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    Perinatal Nursing: Day 2 online discussion

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    Angel Ve
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    Answer 2

    Post  Angel Ve on Tue 11 Aug 2009, 8:38 pm

    Follow up question.. Most of your answers are focused on the external factors (doctor's negligence, inaccessibility of the health facility..). What could be other factors that led to Jyotsana's death?

    ma. cristina arroyo

    Posts : 75
    Join date : 2009-06-24

    Re: Perinatal Nursing: Day 2 online discussion

    Post  ma. cristina arroyo on Tue 11 Aug 2009, 8:38 pm

    maybe the doctor was not expert on such cases OR maybe there weren't tests to support any diagnosis. BUT THE THING IS, the doctor SHOULD have at least REFER the patient if he cant examine well or instruments/tests were not possible.

    arch_ang
    Guest

    Re: Perinatal Nursing: Day 2 online discussion

    Post  arch_ang on Tue 11 Aug 2009, 8:37 pm

    Underlying cause of her death
    The underlying causes of her death are the fever and abdominal pain which was not given proper medical management upon consulting with a doctor. She died due to the untreated infection which is manifested by the fever.

    What should she have done differently?
    She should have asked the doctor for the diagnosis of her condition. If she is not satisfied with the way the doctor examined her, she should have looked for another doctor who could really take care of her.

    What should her family have done differently?
    The family could help her by looking for another physician since her condition worsens.

    What should the doctors have done differently?
    The doctor should discuss to her the differential diagnosis so that the patient is informed about her condition. By that, the family can do something out of her condition. Since the family is capable to meeting her needs.
    If the doctor happens to be really busy at the moment, the doctor should refer immediately the patient since her condition is serious.

    Angel Ve
    Guest

    Answer 1

    Post  Angel Ve on Tue 11 Aug 2009, 8:34 pm

    Yes I agree with you girls.. I can see that most of you are blaming the doctor for his negligence. But what do you think is the reason why the doctor did not reveal his diagnosis for Jyotsana?

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    I agree..

    Post  ara_portillo on Tue 11 Aug 2009, 8:33 pm

    YEs thea and tina.. it is really on the delays in decision making of the doctor... and the full disclosure of the condition of the patient with the family is not made by the doctor.

    ma. cristina arroyo

    Posts : 75
    Join date : 2009-06-24

    Re: Perinatal Nursing: Day 2 online discussion

    Post  ma. cristina arroyo on Tue 11 Aug 2009, 8:30 pm

    i agree thea, the PRIMARY reason was in the part of the doctor in which he/she should have paid attention to the condition of jyotsana, or to the very least, refer her to another facility.

    ara_portillo

    Posts : 74
    Join date : 2009-06-24

    for case 3...

    Post  ara_portillo on Tue 11 Aug 2009, 8:30 pm

    There is a multitude of factors that can be attributed to Jyotsana's death. First factor would be the inadequacies in terms of the health care provided to her. The lapses in the management of her condition specially at the level of consultation with the private doctor contributed a lot with the DELAYS in treatment that she could have received if her condition is diagnosed early and early referral is made.

    Accessory with this would be again traced to the capability of the doctor (the private one) in handling such cases. In the case of Jyotsana, TIME is an important element. If the doctor only have been knowledgeable with her condition, it did not take almost a day to wait for proper management.

    Also, the assessment procedures implemented in that health facility is quite questionable since they are not able to detect signs of fetal distress or death through simple assessment interventions like FHR monitoring...


    Last edited by ara_portillo on Tue 11 Aug 2009, 8:35 pm; edited 2 times in total

    railibo-
    Guest

    Re: Perinatal Nursing: Day 2 online discussion

    Post  railibo- on Tue 11 Aug 2009, 8:30 pm

    the causes of her death includes;
    first and foremost. her condition was not detected early by the doctor who attended to her because, he was suddenly called. It's a neglect on that doctor's part for not even bothering to discuss to her about his diagnosis or the treatment that could have saved her life. There was also the delay in decison making process baout what is the best thing to do with her condition. Another factor would be the distance of the hospital from their place.

    Althea P
    Guest

    Re: Perinatal Nursing: Day 2 online discussion

    Post  Althea P on Tue 11 Aug 2009, 8:29 pm

    There are different underlying causes of Jyotsana’s death: First, the doctor’s negligence, it was his responsibility to tell Jyotsana and her family the real diagnosis of what had happened. Jyotsana has a right to know what’s happening to her and even her baby. But the doctor failed to do so. The doctor didn’t even discuss any treatment or safety measures regarding her pregnancy. Another factor is the accessibility of the health care facility. A 40 km hospital is not an ideal health care set up.

    ma. cristina arroyo

    Posts : 75
    Join date : 2009-06-24

    answer for case2

    Post  ma. cristina arroyo on Tue 11 Aug 2009, 8:25 pm

    One of the primary factors that lead to the death of jyotsana is the patient's condition was not detected early. Note that in the situation, the health care provider was not able to examine the patient well to arrive at an accurate diagnosis. and then the patient was sent home. The lack of diagnosis and lack of health measures advise became the number one factor which lead to the death of the patient. If only the doctor paid attention and refer the condition immediately to the nearest facility, then jyotsana might have been saved.

    The second most obvious factor is the delay in decision-making of the family. Knowing that the patient already has clinical signs and symptoms, the family must have consulted another doctor to examine jyotsana.

    Another factor also is again, very obvious in our past cases, the proximity of the nearest health care facility to a small village like jyotsana's. The patient needed immediate and emergent care and this was delayed because the facility was 40 km away!! The delay in reaching the hospital is also another factor that adds to the death of the patient.

    In contrast to out past cases, socio-economic factor was not highlight here. jyotsana came from a well-to-do family and might have afford the cost of medical care IF ONLY GIVEN IMMEDIATELY.

    Angel Ve
    Guest

    Perinatal Nursing: Day 2 online discussion

    Post  Angel Ve on Tue 11 Aug 2009, 8:09 pm

    Good evening Classmates! I’m Angel and I will be your moderator for tonight. Our discussion will first focus on the Case 3 that we were not able to finish last time. Then we’ll move on to the next topic Case # 4 after we all agreed to each other’s posts.

    Classmates, please be guided by the instructions that were posted by Miss Ara last night.

    Let’s start. Good Luck!

    Case Study # 3: Treating Complications in Pregnancy

    Jyotsana’s Story

    Jyotsana was 20 years old and had been married for one year. She came from a well-to do family, and now lived in a small village with her husband. This was her first pregnancy. She had regular antenatal check- ups at a private clinic, and her pregnancy had been uneventful. When she was eight months pregnant, however, she suddenly developed a fever and a pain in her abdomen. She was taken to a private doctor, who admitted her for observation, but he was soon called away and did not examine her very well. The doctor did not tell Jyotsana or her family what he thought her diagnosis was or discuss any treatment options with them. The next day her condition became worse, and her relatives were told to take her to the hospital, which was located more than 40 km away.

    By then, Jyotsana could not speak and was unresponsive. By the time they arrived at the
    hospital, she had already died. The doctor examined her and told the relatives that the baby had died earlier in her abdomen and might have poisoned her body, leading to her death.

    Questions for Students
    1. What were the underlying causes of Jyotsana’a death?
    2. What should she have done differently?
    3. What should her family have done differently?
    4. What should the doctors have done differently?

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