Why does Helen Haskell start the story by talking about Lewis?
Helen Haskell starts her story with a discussion about Lewis, the person responsible for her becoming a patient safety advocate. Lewis was her son, who died at 15 due to medical errors. Helen wants to share his story to raise awareness about the importance of patient safety and prevent similar tragedies from happening to other families.
What is Ketorolac (indications, side effects, normal dosages for 15-year-olds, risks and benefits)?
Ketorolac is an NSAID – Nonsteroidal Anti-Inflammatory Drug typically used for patients with moderate to severe pain. Stomach ache, fever, nausea, and dizziness are potential adverse effects of ketorolac medication (Ziesenitz et al., 2022). The recommended dosage for a 15-year-old is 10-30 milligrams (mg) every six hours, with a maximum dose of 120 milligrams per day. However, Ketorolac can increase the risk of bleeding and kidney problems, especially when used for extended periods or at high doses. In terms of benefits, Ketorolac provides effective pain relief for postoperative pain and has a non-opioid mechanism of action, reducing the risk of opioid dependence and overdose (Cooney, 2021).
What was the significance of the lack of urine output (to the underlying problem, amount of Ketorolac, and need for fluids)?
The lack of urine output was noteworthy because it suggested that Lewis may have had kidney damage, possibly caused by Ketorolac. Ketorolac can affect kidney function (Chang et al., 2020), and the lack of urine output could have been an early sign of kidney failure. The need for fluids was also important to prevent dehydration and help flush out any potential toxins from the Ketorolac.
Capstone Class 4580 Module 2 Discussion Question
Why do healthcare providers dismiss the implications of undetectable blood pressure? Why would they think it was equipment failure?
There could be several reasons healthcare providers downplayed the significance of non-existent blood pressure readings. They may have assumed it was an issue with the equipment because blood pressure monitors can sometimes give inaccurate readings. Additionally, they may have been focused on treating Lewis’s pain and not recognized the potential complications of Ketorolac.
Do you agree that it was significant that Lewis’s crises developed on the weekend? Explain why or why not.
Yes, Lewis’s problems that erupted over the weekend are significant because fewer healthcare providers and nurses were available, and communication between different nurses was more difficult. This could have contributed to delays in recognizing and treating Lewis’s deteriorating condition. Furthermore, the reduced staffing levels and lack of senior physicians on duty during the weekend have also contributed to delayed recognition of his deteriorating condition and inadequate management of his care. Moreover, the nursing staff caring for Lewis also consisted of inexperienced nurses, which further contributed to his suboptimal care.
Capstone Class 4580 Module 2 Discussion Question
Lewis died from septic shock. Describe the incidence, signs/symptoms, and appropriate interventions for this problem.
Septic shock is a potentially fatal illness when the body’s response to infection becomes dysregulated, leading to a systemic inflammatory response that can cause organ failure and death. A high mortality rate is associated with septic shock, especially when an infection causes a systemic inflammatory response that damages organs and tissues (Font et al., 2020). Likewise, septic shock signs and symptoms can include low blood pressure, fever, rapid heart rate, confusion, and difficulty breathing. Appropriate interventions for septic shock include administering antibiotics to treat the infection, providing intravenous fluids to maintain blood pressure, and supporting organ function with medications like vasopressors or inotropes. Early recognition and treatment of septic shock are crucial to prevent organ failure and death.
Capstone Class 4580 Module 2 Discussion Question
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
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
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.
