Nursing Pediatric

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Develop a discharge plan with three goals listed in order of priority before discharge from current orders. Provide a rationale for why you listed the goals in a particular order. Also, list three nursing interventions to meet each goal (you should have nine interventions in total). Last, the mother should give the child the exact dosage she will need for acetaminophen, ibuprofen, and cefuroxime when she gets home and explain why the same dosage is essential.

 

Scenario:

A 5-year-old Gabriel, a multiracial male weighing 48 lbs with a penicillin allergy, arrives in the emergency room; no cultural considerations are identified. You are handed the following notes on the patient that read:

He arrived in the ER with his mother after falling out of bed after jerking movement activity, as witnessed by his older brother while sleeping. The right upper extremity appears with deformity. Mother and child speak English. The child has no significant medical history. The mother reports incontinent of urine during the episode.

The physician discharges Gabriel from the ER to home with a diagnosis of Right ear infection, Acute Febrile Seizure, and fracture of the right ulna.

Discharge orders include:

Sample Solution

Scenario:

 

A 5-year-old Gabriel, a multiracial male weighing 48 lbs with a penicillin allergy, arrives in the emergency room; no cultural considerations are identified. You are handed the following notes on the patient that read:

 

He arrived in the ER with his mother after falling out of bed after jerking movement activity, as witnessed by his older brother while sleeping. The right upper extremity appears with deformity. Mother and child speak English. The child has no significant medical history. The mother reports incontinent of urine during the episode.

 

The physician discharges Gabriel from the ER to home with a diagnosis of Right ear infection, Acute Febrile Seizure, and fracture of the right ulna.

 

Discharge orders include:

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Discharge Plan for Gabriel

Goals

  1. Prevent recurrence of febrile seizures: This is the highest priority as febrile seizures can be frightening for both the child and parents. Preventing future seizures will provide peace of mind and reduce the risk of complications.
  2. Manage pain and discomfort: Addressing the child’s pain from the fracture and ear infection will improve his overall well-being and promote healing.
  3. Educate the mother on home care: Ensuring the mother understands the proper care for Gabriel’s fracture and ear infection will help prevent complications and promote optimal recovery.

Nursing Interventions for Goal 1: Prevent recurrence of febrile seizures

  • Monitor temperature closely: Advise the mother to check Gabriel’s temperature frequently, especially during illness.
  • Administer antipyretics as directed: Ensure the mother understands the correct dosage and frequency for acetaminophen and ibuprofen to manage fever.
  • Hydrate adequately: Encourage the mother to offer plenty of fluids to help reduce fever and prevent dehydration.

Nursing Interventions for Goal 2: Manage pain and discomfort

  • Administer pain medication as prescribed: Ensure the mother understands the correct dosage and frequency for acetaminophen and ibuprofen.
  • Provide comfort measures: Suggest comfort measures such as applying a cool compress to the affected area or using over-the-counter pain relief creams.
  • Elevate the affected limb: Advise the mother to elevate Gabriel’s right arm to reduce swelling and discomfort.

Nursing Interventions for Goal 3: Educate the mother on home care

  • Explain fracture care: Provide clear instructions on how to care for the fracture, including immobilization and range-of-motion exercises.
  • Discuss ear infection management: Explain the importance of completing the full course of antibiotics and avoiding exposure to irritants.
  • Review signs and symptoms of complications: Educate the mother on the signs and symptoms of complications, such as worsening pain, swelling, or fever.

Medication Dosage and Rationale

  • Acetaminophen: The exact dosage will be determined by the child’s weight. The mother should follow the instructions on the medication label or as prescribed by the physician. Acetaminophen is a safe and effective antipyretic and analgesic for children.
  • Ibuprofen: The exact dosage will be determined by the child’s weight. The mother should follow the instructions on the medication label or as prescribed by the physician. Ibuprofen is another effective antipyretic and analgesic, especially for pain associated with inflammation.
  • Cefuroxime: The exact dosage will be determined by the physician and should be followed as prescribed. Cefuroxime is an antibiotic used to treat bacterial infections, including ear infections.

The same dosage for acetaminophen, ibuprofen, and cefuroxime is essential to ensure consistent medication levels and optimal treatment. Deviating from the prescribed dosage can lead to ineffective treatment or adverse effects.

 

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