Question

(1) Case Studies Chapter 28: Growth and Development of the School-Age Child 1. Gina has come into the primary care center with her mother Kris for an 11-year-old wellness examination. As the nurse prepares Gina for her examination, Kris asks to speak to the nurse outside the examination room. Kris shares with the nurse her concerns about recent changes she has noticed in Gina. She explains that Gina’s body is beginning to change and she has made a number of comments about her body image. Kris is concerned about Gina’s self-esteem and emotional development. (Learning Objectives 1, 2, and 3) a. What are some of the prepubescent changes school-age children experience that the nurse can share with Kris? b. What are some of the issues regarding body image that the nurse can teach Kris about? c. What can the nurse teach Kris regarding self-esteem in school-age children to address her concerns? 2. Don is a 10-year-old boy who is being seen by the school nurse today for a fall he experienced on the school’s playground. Don’s mother, Kandis, has arrived and expresses some concern regarding Don’s recent behavior. She explains that he has engaged in more risk-taking behavior and has had more injuries lately. Kandis then asks the nurse what Don’s weight is and asks her if she thinks Don is overweight. Don is 5’1” and weighs 130 lbs. His body mass index (BMI) is 24.5. (Learning Objectives 4, 5, and 6) a. What can the nurse teach Kandis about promoting a safe lifestyle for Don? b. What can the nurse teach Kandis regarding Don’s weight and corresponding BMI? c. What can the nurse teach Kandis regarding Don’s nutritional needs, promoting nutritional healthy intake, and preventing overweight/obesity?

(2) Case Studies Chapter 37: Nursing Care of the Child With an Infectious or Communicable Disorder 1. Mrs. Acton, the mother of 6-year-old Christina, calls the physician’s office to speak to the nurse. Mrs. Acton is concerned because Christina went to a birthday party 8 days ago and was exposed to the chickenpox. (Learning Objectives 4 and 5) a. What information would be appropriate to give to Mrs. Acton? b. What data would be important for the nurse to gather when speaking with Mrs. Acton? 2. Six-month-old Joshua is brought to the acute care center by his parents. The parents tell the nurse that Joshua has become “very fussy,” seems to be pulling at his right ear, and is running a fever. The nurse finds the infant’s temperature to be 100.2°F axillary. His weight is 7.7 kg and he is crying inconsolably. Joshua’s anterior fontanel is flat when he is crying and his skin feels hot to the touch and dry. Joshua’s mother tells the nurse that when the infant saw his physician 10 days ago he weighed 8.1 kg. (Learning Objective 3) a. Based on the data obtained during this assessment by the nurse, what interventions should the nurse expect to provide? b. What child/family teaching would the nurse be expected to provide?

(3) Case Studies Chapter 40: Nursing Care of the Child With a Respiratory Disorder 1. Gloria is an 8-year-old girl who is admitted to the pediatric unit with a history of cystic fibrosis and difficulty breathing. (Learning Objectives 3, 4, and 6) a. What would the nurse know to include in the health history? b. When conducting a physical assessment on Gloria, what will the nurse do in relation to the child’s cystic fibrosis? c. What tests would the nurse expect to be ordered for Gloria? 2. Jimmy Jones, age 6, is diagnosed with asthma. He has been hospitalized for 3 days for an acute exacerbation and is scheduled to go home tomorrow. (Learning Objectives 9 and 10) a. What would the nurse know to include in a child/family teaching plan? b. How can asthma affect a child’s self esteem?

Answer 1

(1) Case studies:

1. a. What are some of the prepubescent changes school-age children experience that the nurse can share with Kris?

These are the changes normally occur in all girls before the beginning of menarche. The first changes that you can see at this age are the development of breast buds. Then the hair begins to grow in the pubic area and under the arm. Body fat and weight gain occur due to deposition of adipose tissue. sexual orientation develops at this stage due to hormonal changes.

b. What are some of the issues regarding body image that the nurse can teach Kris about?

Usually, Gina may feel fear and misconception of their body image. Make her accept the body image as positive. Tell her that is the normal body function of transition of child to the adult stage. Support them emotionally and talk to them about the changes of her own. Explain her about the menarche and how to take care of her. Secondly, she will worry about the body fat and an increase in weight gain. Give her Healthy nutritious diet and to be active to maintain a healthy weight.

c. What can the nurse teach Kris regarding self-esteem in school-age children to address her concerns?

At this stage, she faces a number of challenges in the home and at school. Treat them with respect which helps them to grow the self-confidence and self-esteem. Increased self-esteem will grow positive behavior. Peer acceptance and social acceptance is necessary which improves her communication skills. Try to avoid health issues and eating disorders which may decrease her self-esteem.

2.  a. What can the nurse teach Kandis about promoting a safe lifestyle for Don?

The nurse can teach Kandis about the importance of safe lifestyle by promoting a nutritious diet, healthy eating behavior, exercise, personal growth, caring for body image, keenness, and avoid of injuries during playing by adopting appropriate lifestyle manner. As Don overweight is one of the causes for injuries, so explain Kandis about the healthy eating habits.

b. What can the nurse teach Kandis regarding Don’s weight and corresponding BMI?

Don's weight and BMI show that he is overweighed for his age. This is mainly due to bad eating habits, inappropriate sleep, wrong selection of food items, and a sedentary lifestyle. This may increase his health risks. Teach Kandis about healthy eating habits, physical activity, the proper sleeping pattern will help him to maintain normal healthy weight.

c. What can the nurse teach Kandis regarding Don’s nutritional needs, promoting nutritional healthy intake, and preventing overweight/obesity?

The nurse may develop a menu plan which consists of three meals and two nutritious snacks. The nurse may include the fruits, vegetables, grains, and dairy products to meet the essential requirements of carbohydrates, proteins, vitamins, and minerals. Exercise and physical activity should also be included to prevent obese. Serving size should be strictly followed and advised her to minimize the calorie and increase the nutrient.