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

Ans.

1 )

Childhood obesity: understanding the problem

Those extra pounds put kids at risk for developing serious health problems, including diabetes, heart disease, and asthma. Childhood obesity also takes an emotional toll. Overweight children often have trouble keeping up with other kids and joining in sports and activities.

Childhood obesity is particularly troubling because the extra pounds often start children on the path to health problems that were once considered adult problems — diabetes, high blood pressure and high cholesterol. ... Childhood obesity can also lead to poor self-esteem and depression.

Childhood obesity may itself be enough to cause outcomes including metabolic syndrome, cardiovascular disease, type 2 diabetes and its associated cardiovascular, retinal and renal complications, nonalcoholic fatty liver disease, obstructive sleep apnea, polycystic ovarian syndrome, infertility, asthma, orthopedic.

Maintaining a Healthy Weight

• Limit portion size to control calorie intake.
• Add healthy snacks during the day if you want to gain weight.
• Be as physically active as you can be.
• Talk to your doctor about your weight if you think that you weigh too much or too little.

2 ) Grade I brain tumors may be cured if they are completely removed by surgery. Grade II — The tumor cells grow and spread more slowly than grade III and IV tumor cells. They may spread into nearby tissue and may recur (come back). ... Grade IV tumors usually cannot be cured.

Medications used for brain tumors include chemotherapy, hormonal treatments, anticonvulsants, and pain medications. Chemotherapy works to shrink or eliminate brain tumors, while the other prescription medications are used to control symptoms while the tumor is being treated.

Brain Tumor Treatments

• Surgery. Surgery is the usual treatment for most brain tumors. ...
• Radiation therapy. Radiation therapy, also called radiotherapy, is the use of high-powered rays to damage cancer cells and stop them from growing. ...
• Chemotherapy. ...
• Treatments we specialize in.

3 )

Complications of traumatic hyphema may be directly attributed to the retention of blood in the anterior chamber. In addition to glaucoma, the four most significant complications include posterior synechiae, peripheral anterior synechiae, corneal bloodstaining, and optic atrophy.

Complications · While the vast majority of hyphemas resolve on their own without issue, sometimes complications occur. Traumatic hyphema may lead to increased intraocular pressure (IOP), peripheral anterior synechiae, atrophy of the optic nerve, staining of the cornea with blood, re-bleeding, and impaired accommodation.

Prevent complications of hyphema -

However, it may appear without warning in children who have other medical conditions such as sickle cell anemia or hemophilia. Immediate medical attention is needed if hyphema occurs. The best way to prevent hyphema is to wear eye protection when playing sports. Also, never take an eye injury lightly.

Medical treatment for an isolated hyphema typically is topical. Topical corticosteroids (systemic for severe cases) may reduce associated inflammation, although the effect on the risk for rebleeding is debatable. Topical cycloplegic agents are also useful for patients with significant ciliary spasm or photophobia.