Question

What are the different types of hearing loss? Follow the discussion guidelines below.

For the case study section only: Please only provide short answers for the case study No more than 2 sentence response. Answer all the questions in all case study scenarios.

1. Case Study: Childhood Obesity

Mason is a 7-year-old boy who is at his primary care physician for a routine physical examination. Mason’s mother expresses concern about childhood obesity and is worried that he sleeps too much.

Subjective Data: Mason has been eating more than usual. Mason sleeps between 11 and 12 hours a day. Mason plays team soccer.

Objective Data

Height: 121 cm

Weight: 23 kg

Vital signs: temp, 37º C; pulse, 78 bpm; resp, 22 breaths/min; blood pressure, 102/62 mm Hg

Height: 90 cm

Mason has a normal physical examination for his age.

Questions:

1. 1. What should the nurse tell Mason’s mother when discussing her concerns about childhood obesity?
   2. What can Mason’s mother do to help Mason maintain a healthy weight?
   3. Mason’s mother has questions about his joining a soccer team. What should the nurse tell her?
2. Case Study: Brain Tumor

Caroline is an 11-year-old girl who has an inoperable brain tumor. Caroline has been admitted for palliative care. Her mother, father, and two siblings are with her.

Subjective Data: Caroline complains of a severe headache. She states that she is “afraid to be alone.”

Objective Data

Vital signs: temp, 37.8º C; pulse, 120 bpm; resp, 24 breaths/min; blood pressure, 110/60 mm Hg

Caroline is unable to walk unassisted.

Her pupils are unequal 4 mm right and 6 mm left.

Questions:

1. What is the most immediate priority for Caroline?
2. How can Caroline’s nurse help with Caroline’s fears?
3. How can Caroline’s nurse maintain professional boundaries?

3. Case Study: Hyphema

Johnny is a 10-year-old boy who seeks care after being hit in the right eye with a stuffed snake by his brother 15 minutes before arrival.

Subjective Data: Johnny complains of light sensitivity. Vision in the right eye is blurred.

Objective Data

Vital signs: temp, 36.8º C; pulse, 90 bpm; resp, 18 breaths/min; blood pressure, 110/60 mm Hg

Pupils: Left, 3 mm briskly reactive to light. Right, 3 mm and sluggishly reactive to light

Visual acuity: Right eye unable to see chart; left eye 20/15

Approximately a 30% hemorrhage is noted to the anterior chamber of the right eye with an intact globe.

Questions:

1. Johnny is at risk for what complications?
2. What measures may help prevent these complications?
3. What should the nurse do in this situation? Prioritize these actions.

Answer 1

Case study 1:-

a. It is good that Mason’s mother is aware of the importance of preventing childhood obesity, but Mason’s current weight-for-stature is in the 50thpercentile according to the CDC growth charts. His increased appetite is not unusual for a school-age child as they often have increased energy needs. With proper nutrition and exercise, Mason should have no difficulty remaining a healthy weight.

b. Some of the ways Mason’s mother can do to help Mason maintain a healthy weight are :-

- Avoiding junk foods

- Engaging in regular exercise or physical activity

- Providing nutritious diet

- Encouraging to drink plenty of fluids

- Providing education about healthy lifestyle and it's importance

c. It's very good to be a part of soccer team as it will help him to be physically active and also be a sports person and if he is interested he can persue it as a career.

2) a. The most immediate priority for Caroline is the management of severe headache

b. Caroline’s nurse can help with Caroline’s fears by the following ways :-

Be with the patient to promote safety especially during frightening procedures or treatment.The physical connection with a trusted person helps the patient feel secure and safe during a period of fear.

Maintain a relaxed and accepting demeanor while communicating with the patient.The patient’s feeling of stability increases in a peaceful and non-threatening environment.

Familiarize the patient with the surrounding as necessary.Familiarity with the setting promotes comfort and a decrease in fear.

Provide accurate information if irrational fears based on incorrect information are present.Replacing inaccurate beliefs into accurate information reduces anxiety.

If patient’s fear is a reasonable response, empathize with him or her. Avoid false reassurances and be truthful.Reassure patients that asking for help is both a sign of strength and a step toward resolution of the problem.

Use simple language and easy to understand statements regarding diagnostic procedures The patient may find it hard to understand any given explanations during excessive fear. Simple, clear, and brief instructions are necessary.

Maintain a quiet environment whether at home or in a hospital setting. Drop any unnecessary stuff around the patient.Patient’s fear is not reduced and resolved if the environment is unsafe.

Provide safety measures within the home when indicated (e.g., alarm system, safety devices in showers or bathtubs). Patient’s fear will not be reduced or resolved if the home environment is unsafe.

Support the patient in recognizing strategies used in the past to deal with fearful situations.This method allows the patient to think that fear is a natural part of life and can be dealt with successfully.

c. Some of the ways to maintain professional boundaries :-

- Ensuring care is totally focused on patient and family' s health and well being

- Ensuring that you are there only as a practitioner

- Honouring confidentiality where appropriate

- Maintaining a proper appointment system

- Getting help for yourself in crisis

- Consulting with colleagues in difficult situation

- Refraining from over familiarity

- Not accepting or giving gifts