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what the NP failed to do in this case .       A 15-year-old female student left school early due

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what the NP failed to do in this case. 

     A 15-year-old female student left school early due to a severe headache, joint stiffness, over-all aching, and a fever. The student’s mother gave her Tylenol and took her to see an NP that evening. The student told the NP of her symptoms and took her temperature, which was 103.7 degrees. The NP’s assessment indicated no cough, no chest congestion, no abdominal complaints and no rhinitis. The student’s CBC showed a white cell count of 16,600 but tests for meningeal irritation were negative. A pediatrician in the same office did a quick exam of the patient as well.
The NP diagnosed the patient’s condition as “probable flu” and instructed the mother that if her daughter vomited or had changes in her symptoms to call the NP. The student and her mother left the office for home.

     Later that evening, the mother called to tell the NP that her daughter had vomited several times. The NP instructed the mother to keep her daughter at home that evening and to come to the office in the morning. By the next morning, the patient was lethargic to the point of being only “marginally responsive” when brought to the clinic. Clinic staff called 9-1-1. At the hospital, the student was diagnosed with meningitis, placed on antibiotics, intubated, and admitted to the ICU. Her condition continued to worsen, suffered a brain herniation and died one week after her initial visit to the NP.

SCIENCE
HEALTH SCIENCE
NURSING
NRSG 627

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