Question

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.

Case Study # 1

Jordan is a 9-year-old boy who is a direct admit for observation. He has had a history of vomiting and diarrhea for 48 hours.

Subjective Data

Has a history of nausea and vomiting for 24 hours.

Has not voided today.

Is unable to tolerate oral fluids.

Objective Data

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

Weight: 34 kg

Hyperactive bowel sounds to auscultation

Questions:

1. When should the discharge teaching begin for Jordan and his family?
2. What is the best way to approach Jordan regarding the intravenous (IV) line that has been ordered?
3. What would be good distractions for a child of Jordan’s age?

Case Study #2

Susan is a 4-year-old girl with a 7-day history of fever and lethargy. Susan’s physician has ordered laboratory work that includes a blood culture.

Subjective Data

Susan has had fever for 1 week.

Her mother has noticed a decreased activity level.

Susan states she is “afraid” of needles.

Objective Data

Weight: 26.1 kg

Vital signs: temp, 39.3º C; pulse, 110 bpm; resp, 40 breaths/min; blood pressure, 108/54 mm Hg; oxygen saturation (O₂ sat) 100%

No abnormal findings on physical examination

Questions:

1. When should Susan’s nurse explain the procedure to her?
2. To give Susan some control over this situation, what choices could be given to her?
3. What actions should the nurse take in this clinical situation? Prioritize the actions.

Discussion Topic: What is the Perez reflex? Why is it important to know how to elicit it? Discuss the use of the Perez reflex in collecting urine specimens from infants.

Answer 1

Case study 1

#The discharge teaching should begin as soon as his fever nausea and vomiting decreases .His bowels sound returns to normal

#The best way to approach him is by engaging in playful conversation and getting rid of his fear and then making him understand the need of IV line to recover faster and go home

#The best way to distract the child of this age group is by providing some play materials ,activities and task in the devices

Case study 2

#Susan should be explained before the procedure. This can help the child to have some time to think that the nurse will come to do some procedure in them

#The choices which can given are

• Reward if cooperates
• Play materials
• Demonstrate on a doll or toy
• Letting her to be in the comfortable way and place to cooperate with the procedure

#The nurse should take the following action in priority

• Providing comfort zone to the child
• Orientation the client to new environment
• Playful therapeutic measures

#Perez reflex

Here the baby is holded in a prone position and a gentle stroke is given along the spine using the finger .This should cause extension of the baby body.

It is important to know this because this method can help the healthcare professionals to identify the sensory perception of the infant

It is useful in infant for collecting clean catch urine for urine analysis.