Question

Discussion Topic: What are the different types of hearing loss? Follow the discussion guidelines below.

For the case study section only: Please only provide short answers for the case study No more than 2 sentence response. Answer all the questions in all case study scenarios.

1. Case Study: Childhood Obesity

Mason is a 7-year-old boy who is at his primary care physician for a routine physical examination. Mason’s mother expresses concern about childhood obesity and is worried that he sleeps too much.

Subjective Data: Mason has been eating more than usual. Mason sleeps between 11 and 12 hours a day. Mason plays team soccer.

Objective Data

Height: 121 cm

Weight: 23 kg

Vital signs: temp, 37º C; pulse, 78 bpm; resp, 22 breaths/min; blood pressure, 102/62 mm Hg

Height: 90 cm

Mason has a normal physical examination for his age.

Questions:

1. 1. What should the nurse tell Mason’s mother when discussing her concerns about childhood obesity?
   2. What can Mason’s mother do to help Mason maintain a healthy weight?
   3. Mason’s mother has questions about his joining a soccer team. What should the nurse tell her?
2. Case Study: Brain Tumor

Caroline is an 11-year-old girl who has an inoperable brain tumor. Caroline has been admitted for palliative care. Her mother, father, and two siblings are with her.

Subjective Data: Caroline complains of a severe headache. She states that she is “afraid to be alone.”

Objective Data

Vital signs: temp, 37.8º C; pulse, 120 bpm; resp, 24 breaths/min; blood pressure, 110/60 mm Hg

Caroline is unable to walk unassisted.

Her pupils are unequal 4 mm right and 6 mm left.

Questions:

1. What is the most immediate priority for Caroline?
2. How can Caroline’s nurse help with Caroline’s fears?
3. How can Caroline’s nurse maintain professional boundaries?

3. Case Study: Hyphema

Johnny is a 10-year-old boy who seeks care after being hit in the right eye with a stuffed snake by his brother 15 minutes before arrival.

Subjective Data: Johnny complains of light sensitivity. Vision in the right eye is blurred.

Objective Data

Vital signs: temp, 36.8º C; pulse, 90 bpm; resp, 18 breaths/min; blood pressure, 110/60 mm Hg

Pupils: Left, 3 mm briskly reactive to light. Right, 3 mm and sluggishly reactive to light

Visual acuity: Right eye unable to see chart; left eye 20/15

Approximately a 30% hemorrhage is noted to the anterior chamber of the right eye with an intact globe.

Questions:

1. Johnny is at risk for what complications?
2. What measures may help prevent these complications?
3. What should the nurse do in this situation? Prioritize these actions.

Answer 1

Case study 1: Childhood obesity. A.Nurse can educate Manson's mother that his physical examination was correct for age ,and his BMI also Correct to age (23 weight/1.21heightin meter square=19 ) ,so no need to vary about obesity  

B.Manson's weight can be maintained by reducing carbohydrate diet , Having adequate protein diet with high fiber diet ,this will help to maintain good weight .Menu plan has to formulated according to this ,don't forgot to include all types of nutrients like calcium to improve bone strength.

C.Soccer game is a introduction to football .Manson's mother can encourage boy to join team.

Case study 2:Brain tumor

A .With the presenting symptoms of Caroline severe head ache ,unable to walk ,pupils not in equal size she need immediate care with stabilization. Provide laying position with good ventilation ,collect history about medications ,inform to physician . Provide pain reliving medication

B.To reduce Caroline's fear nurse has to provide psychological support ,and allow their family member to stay with her.

C.Professional boundaries are very important while providing care it can be maintained by avoiding to involve in personal matters of patient.

Case Study 3: Hyphema

A. Hyphema is a collection of blood inside the anterior chamber of eye.Johnny visual acuity was reduced due to blood accumulation ,if it was left un treated it mag leads to permanent loss of vision.It was the major complication of Johnny.

B.To prevent this complications first need to reduce further bleeding ,period of bed rest is needed to limited activity.Physician should encourage for draining of blood from accumulated site.

C. Nurse has to provide comfortable rest position,encourage them to not to move.