Question

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.

Case Study # 1
Jordan is a 9-year-old boy who is a direct admit for observation. He has had a history of vomiting and diarrhea for 48 hours.
Subjective Data
Has a history of nausea and vomiting for 24 hours.
Has not voided today.
Is unable to tolerate oral fluids.
Objective Data
Vital signs: temp, 37.8º C; pulse, 120 bpm; resp, 24 breaths/min; blood pressure, 110/60 mm Hg
Weight: 34 kg
Hyperactive bowel sounds to auscultation
Questions:
1. When should the discharge teaching begin for Jordan and his family?
2. What is the best way to approach Jordan regarding the intravenous (IV) line that has been ordered?
3. What would be good distractions for a child of Jordan’s age?

Case Study #2
Susan is a 4-year-old girl with a 7-day history of fever and lethargy. Susan’s physician has ordered laboratory work that includes a blood culture.
Subjective Data
Susan has had a fever for 1 week.
Her mother has noticed a decreased activity level.
Susan states she is “afraid” of needles.
Objective Data
Weight: 26.1 kg
Vital signs: temp, 39.3º C; pulse, 110 bpm; resp, 40 breaths/min; blood pressure, 108/54 mm Hg; oxygen saturation (O2 sat) 100%
No abnormal findings on physical examination
Questions:
1. When should Susan’s nurse explain the procedure to her?
2. To give Susan some control over this situation, what choices could be given to her?
3. What actions should the nurse take in this clinical situation? Prioritize the actions.

Discussion Topic: What is the Perez reflex? Why is it important to know how to elicit it? Discuss the use of the Perez reflex in collecting urine specimens from infants.

Answer 1

#1

1.Provide the discharge education when nausea is controlled diarrhoea is stopped ,fever is controlled .Start when the parents are comfortable by seeing their child improves

2. Demonstration and divertional techniques are best way to approach the child for IV procedures. Provide a calm and quiet ,comfortable environment which can promote the child to cooperate to the procedure

3.Provide video games ,offer to watch TV for cartoons to distract the child during procedure.

#2.

1.The nurse can explain this procedure to the parents and help them to make their child aware that a procedure will be done on them in advance or at the time of admission when other procedure are carried out.

2.Ensure the parents or mother is with the child ,provide toys to play .

3.The priority nursing care are

• Provide diversional therapy to calm the child
• Provide a reassuring environment which can reduce anxiety and fear
• Private de any preferred healthy oral feeds
• Prepare the child for the procedure

Perez reflex is useful to determine how well the sensory system functions

It is important to know how to elicit it because it is one of the assessment techniques used in infants riding the sensory functions

A clean catch urine cannoned college yes in the infants for urine specimen .It is still in practice to collect urine specimen in the infant.