Question

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 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.

pls with the reference. Thanks

Answer 1

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*Discharge teaching always starts, at the crime of discharge only. When the doctor plans discharge, then nurse will give the health education or discharge advices. Here also that will only happen. Here he is admits for observation. So at time if discharge, teaching can do.

*Jordan us 9 years old. So he can understand what nurses are telling. So nurse can explain to him regarding intravenous fluid administration, in a simple form. And she can tell it as a, very small pain will only happen.

*Jordan is 9;yrs old and a boy. So nurse can tell distract his mind asking, by asking sports items like cricket or football .Nurse can gather the topic which he have interest, and then she can distract his mind by that communication.

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*The nurse can explain the procedure to Susan, when she become friendly with nurse. When Susan is relaxed, then nurse can explain the procedure to her.

*Susan have only 4 yrs. So by giving some chocolates(if is advisable), or giving some toys, it's able for change her mind.

*Actions nurse xan taken are

?Make a good IPR with Susan, for reduce her anxiety.

Make her relax, by talking lovingly, to reduce fear.

If she is uncomfortable with nurse, take help from mother.

Make her calm, after that explain procedure. At that time, just explain as a mind pain only will occur. Other ways due to fear she will not coperate.

So making her mind some distract, do procedure.