Module 08 Assignment – Pediatric Data, Assessment, and Prioritization of Interventions

Module 08 Content

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Purpose

The nursing student should be able to identify seizure activity, how to educate the family and or caregiver of the pediatric patient on what to do if a seizure occurs and what medications to administer, implement safety to prevent injury and treatment of fracture. Develop education to support discharge based on assessment of data.

Competency

Prioritize nursing interventions when caring for pediatric clients with health disorders.

Scenario

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

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

Your Assessment

Vital Signs: T 102.9, P 135, R 24, BP 118/60, O2 sat 100% RA

General Appearance: appears drowsy; face flushed, quiet

Neuro: oriented X3

Cardiovascular: unremarkable

Respiratory: lungs clear

Integumentary: very warm, dry

GI/GU: abdomen normal

Physician Orders

    • Complete Blood Count (CBC)
    • Complete Metabolic Panel (CMP)
    • Urinalysis with culture and sensitivity (U/A C&S)
    • Blood Cultures x 2
    • X-rays kidneys,
    • Influenza screening
    • Acetaminophen 15 mg/kg PO now
    • Ibuprofen 10 mg/kg PO now
    • Pad side rails
    • Suction at bedside with seizure precautions
    • Radiographs of right arm
    • Cast to right arm
    • Start PO fluids and increase as tolerated

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

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Discharge orders include:

    • Follow up with pediatrician in 7 days
    • Follow up with pediatric orthopedics in 7-10 days
    • Cefuroxime 30mg/kg PO BID for 10 days not to exceed 1,000mg daily. What is the recommended dosage if cefuroxime is supplied as an oral suspension 125mg/5ml or 250mg/5ml?
    • Acetaminophen 15 mg/kg PO Q4 hours PRN fever or pain and ibuprofen 10 mg/kg PO Q6 hours PRN fever and pain for up to 3 days
    • Acetaminophen is available as 160 mg/5 mL. Ibuprofen is available as 100 mg/ 5 mL.
    • What is the amount of acetaminophen in mg and ml per dose? What is the amount of ibuprofen in mg and ml per dose?

Instructions

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

Format

    • Standard American English (correct grammar, punctuation, etc.)
    • Logical, original and insightful
    • Professional organization, style, and mechanics in APA format

 

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APA FORMAT AND INDEX CITATION

PLEASE WRITE FROM NURSING PROSPECTIVE

References three

  • FOLLOW ALL Rubric Details CORRECTLY TO AGAIN FULL POINTS
  • Dosage

16% of total grade

Mastery: Advanced or exceeds achievement

The correct dosage is specified and the explanation for the exact dosage is skillfully explained.

9.6

Proficiency: Clear/effective achievement

The correct dosage is specified and the explanation for the exact dosage is evident.

8.93

Competence: Adequate/basic achievement

The incorrect dosage is specified and the explanation for the exact dosage is reasonable based on the incorrect dosage.

8.06

Emerging: Limited or growing achievement

The incorrect dosage (or no dosage) is specified and there is no explanation for the exact dosage.

6.24

  • Discharge Goals and Prioritization of Discharge Goals

33% of total grade

Mastery: Advanced or exceeds achievement

Goals are detailed and listed in order of priority. The rationale for the prioritization of the goals is explained in depth.

19.8

Proficiency: Clear/effective achievement

Goals are concise and listed in order of priority. The rationale for the prioritization of the goals is sufficient.

18.41

Competence: Adequate/basic achievement

Goals are reasonable and listed in order of priority. The rationale for the prioritization of the goals is mostly reasonable.

16.63

Emerging: Limited or growing achievement

Only partial goals are listed, or the goals listed are vague. Rationale for the prioritization of the goals is vague or missing.

12.87

  • Nursing Interventions

40% of total grade

Mastery: Advanced or exceeds achievement

The nursing interventions are detailed and show a direct relation to the goals listed.

24

Proficiency: Clear/effective achievement

The nursing interventions are sufficient and are mostly related to the goals listed.

22.32

Competence: Adequate/basic achievement

The nursing interventions are reasonable and occasionally relate to the goals listed.

20.16

Emerging: Limited or growing achievement

Only partial nursing interventions are listed and/or the interventions seldom relate to the goals listed.

15.6

  • Spelling and Grammar

5% of total grade

Mastery: Advanced or exceeds achievement

Demonstrates an exemplary application of spelling and grammar.

3

Proficiency: Clear/effective achievement

Displays proper grammar application and writing contains minimal to no spelling errors. May contain rare improper uses of words (ex., their vs. there), a misplaced modifier, or a run-on sentence, but does not detract from the overall understanding of the sentence and/or paragraph.

2.79

Competence: Adequate/basic achievement

Spelling and grammar errors occur but are inconsistent. Paragraphs and sentences are coherent but may exhibit spelling errors, run-on’s or fragments, and/or improper verb tense usage.

2.52

Emerging: Limited or growing achievement

Spelling and grammar contain substantial errors that makes sentences and/or paragraphs incoherent.

1.95

  • APA Style

6% of total grade

Mastery: Advanced or exceeds achievement

APA citations are free of style and formatting errors.

3.6

Proficiency: Clear/effective achievement

Errors in APA citations are less noticeable and do not detract from the ability to locate the original source (for example, a missing or misused comma or period, missing parentheses, author name not properly abbreviated, indentation is misaligned).

3.35

Competence: Adequate/basic achievement

Errors in APA citations are noticeable and may detract from the ability to locate the original source (for example, no title provided, year of publication is missing, no punctuation).

3.02

Emerging: Limited or growing achievement

Citations do not follow APA Style. Quotations, paraphrases, and summaries are not cited, or there is no attempt to cite them using APA style.

2.34