Legal Issues Case Study for Nursing
Cindy Black (fictitious name), a four-year-old child with wheezing, was
brought into the emergency room by her mother for treatment at XYZ (fictitious
name) hospital at 9:12 p.m. on Friday, May 13.
Initial triage assessment revealed that Cindy was suffering from a sore
throat, wheezing bilaterally throughout all lung fields, seal-like cough,
shortness of breath (SOB), bilateral ear pain. Vital signs on admission were
pulse rate 160, respiratory rate 28, and a temperature of 101.6 °Fahrenheit (F)
(rectal). Cindy Black was admitted to the emergency department for treatment.
Notes written by the emergency department physician on initial examination
read, "Croupy female; course breath sounds with wheezing; mild bilateral
tympanic membrane hyperemia. Chest X-ray reveals bilateral infiltrates."
Medication prescribed included Tylenol (acetaminophen) 325 mg orally for
elevated temperature, Bronkephrine (ethylnorepinephrine hydrochloride) 0.1
millimeter subcutaneous, and monitor results.
Nurse Slighta Hand, RN (fictitious name) administered the medication as
ordered and the child was observed for thirty minutes. Miss Hand's charting was
brief, almost illegible, and read, "Medicines given as prescribed. Cindy
observed without positive results. Physician notified."
The physician examined the child; notes read that the child had "minimal
clearing" in response to the bronchodilator. The following medications were
then prescribed: Elixir of turpenhydrate with codeine one milliliter by mouth,
Gantrinsin (sulfisoxazole) 10
milliliters, and Quibron (theophylline-glycerol guaiacolate) 10 milliliters.
Nurse Slighta Hand, RN charted the medications were given as prescribed.
Her note at 11:08 p.m. read, "Vomiting; unable to retain medicine. Respiration
increased (54), temperature 101.4°F (rectal); wheezing with increased difficulty
breathing." No further notes were made regarding Cindy's condition on the
emergency department record by the nurse, except to state that at 12:04 am,
"child released from emergency department."
Thirty minutes after discharge from the emergency department, Cindy Black
was brought back to the hospital. This time her vital signs were absent, her
skin was warm without mottling, and the pupils of the eye were dilated but
reacted slowly to light. Cardiopulmonary resuscitation was instituted without
success, and Cindy Black was pronounced dead. Departure from professional
standards of nursing care:
In every nursing malpractice case the defendant nurse's conduct is measured
against that of a reasonably prudent nurse under the same or similar
circumstances. Departure from the professional standards of nursing care for
the first admission to the emergency department included the following
· Failure to assess Cindy Black comprehensively upon discharge
· Failure to assess the patient systematically for the duration...