinical issue. This misjudgment may stem from overreliance on devices or failure to correlate the reading with the patient’s overall presentation. Additionally, the care team may have been preoccupied with managing his pain, potentially overlooking the broader implications of his declining physiological state.
Weekend Staffing and Its Impact on Patient Outcomes
Do you agree that it was significant that Lewis’s crises developed on the weekend? Explain why or why not.
Yes, the timing of Lewis’s deterioration during the weekend was highly significant. Hospitals typically operate with reduced staffing on weekends, often relying on less experienced personnel and having limited access to senior medical staff. This staffing gap can hinder timely communication and intervention. In Lewis’s situation, inadequate handoffs and inexperience among the nursing staff may have led to missed warning signs and delayed treatment, contributing to his decline.
Septic Shock: Definition, Incidence, and Management
Lewis died from septic shock. Describe the incidence, signs/symptoms, and appropriate interventions for this problem.
Septic shock is a severe manifestation of sepsis where the body’s immune response to infection causes widespread inflammation, low blood pressure, and eventual organ failure. It carries a high mortality rate, especially when diagnosis and treatment are delayed (Font et al., 2020). Common symptoms include hypotension, tachycardia, fever, altered mental status, and respiratory distress. Timely treatment includes administering broad-spectrum antibiotics, intravenous fluids for circulatory support, and medications like vasopressors to stabilize blood pressure. Prompt recognition and aggressive treatment are critical to improving outcomes and reducing fatality risks.
References
Chang, R. W., Tompkins, D. M., & Cohn, S. M. (2020). Are NSAIDs safe? Assessing the risk-benefit profile of nonsteroidal anti-inflammatory drug use in postoperative pain management. The American Surgeon, 87(6), 872–879. https://doi.org/10.1177/0003134820952834
NURS 4580 Module 2 DQ
Cooney, M. F. (2021). Pain management in children: NSAID use in the perioperative and emergency department settings. Paediatric Drugs, 23(4), 361–372. https://doi.org/10.1007/s40272-021-00449-
Font, M. D., Thyagarajan, B., & Khanna, A. K. (2020). Sepsis and septic shock – Basics of diagnosis, pathophysiology and clinical decision making. Medical Clinics of North America, 104(4), 573–585. https://doi.org/10.1016/j.mcna.2020.02.011
NURS 4580 Module 2 DQ
Ziesenitz, V. C., Welzel, T., van Dyk, M., Saur, P., Gorenflo, M., & van den Anker, J. N. (2022). Efficacy and safety of NSAIDs in infants: A comprehensive review of the literature of the past 20 years. Paediatric Drugs, 24(6), 603–655. https://doi.org/10.1007/s40272-022-00514-