Question

Devon Bynum, an 11-year-old, is admitted to the hospital in sickle cell crisis. This is the first time he has been admitted to a hospital. He states he hurts all over and rates his pain at a 7 out of 10. Devon has been in the emergency department all night and last received morphine 2 mg IV at 0400 for his pain. He is receiving oxygen at 2 liters per minute (LPM) via nasal cannula. He has an IV of D5 ½ NS running at 83 mL/hour. His mom, who has been with him throughout the night, is anxious for her son to feel better. His last vital signs are TO 99.3°F; P 122 bpm; R 22/min; BP 100/64 mmHg; and oxygen saturation of 93% on oxygen at 2 LPM. He says he is tired and just wants to go to sleep. Devon’s mom tells the nurse that she doesn’t know how she will be able to pay the hospital bills. She shares that she is a single parent with two other children at home.

Question 1 What are three nursing diagnoses that you would give for Devon (NANDA diagnoses)?

Question 2 Would you include his mom’s concern about finances in his plan of care? How?

Question 3 What other healthcare disciplines (s) would you expect to include in Devon’s plan of care?

Answer 1

1, NANDA nursing diagnosis:
-Acute pain
-Impaired gas exchange
- the risk for deficient fluid volume
2, Plan of care should include family concerns about a patient. patient mother's burden about finances should be included in the plan of care. As an Interdisciplinary care provider can talk with the insurance companies for guiding any reimbursement, medicare or Medicaid coverage for their eligibility for their treatment. Improve mother knowledge about self-care for managing pain, it can reduce the hospital utilization cost and avoid out of pocket money spending. comprehensive management program for pediatric patient sickle cell crisis needs improvement in the transition of care to reduce hospitalization.
3, plan of care for patient should include maintaining patient EMR for clear communication with team members and improve patient care. patient nutrition status, preventing complications should be included. collaboration and communication with the mother and the patient can improve better health outcomes. Implementing doctors' orders can limit their pain, documentation and using knowledge and skills for decision making, and identify the patient episode of illness important in health care discipline.  educate a child with managing pain including relaxation techniques, massage, etc. support the child with their pain, patient-centered care can address the child's illness. provide psychological support for reducing anxiety for the child.