Can we say that our patient was misdiagnosed?

Question

i am a nursing student and we're doing a case study on preeclampsia. while studying about it, i've read that to have preeclampsia, u have to have hypertension and proteinuria. but our client has only hypertension, but no proteinuria. but whats written on the doctor's diagnosis is preeclampsia. we have submitted our paper and while the defense is still 2 weeks from now, some professors are questioning now why we proceeded with the study when we know that the patient is not a candidate for preeclampsia. i know they will ask this again on the defense day.how and what should i,as a leader, answer? pls help.

Answer 1

As a former nursing student myself, you cannot be that blatant and say that doctors "misdiagnosed" the patient. You can, however, say that you FEEL the doctors may have jumped at this too soon and MAYBE they should have looked into it more.
You have to be very careful about saying anyone misdiagnosed a patient. That could be a lawsuit just waiting to happen. I say you have a helluva case with this, as it is definite that by saying a patient is pre-eclampsia they have to have both symptoms.
I feel you'll do okay with this case study, but just don't say that you "KNOW" that it was a misdiagnosis, but kinda dance around the subject.
Good luck girl and WTG on catching this..

Answer 2

This is a wonderful thing for you to deal with before getting out in the real world! I have been a nurse for several years. Never take an admitting diagnosis as absolutely definative; it may well be that the diagnosis is the what the admitting MD suspects, but requires further testing to ascertain for certainty. Even when the diagnosis has been ruled out, those admitting diagnoses seem to hang on for dear life until a human being takes responsibility to see to it that the diagnosis gets changed (by attending's order / in the computer / on the kardex / on the MAR / billing / etc.). For that reason, I think it is likely that the woman was not misdiagnosed so much as that her chart had not been properly updated.

Having a written diagnosis is a wonderful guide as to what to watch for, but for your client's sake, NEVER to have it close your eyes to symptoms that don't "fit" the diagnosis. And you can't pass this off to your instructors as preeclampsia; they will see right through you. But you will do well to present this case as a "rule out preeclampsia" by showing how this client did not fit the diagnosis. Make your instructors very happy by explaining how you would follow up with this client (discharge teaching, change in symptoms / labs to continue to monitor for possible development of preeclampsia down the road).

Good luck to you, and welcome to nursing!

Answer 3

Preeclampsia is diagnosed when at least 2 out of these 3 are present: Hypertension, proteinuria and edema feet. Even if there was no proteinuria, may be edema was present along with hypertension.