Question

CASE STUDY OUTCOME Z.O. dies at home just before his fourth birthday. The hospice nurse helps the family by assessing their coping strategies and offers them family bereavement resources. From Winningham's Critical Thinking Cases in Nursing(5th Edition) - Chapter 10.99 Last problem

Z.O. is a 3yr old boy with no significant medical history. He is brought into the ED by the emergency medical technicians after experiencing a seizure lasting 3 mins. A CT scan of the brain shows a 1-cm mass in the posterior fossa region of the brain, and pt diagnosed with a cerebellar astrocytoma.

Answer 1

Zo was diagnosed to have brain tumor the question outcome of the chapter are:

The common presenting symptoms of brain tumor are as follows :

* headache can be acute or persistent and later stages it would be more chronic

* muscular problems such as difficulty walking, lack of co ordination,

* dizziness, restlessness, fatigue and vertigo may be present

*difficulty in speech, personality changes

* other changes would include the blurred vision, loss of sensation

2. The nutrition plays a very important role as there is muscle wasting, muscle weakness hence monitoring and providing nutrition helps to maintain proper nutritional status.

The diagnosis are:

* Imbalanced nutrition less than body requirement related to cachexia due to treatment as evidenced by reduced nutrition intake

The interventions are:

* the meals must be planned during rest periods

* small frequent diet must be provided sufficiently to improve the child's energy

* monitoring of intake and output to enhance and manage the fluid balance

* protein rich diet must be initiated which helps in the new muscle formation

* start with the enteral feeding or total parental nutrition to maintain the nutritional status

* check the latency of the central vein

For preoperative teaching:

* educate regarding the skin preparation, environment and after procedure routines

* teaching regarding the post op recovery strategies by family members in collaboration with health care team members

Facilitating family coping: There would be interupted family process whereby the whole family would be disturbed due to child's hospitalization:

* educating parents regarding the care provided in order to reduce their anxiety

* provide psychological support

* encourage the patient to ask doubts and clear the doubts of patient.

Preparation of zo and family for operation:

* provide the adequate information regarding the procedures, complications and care provided

* encourage and clear the doubts

* provide psychological support