Question

History of Present Problem:

Harper Anderson is a 5-month-old female who was brought into the physician’s office for diarrhea and vomiting over the past two days. She had two loose large loose stools the first day and now her mother reports that she has been less active, is not interested in playing, and has been more sleepy today. She is unable to keep any feedings down today. She has had four loose, watery stools and emesis x3 this morning. She has not had a wet diaper since yesterday evening. She is 25 inches (63.5 cm) in length and weighs 14 pounds, 2 ounces (6.4 kg). She weighed 15 pounds, 2 ounces (6.86 kg) at her last office visit two weeks ago. Harper is a direct admit to the pediatric unit where you are the nurse responsible for her care.

Personal/Social History:

Harper’s mother Nicole is 21 years old. She is a single mother and this is her first child. Nicole is not currently working and lives with her parents. Though she has strong social support from her parents, she feels consistently overwhelmed as a new mother.

Past Medical History (PMH):

• Healthy full-term infant that weighed 6 pounds 10 ounces (3.0 kg) at birth.
• No current health problems. Mom is no longer breast feeding and Harper is on formula.
• Mother had no complications with pregnancy.
• Has not had any immunizations from birth, including rotavirus

1.What psychosocial/holistic care PRIORITIES need to be addressed for this patient? with dehydration and vomitting in a child

(Psychosocial Integrity/Basic Care and Comfort)  

2.What educational/discharge priorities need to be addressed to promote health and wellness for this patient and/or family? (Health Promotion and Maintenance

Answer 1

1, psychosocial care for the patient and family should be culturally sensitive in order to fulfill their
psychological, social, and spiritual care with communication, that improve patient health outcome and quality of life.
there are many reasons for infants dirrarea like cow milk allergy, lactose intolerance the infant can not able to tolerate that formula that causes lot of gas, loose stools.formula-fed babaies have much diarrhea.
Rehydrate the child first with ORS solution till diarrhea stops, check the weight daily, advice the mother to give formula but feed more often, mix formula with plenty of water, provide zinc supplement for 14 days, follow strict hygienic care, add solid foods in the baby diet. understand the mother belief and their cultural followup about foods and fluids, and diarrhea approaches for the baby. establish a rapid family and nurse communication to provide care for the baby, provide psychological and emotional support to the mother while caring the baby.
2, Advice the mother to maintain hygiene when preparing the formula, handwashing with soap and water and using alcohol-based sanitizer to prevent infection, advice the mother to avoid high-fat foods and complex carbohydrate foods. monitor the child dehydration status. advice the mother about breastfeeding, advice to feed more often than usual, use ORS in between feeding, stop giving the rehydration solution when providing normal feeding. educate the mother about the importance of immunization and infection control.advice the mother about first dose of rotavirus vaccine before 15 weeks of age it avoids baby rotavirus diarrhea. advice the mother if any diarreha symtpoms worsen should seek medical suppot immediately.