Question

Case Study:
Yasmin is a 12-month-old female who was brought to the Emergency Department by her aunt. Yasmin’s aunt anxiously reports that the child has been having diarrhea for the past two days and “is not her usual self”. She adds that the child is fussy, lethargic, not feeding well and when she attempted to give Yasmin acetaminophenshe spit it out. Yasmin’s aunt reports that her parents are out of town, but that she does have the phone number of the hotel in which they are staying.
Assessment:
Weight: 11 kg
Vital Signs:
Heart Rate: 115
Blood pressure: 85/50
Respiratory rate: 30 per minute, deep and rapid breathing
Oxygen saturation: 95% on room air
Temperature: 39.0 degrees Celsius
General Appearance: Appears stated age. Height and weight proportional
Cardiovascular: Sinus tachycardia
Respiratory: Clear breath sounds
Gastrointestinal: Hypoactive bowel sounds, is refusing fluids
Urinary: Has not voided in 8 hours
Integumentary: Skin warm and dry to touch. Dry lips. Eyes appear sunken. No tears. Poor skin turgor
Neurological: Awake, but lethargic and irritable. Pupils equal, round and reactive to light, weak movements present in all four limbs

1.   Identify three communication techniques that could be utilized to support and help build a therapeutic relationship with Yasmin and her aunt.
2.   Discuss three safety concerns related to Yasmin’s developmental stage and hospital admission.
3.   Describe and give rationale explaining what findings in Yasmin’s assessment are of concern.
4.   Identify two early and two late signs and symptoms of dehydration in pediatric patients.
5.   Differentiate between mild, moderate and severe dehydration in the pediatric patient.
6.   Outline four priority nursing actions while caring for Yasmin.
7.   Explain how diarrhea causes electrolyte imbalances and dehydration.
8.   Describe 3 common methods of treatment for dehydration and diarrhea in young children.
9.   Describe what actions should be taken to administer an antipyretic to Yasmin considering she is spitting up the medication.
10.   Identify 3 assessment findings that indicate improvement in the dehydrated child.

Answer 1

1. One if the main ways nurses establish trust with patients is through communication. Because are likely to have the most direct contact with patients, effective nurse - patient communication is critical. Nurses can utilize proven therapeutic communication techniques that promote quality.

A. Accepting   

​​​​​​B. Making observations

C. Self disclosing

2.

A.Follow home routine and rituals

B. Maintain a safe environment for the baby's physical acting out and temper tantrums. C..Approach with a positive attitude

​​​​D. Children contain to develop new skills. Opportunities to develop these skills may be limited by illness

4.early signs of dehydration

*thirst

*dry mouth, sunken eyes

Late signs and symptoms

*tachycardia

*hypotension and shock

​5.differentiate between mild, moderate and severe dehydration in the pediatric patient is

In mild- no hemodynamic changes-typically minimal findings but may have slightly dry buccal mucous membranes, increased thirst, slightly decreased urine output. (5%)

In moderate - tachycardia ,little or no urine output, lethargy, sunken eyes, loss of skin turgor. (10%)

In severe--hypotension with impaired perfusion. No tears, cyanosis, rapid breathing, mottled skin, coma. (15%)

8.oral re hydration if in mild condition

In case of moderate means Iv fluids

If severe should admitted in hospital with iv fluids