CASE STUDIES
\nI- Case Study: Care of the Child in Inpatient and Outpatient Settings
\nJordan is 9-year-old male who is a direct admit for observation. He has a history of vomiting and diarrhea for 48 hours.
\nSubjective Data<\/p>\n
Nausea and vomiting for 24 hours
\nHas not voided today
\nUnable to tolerate oral fluids<\/p>\n
Objective Data<\/p>\n
Vital signs: T 37.8\u00b0 C, P 120, R24, BP 110\/60
\nWeight: 34 kg
\nHyperactive bowel sounds to auscultation<\/p>\n
1. Question 1
\nWhen should the discharge teaching begin for Jordan and his family?
\n2. Question 2
\nWhat is the best way to approach Jordan regarding the IV that has been ordered.
\n3. Question 3
\nWhat would be good distractions for a child of Jordan’s age?
\nII- Case Study: Pediatric Cancer
\nMario is a 7-year-old male who presents with a 1-week history of body aches and pallor. He has a 2-day history of fever to 103\u00b0 F and a 1-day history of bruising and lethargy.
\nSubjective Data<\/p>\n
Complains of hurting all over
\nStates he feels very tired
\nStates he feels dizzy when he stands up<\/p>\n
Objective Data<\/p>\n
Weight 26.1 kg
\nVital signs: T 38.9\u00b0 C, P 140, R 40, BP 108\/54, O2 sat 100%
\nPurpural rash on extremities
\nWBC 0.7
\nHGB 3.1
\nHct 8.5
\nPlt .08
\nANC 0.1<\/p>\n
4. Question 1
\nWhich of Mario’s presenting symptoms must be treated and stabilized before chemotherapy induction?
\n5. Question 2
\nWhat testing is required for a definitive diagnosis of meningitis?
\n6. Question 3
\nWhat should the nurse do in this clinical situation? Prioritize actions.
\nIII- \u00a0Case Study: Pediatric Respiratory System
\nWill is a 4-month-old infant born at 34 weeks of gestation. Will\u2019s mother states that he has not been able to go to day care because he has been coughing with a fever for the past 3 days. She states today he is unable to feed well from the bottle because of nasal secretions.
\nSubjective Data<\/p>\n
Mother complains that infant has had cough for 3 days
\nMother states that infant is having trouble sleeping
\nNot voided in past 6 hours<\/p>\n
Objective Data<\/p>\n
Birth Weight: 1.9 kg
\nToday\u2019s Weight: 5.5 kg
\nVital Signs: T 38\u00b0 C, P 186, R 60, BP 90\/52, Pulse Oximetry 93%
\nThick yellow nasal secretions
\nNasal flaring with moderate intercostal retractions
\nBreath sounds decreased with crackles bilaterally to auscultation<\/p>\n
7. Question 1
\nWhat risk factors does Will have for contracting bronchiolitis?
\n8. Question 2
\nWhat is the first priority for Will’s treatment?
\n9. Question 3
\nWhat should the nurse do in this clinical situation? Prioritize actions.
\nIV- \u00a0Case Study: Pediatric Gastrointestinal System
\nLucy is a 44-day-old formula-fed infant who presents with a 4-day history of vomiting.
\nSubjective Data<\/p>\n
Mother states infant has been vomiting undigested formula after feedings
\nMother states that infant has not had fever or diarrhea
\nMother states that infant has had 8 wet diapers in the past 24 hours<\/p>\n
Objective Data<\/p>\n
Weight 4.8 kg (birth weight 3.5 kg)
\nVital signs: T 37.1\u00b0 C (rectal), P 130, R 30, BP 92\/52
\nMucous membranes moist, anterior fontanel flat and soft
\nAwake and alert, lusty cry
\nGood muscle tone
\nOlive-sized mass palpated at epigastrium<\/p>\n
10. Question 1
\nWhat test will be used to diagnose pyloric stenosis?
\n11. Question 2
\nWhat should the nurse do in this clinical situation? Using the case study above, the first prioritization step the nurse would take is ____.
\n12. Question 3
\nThe second prioritization step the nurse would take is ____.
\n13. Question 4
\nThe third prioritization step the nurse would take is ____.
\n14. Question 5
\nThe fourth prioritization step the nurse would take is ____.
\n15. Question 6
\nThe fifth prioritization step the nurse would take is ____.
\n16. Question 7
\nThe sixth prioritization step the nurse would take is ____.
\n17. Question 8
\nThe seventh prioritization step the nurse would take is ____.
\n18. Question 9
\nThe eighth prioritization step the nurse would take is ____.
\nV- Case Study: Pediatric Cardiovascular System
\nMichael is a 7-week-old breastfed infant who presents with a 2-day history of irritability and poor feeding.
\nSubjective Data<\/p>\n
Mom states patient has been \u201cfussy\u201d for past 2 days
\nOnly feeds for a \u201cfew\u201d minutes at a time
\nBreathing heavily and fast for 2 days<\/p>\n
Objective Data<\/p>\n
Weight: 4.8 kg
\nVital Signs: T 36.8\u00b0 C, P 250, R 65, BP 84\/58
\nBreath sounds clear to auscultation
\nOxygen Saturation 95%
\nCentral capillary refill 4 sec<\/p>\n
19. Question 1
\nWhat is the treatment for an unstable patient with SVT?
\n20. Question 2
\nDecreased cardiac output from prolonged SVT will produce what complication?
\n21. Question 3
\nIn this clinical situation what should the nurse do? Prioritize actions.
\nVI- \u00a0Case Study: Hematologic System
\nLiam is an 8-year-old male with a history of hemophilia. Liam presents today with a 1-day history of right elbow pain.
\nSubjective Data<\/p>\n
Right elbow pain for 1 day
\nPatient states he hit his right elbow on desk yesterday
\nPatient complains that he cannot move his elbow<\/p>\n
Objective Data<\/p>\n
Weight 31.6 kg
\nVital sighs: T 37.4\u00b0 C, P 82, R 20, BP 108\/68
\nRates pain 6 on scale of 10<\/p>\n
22. Question 1
\nHow should the nurse respond when Liam’s father explains that they watched and waited to see if Liam needed treatment after his injury?
\n23. Question 2
\nWhy are neuro checks an important part of Liam’s physical exam?
\n24. Question 3
\nWhat should the nurse do in this clinical situation? Prioritize actions.
\nVII- Case Study: Common Disorders of the Red Blood Cells
\nSusan is a 26-year-old G1P0 at 6 weeks of gestation with type 2 diabetes. Her BMI is 32. Her hemoglobin A1C is 9. She uses glyburide 10 mg PO daily. The physician has switched her to insulin at this time.
\n1. Question 1
\nWhat is the nursing priority at this time?
\n2. Question 2
\nWhat should Susan be taught about insulin needs during pregnancy?
\n3. Question 3
\nWhat additional risk factor does Susan have?
\n4. Question 4
\nHow should Susan be counseled regarding weight gain in pregnancy?
\n5. Question 5
\nWhat advice can be given to Susan regarding exercise?
\nVIII- \u00a0Case Study: Pediatric Genitourinary System
\nLilly is a 3-year-old female who presents with complaints of abdominal pain and fever since yesterday.
\nSubjective Data<\/p>\n
Complains of lower abdominal pain
\nFever for 24 hours
\nLilly has \u2018wet her pants\u2019 despite being recently potty trained<\/p>\n
Objective Data<\/p>\n
Vital signs: T38.5\u00b0 C, P 114, R 32, BP 104\/62
\nUrine positive for WBCs, nitrites, blood<\/p>\n
6. Question 1
\nWhat risk factors does Lilly have for UTI?
\n7. Question 2
\nWhat might prevent Lilly from a recurring UTI?
\n8. Question 3
\nWhat should the nurse do in this situation? Prioritize actions.
\nIX- \u00a0Case Study: Pediatric Neurologic System
\nAbby is a 1-year-old female who presents after a reported seizure at day care.
\nSubjective Data<\/p>\n
Fever for 1 hour
\nEating and drinking normally per mother<\/p>\n
Objective Data<\/p>\n
Vital signs: T 40\u00b0 C, HR 160, R 44, BP 104\/68
\nAwake and alert
\nSkin hot to touch, otherwise normal physical examination<\/p>\n
9. Question 1
\nHow should the nurse respond to Abby’s mother when she asks if Abby has epilepsy?
\n10. Question 2
\nHow should the nurse respond to Abby’s mothers question about brain damage?
\n11. Question 3
\nIn this clinical situation what should the nurse do?
\n\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"
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