Question

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Use your own words. Please use your text book “Maternal-Child-Nursing-Care-6th-Edition”. Think about the challenges for the patient and the family. Think about how to connect with a child who is confused and frightened. Think about how you might be perceived to the child and family.  

1. During a health supervision visit for a 5 year old girl, the mother tells you she is worried about her hearing. She has been seen at your clinic since birth. She was the product of a normal pregnancy and delivery. She has had frequent ear infections since the age of 8 months. Six months ago she had a ruptured appendix and was treated with aminoglycoside. She has been fully recovered for 4 months.

a. What additional information would you seek from the mother during the office visit?

b. What information would you (the RN) would you want to verify from the medical record?

c. What are the risk factors? What is the plan of action?

2. A family arrives for their amniocentesis at 16 weeks pregnant with their third child. Their NT test was positive for likely Down Syndrome. The amniocentesis is clinically diagnostic for Down Syndrome.

a. Describe Down Syndrome- physical features, social features, life expectancy, level of functioning.

3. Public schools in this area have yearly vision and hearing screenings. Why do public schools (and many private as well) do these free screenings?
4. A parent is concerned about their toddler’s behavior as they are acting out at school, have difficulty paying attention and are struggling to sleep at night.

a. What would you anticipate the doctor having as differential diagnoses (options for possible conditions to rule out)- list at least three with brief general description (2-3 sentence description)

b. What are five possible nursing diagnoses going on with this family and patient?

Answer 1

Answer to question number 1:

a) i would ask the mother regarding the duration of her child's hearing problem and whether she noticed any discharge from her child's ear and does her child gets recurrent cold or throat infections as well.

b) i would check her medical record regarding the aminoglycoside dose and duration of therapy which she had received during treatment for ruptured appendix.Also, i would check the nature, duration and the treatment she had received for her past ear infections.

c)she is at risk of developing ototoxicity as it is a common adverse affect of aminoglycosides. recurrent ear infections indicates chronic middle ear infection referred as otitis media which is common in children .

plan of action includes examination of the ear and advise her to consult a E.N.T specialist .