Child in Inpatient
I- Case Study: Care of the Child in Inpatient and Outpatient Settings
Jordan is 9-year-old male who is a direct admit for observation. He has a history of vomiting and diarrhea for 48 hours.
Subjective Data
- Nausea and vomiting for 24 hours
- Has not voided today
- Unable to tolerate oral fluids
Objective Data
- Vital signs: T 37.8° C, P 120, R24, BP 110/60
- Weight: 34 kg
- Hyperactive bowel sounds to auscultation
1. Question 1
When should the discharge teaching begin for Jordan and his family?
2. Question 2
What is the best way to approach Jordan regarding the IV that has been ordered.
3. Question 3
What would be good distractions for a child of Jordan’s age?
II- Case Study: Pediatric Cancer
Mario 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° F and a 1-day history of bruising and lethargy.
Subjective Data
- Complains of hurting all over
- States he feels very tired
- States he feels dizzy when he stands up
Objective Data
- Weight 26.1 kg
- Vital signs: T 38.9° C, P 140, R 40, BP 108/54, O2 sat 100%
- Purpural rash on extremities
- WBC 0.7
- HGB 3.1
- Hct 8.5
- Plt .08
- ANC 0.1
4. Question 1
Which of Mario’s presenting symptoms must be treated and stabilized before chemotherapy induction?
5. Question 2
What testing is required for a definitive diagnosis of meningitis?
6. Question 3
What should the nurse do in this clinical situation? Prioritize actions.
III- Case Study: Pediatric Respiratory System
Will is a 4-month-old infant born at 34 weeks of gestation. Will’s 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.
Subjective Data
- Mother complains that infant has had cough for 3 days
- Mother states that infant is having trouble sleeping
- Not voided in past 6 hours
Objective Data
- Birth Weight: 1.9 kg
- Today’s Weight: 5.5 kg
- Vital Signs: T 38° C, P 186, R 60, BP 90/52, Pulse Oximetry 93%
- Thick yellow nasal secretions
- Nasal flaring with moderate intercostal retractions
- Breath sounds decreased with crackles bilaterally to auscultation
7. Question 1
What risk factors does Will have for contracting bronchiolitis?
8. Question 2
What is the first priority for Will’s treatment?
9. Question 3
What should the nurse do in this clinical situation? Prioritize actions.
IV- Case Study: Pediatric Gastrointestinal System
Lucy is a 44-day-old formula-fed infant who presents with a 4-day history of vomiting.
Subjective Data
- Mother states infant has been vomiting undigested formula after feedings
- Mother states that infant has not had fever or diarrhea
- Mother states that infant has had 8 wet diapers in the past 24 hours
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