Question

(1) Case Studies Chapter 41: Nursing Care of the Child With a Cardiovascular Disorder 1. Baby boy Ellis, 2 hours old, is being evaluated in the newborn nursery by the nursing staff. Findings include T 37°C; apical heart rate 140 bpm; respirations 58 breaths per minute; BP (arms) 70/47, (calves) 62/39; head circumference 34 cm; chest circumference 31 cm; length 48 cm; weight 2,700 g. The infant is crying. (Learning Objectives 1, 2, 3, 4, and 8) a. Based on the physical findings, what should be the nurse’s priority? b. What assessments/tests should the nurse expect to be done on this infant? c. What should the nurse include in the teaching plan for the parents of this infant? 2. Jennifer Collins, 13 years old, is admitted to the pediatric floor with a diagnosis of probable acute rheumatic fever. a. What would the nurse include when performing an initial assessment? b. What tests would the nurse expect to be done on Jennifer? The diagnosis of acute rheumatic fever is confirmed. c. What would the nurse be sure to include in the discharge teaching plan for Jennifer and her family? (2) Case Studies Chapter 44: Nursing Care of the Child With a Neuromuscular Disorder 1. Pamela Souza, 6 years old, was born with cerebral palsy. Pamela suffers from general spasticity, mental impairment, impaired vision and hearing, and hydrocephalus. She has been admitted to the pediatric unit for evaluation of intrathecal spasticity control. (Learning Objectives 2, 3, 4, and 6) a. Identify medications that might be used to help control Pamela’s spasticity. b. What information would the nurse include in the health history? c. What nursing interventions would be important in Pamela’s care? d. What information would be important to include in a teaching plan for Pamela and her family? 2. Kyle Stephens, 15 years old, is brought to the emergency department by ambulance after a diving accident at a local lake. (Learning Objectives 1, 2, 3, 4, and 7) a. What nursing assessments would be important for Kyle? b. What diagnostic tests would the nurse expect to be ordered for Kyle? Kyle is found to have crushed vertebrae at the S4-5 level with a partially severed spinal cord. c. What would be important teaching points for Kyle and his family? (3) Case Studies Chapter 49: Nursing Care of the Child With an Endocrine Disorder 1. Jalissa Twyman, 8 years old, was admitted to the pediatric intensive care unit with a closed head trauma after being involved in a bicycle/motor vehicle accident. Jalissa is unconscious. The nurses caring for Jalissa document a weight loss of 1.82 kg over a 24-hour period, decreased skin turgor, and dry mucous membranes. Urine output for the same 24-hour period is 3.5 L/m2. (Learning Objectives 1, 2, 3, 4, 5, and 7) a. What further assessments should the nurse perform on Jalissa? b. What laboratory tests would the nurse expect to be performed on Jalissa? c. What nursing interventions should be done for Jalissa? 2. Aellai Gianopoulos, 13 years old, is brought to the clinic by her mother, who states that Aellai is losing her hair. Vital signs are as follows: T 98.4°F, HR 85, R 15, BP 121/78. Height is 64 in., and weight is 81.5 kg. Aellai has an olive complexion marred by acne, large brown eyes, and long black hair that is very thin on the top of her head. Her breasts are small and she has an abundance of hair on her arms and legs. She reached puberty approximately 6 months ago. (Learning Objective 1, 2, 3, 4, 5, 7, and 8) a. What other information should the nurse gather in the health history? b. What laboratory tests would the nurse expect to be ordered for Aellai? c. What should the nurse include in the teaching plan for Aellai and her family?

Answer 1

All the findings were in the normal limits

Temperature	36.5-37.5degree celceus
Heart rate	120-160beats per minute
Respiration	40-60breaths per minute
Head circumference	33-35cm
Chest circumference	31-33cm or three CM less than head circumference

And normal weight of the baby is 2.5 to 3.5kgs so only routine care will be provided to this child. For example

• Do suction from mouth and then nose
• Record apgar score in first min of birth
• Dry the baby
• Wrap in a warm blanket
• Then again do apgar score after five minutes
• Provide vit k inj.
• Provide oxygen

Ans:-2) normal routine blood investigation will be sent to the lab for this child because this baby is suffering from heart problems

Ans:-3)parents should be taught that excessive crying of the baby should be avoided in this child as it may lead to oxygen deficiency and that can lead to cynosis in the child.

Ans b1) while doing initial assessment of the rheumatic fever related child the the nurse should assess for previous history of ear or throat infection because rheumatic fever is mainly caused by group a beta Hemolytic straptococci infection and this is more common in the child who has a history of throat or ear infection 2-3weeks ago

Ansb2)ASOtiter is the confirmatory test for rheumatic fever when it is already confirmed then ESR and CRP tests can be done for this child.

Ansb3) Maintain proper personal hygiene of a child should be advised to the parents to prevent recurrent infection

Avoid contact with sick person

Do proper follow up