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.

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

1. Childhood obesity =

a) The nurse has to first instruct the mother to be calm and quite. The she must explain the present physiological condition of the child. That is -

- Mason is now in 7 yrs. old. His hight is 121 cm and weight is 23 kg, so his Nesal metabolic rate is 15.7 kg/m^2, which is not normal for him, he is underwaigh.

- His Vital signs are nor according to his age.

- He sleeps more as he is becoming week.

So, there is no concern about obesity of the child.

b) Mason's mother has to provide a balance diet with more protein and fat containt. She must provide adequate water to the child of 2 litters/day. A regular physical exercise has to perform.

c) The child should not immediately join the soccer team. As he is a under weight child and it may cause injury or more weakness to him.

2. Brain tumor =

a) The most immediate priority for the 11 yrs. girl Caroline is to reduce her fear and provide her company. As this can provide her a happy and safe feeling and reduces her symptoms.

b) The nurse can maintain a better trust worthy relationship with the girl and keep quiet her. Then the nurse can allow her parents in her room to meet her. And then take other interventions to reduce headache.

c) Caroline's nurse maintain a professional boundaries by maintaining a proper IPR with the patient as well as the parents. As the child is in palliative care unit so, the parents and other family members can be allowed in the room for some period of time by maintaining precautions. The nurse must explain them about the child's present condition and the things that should be keep away from her.

3. Hyphema =

a) the main complications that Jonny may suffer from are - increased intra occular pressure (IOP), atrophy of the Optic nerve, impair accomodation of lense, rebleeding etc.

b) The measures that should take by the nurse are - elevate the head of the child in 45 degree.

- if there is any signs of pain then the pain medications like as Paracitamol can be administered.

c) In this setuation the nurse first provide comfort and proper position to the child.

The she assess the child's eyes and find the severity of damage.

She must explain the child's condition properly to the parents and keep quiet the.

The the medications and the procedures has to perform as per physician prescribed.