Stephen Charles Case Study - Nursing Assignment Help

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Stephen Andrew Charles aged 50, on the 12th March 2015 died at St Elsewhere hospital, South Australia as a result of multi-organ failure due to pancreatitis, acute sepsis, and generalized varicella-zoster virus infection due to immunodeficiency related to Non-Hodgkin’s Lymphoma. At the time of his death Mr. Charles was newly released from custody, and before transfer to the hospital had been a prisoner at St Soul’s prison for the past seven years. Mr. Charles had been diagnosed with Non-Hodgkin’s Lymphoma 13 years before he died and had needed bone marrow transplants in 2011 to treat this condition. At various points in his recent past while in prison, Mr. Charles had refused treatment and at times medications, and he only accepted medical aid when he chose to request it. 

The following is an overview of Mr. Charles's health from his release from St Soul’s prison until his death. 

On 7 March 2015, he was released from prison to a detention house to remain there for three months as part of bail conditions. The prison infirmary also provided medical care to inmates of the detention house. He presented to the prison infirmary feeling generally unwell late in the evening of his release and was admitted to the infirmary in the early hours of 8 March 2015. His medical notes reported him to be dehydrated and he was given six litres of normal saline IVI over the next 24 hours. He was kept in the infirmary until his transfer to the hospital. 

On 10 March 2015 at 1905 hours (hs) he was admitted to the St Elsewhere Hospital for a routine bone marrow biopsy after a history of a rapid decrease in WCC. Upon presentation to the St Elsewhere Hospital ED, he was complaining of severe abdominal pain, which reportedly had commenced three days earlier, however, he had chosen not to inform the prison doctors about it. Further physical assessment revealed that he had a varicella rash and this was confirmed with blood tests. This was thought to account for the abdominal pain at that time. He was placed in an isolation room in the ED. He was not under guard due to his status as a released prisoner. 

On 10 March 2015 at 2010hs he suffered a seizure in the toilet and was non-responsive when the ED nurse found him. He regained consciousness at around 2050hs. He was placed on 15 minutely observation at this point. At midnight he complained about a painful IV site (the same IV cannula that had been placed in the prison infirmary on 7 March 2015) but due to having a history of poor access to vasculature the IV was not re-sited. No documentation appears in the patient record in regard to the IV site condition. 

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