CYPRUS INTERNATIONAL UNIVERSITY FACULTY OF HEALTH SCIENCE DEPARTMENT OF NURSING INSTRUCTIONS: Please read the case studı

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CYPRUS INTERNATIONAL UNIVERSITY FACULTY OF HEALTH SCIENCE
DEPARTMENT OF NURSING INSTRUCTIONS: Please read the case studıes
carefully and determine the nursing diagnosis for the holistic care
of the patients. Write the appropriate nursing interventions
according to the case study questions. Choose at least one (1) case
study from Case study 2 and 3. Case study 1 is compulsory In CASE
STUDY 1, 2 and 3  With the case study questions given in this
assignment, kindly prepare a proper Nursing Care Plan for Each Case
Studies. o Identify the Right Pediatric Disease Conditions. o
Identify at least three (3) nursing diagnosis for the disease
condition in each case study. o Discuss at least four (4)
appropriate nursing interventions for each diagnosis that would be
helpful for the Chi CASE STUDY 1 The parents of an 8-year-old
boy enter the emergency department shortly after the child arrives
via ambulance from school. Subjective Data • The parents state, •
“Where is our son? We received a telephone call from the school
nurse that our child collapsed in his classroom and that he was
immediately transported to the hospital via ambulance.” • “He is a
good boy. We know that he didn’t take anything that he shouldn’t.”
• “Please, we must see him to let him know that we love him and
want him to get better.” • “He has had a bad cold for the past
couple of days, but that’s it.” • After a brief interview with the
nurse, the parents state, • “He has been drinking and eating a lot
lately, but we just thought that he was an active, growing boy.” •
“We’ll be honest with you, we don’t pay too much attention to how
often he goes to the bathroom. He is a very private boy.” Objective
Data • Glasgow Coma score: 11/15 (see Glasgow coma scales in
Chapter 22, “Nursing Care of the Child With Neurological Problems”)
• Eye opening: opens eyes in response to speech, 3 • Motor
response: makes localized movements in response to painful stimuli,
5 • Verbal responses: responds with inappropriate words, 3 • Other
assessments Vital Signs Temperature: 99.8 °F Heartrate: 130 bpm
Respiratoryrate: 32 rpm,deep Bloodpressure: 95/56mmHg O2
saturation: 96% Currentweight: 86lb/8.1%weightloss(7lblessthan
hislast well-child checkwhen he wasatthe50thpercentileforheight and
weight) • Dry mucous membranes Skin tenting Lab Results Complete
blood count Red blood cell count: 5.5 million cells/mm3 Hematocrit:
48% Hemoglobin: 16 G/dL Platelets: 180,000 cells/mm3 White blood
cell count: 8,300 cells/mm3 • Serum glucose: 325 mg/dL • Serum
potassium: 2.5 mEq/L • Hemoglobin: A1C 12% • PH: 7.0 Health-Care
Provider’s Orders • Admit to pediatric intensive care unit •
Complete bedrest • NPO • IV NS 400 mL over one hour, 20 mL/kg
thereafter • Insulin drip at 0.05 units/kg/hr • Perform serum
glucose assessments every 15 min and report to primary health-care
provider • Repeat hourly potassium levels and report to primary
health-care provider • Monitor Glasgow findings every 15 min. If
the level drops below 11, notify the primary healthcare provider
immediately (Potassium replacement and additional insulin
administration to be determined based on laboratory data.) CASE 2
6-month-old, Caucasian girl was examined by the primary health care
practitioner. Subjective Data • Crying and shaking her head back
and forth while in her mother’s arms • Repeatedly tugging at her
right ear • Mother states, • “She has had a cold for the past
couple of days. Her nose has been all snotty, she’s had a hard time
breathing through her nose, and she’s had a bit of diarrhea, too.”
• “About 3 a.m. this morning she woke up crying. I took her
temperature with an armpit thermometer, and it was 101.8°F. She has
been miserable all day.” • “I think she needs antibiotics.” • When
asked about factors that place this child at high risk for ear
infections, the mother states, • “She drinks formula from a
bottle.” • “I try to keep my husband from smoking in the house, but
it’s hard. He hates to have to go out onto the porch to smoke when
it’s so cold outside.” Objective Data Nursing Assessments • Color
pink • Lungs clear • Rhinorrhea • Red, bulging tympanic membrane on
right • Slight bulging of tympanic membrane on left • Current
weight: 15½ lb (consistent growth since last well-child visit)
Health-Care Provider’s Orders • Acetaminophen 80 mg PO every 6
hr—administer first dose in office • Ampicillin 150 mg PO every 6
hr for 10 days • Warm or cold packs to ears, as needed • Instill
saline nasal drops prior to feedings • Diet change: ORT instead of
formula for 2 days • Return for reassessment after completion of
the antibiotic course or earlier, if child shows no improvement.
CASE STUDY 3 Mother brings 3-year, 3-month-old female to be
assessed by the health-care practitioner Subjective Data • Child is
seen playing with dolls in the waiting room while pretending to
give the baby a bottle and wrapping the baby in a blanket • Mother
states, • “Everything seems fine, but I noticed that my daughter’s
urine is pink. I first saw it yesterday evening.” • “She has had a
couple of colds this year, but nothing out of the ordinary. What do
you think is going on?” Objective Data Nursing Assessment • Since
birth, the child’s well-child checks have been within normal
limits, including weight, height, and head circumferences all at
the 50th percentile • Child is up to date on all immunizations •
Mass palpated in left upper quadrant—child exhibits minimal
guarding • Ultrasound results • Presumed Wilms’ tumor noted in left
kidney Health-Care Provider’s Orders • Admit to pediatric unit •
Prepare for surgery in a.m. • NPO after midnight • Modified bedrest
• Absolutely no one is to palpate the abdomen Vital Signs
Temperature: 98.8°F Heart rate: 100 bpm Respiratory rate: 26 rpm
Blood pressure: 106/66 mm Hg Lab Results Complete blood count Red
blood cell count: 3.6 million/mm3 Hemoglobin: 11 g/dL Hematocrit:
33% White blood cell count: 10,000/mm3 Platelet count: 225,000/mm3
Urine: within normal limits except Red blood cells: 10 (normal less
than or equal to 2) CASE STUDY QUESTIONS 1. What subjective
assessments indicate that this client is experiencing a health
alteration? 2. What objective assessments indicate that this client
is experiencing a health alteration? 3. After analyzing the data
that has been collected, what primary nursing diagnoses should the
nurse assign to this client? 4. What interventions should the nurse
plan and/or implement to meet this child’s and her family’s needs?
5. What client outcomes should the nurse evaluate regarding the
effectiveness of the nursing interventions? 6. What physiological
characteristics should the child exhibit before being discharged
home? 7. What subjective characteristics should the child exhibit
before being discharged home?