Introduction:
This paper will discuss a case study of Liam, a three-month-old boy who is transferred from the General Practitioner (GP) to paediatric ward with bronchiolitis. Initially, Liam’s chief health issues will be identified, following by nursing assessment and diagnoses of the child’s need. Focus will be made on the management of two major health problems: respiratory distress and dehydration, and summary and evaluation of the interventions with evidence of learning. Lastly, a conclusion of author’s self-evaluation will be present.
Identification of specific key issues:
Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days. His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and inspiratory crackles on chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) to Liam due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010). Moreover, Liam has fever and conjunctiva injection which could be a result of infection, as evidenced by high temperature (38.6°C) and bilateral tympanic membra...
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....) and dehydration (e.g. sunken fontanel, dry mucous membranes, decreased urine output, and intolerance fluid by mouth), participate in care, and reduce anxiety/stress during Liam’s hospitalisation (Axton & Fugate 2009; Pillitteri, 2010). Additionally, Liam’s older sister may understand the reason of Liam’s hospital admission and the care she could carry out once Liam being discharged (Pillitteri, 2010).
Conclusion:
In summary, the paper focused on caring for an infant with bronchiolitis. The student nurse has realised that it is important to gather information from the parents because they know their baby best. Nursing interventions should encourage family members to participate as well as they are the one who care about their child most. Special attention need to pay for children who attend day-care facility and follow up care is necessary.
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In nursing, the patient is often viewed as the main priority of the nursing staff. The nurse works to provide care for the patient based on the patient 's admitting diagnosis. However, the patient must be looked at as a part of the greater system they exist in such as their family or home environment. While the patient may be ill due to a bacterial infection or virus, their family environment also plays a role in their overall health and wellness.
Accurso (1997) found that at birth the lungs of CF babies are normal but soon, many become infected with bacteria. This bacterial infections cause chest exacerbations in the patients. A 14-day course of intravenous antibiotics is usually given to the patients (CF Trust, 2011). CF patients constantly seek medical attention for various reasons and in most cases, because of the exacerbations. However, hospital-based care is not always favoured by the patients, as it is disruptive for them and their families, taking patients away daily, work activities and social lives for considerable amounts of time (Sequeiros and Jarad 2009). Both consultants and physiotherapist encourage less interruptive patient-administered homecare....
Education regarding unit or group thinking is to be encouraged and reinforced. The fact that newborn Rosarie will be entering the home poses unique challenges that will require all members of the family to work together. Maria, Jamie, and Alice must be educated on the signs and symptoms of respiratory distress in the newborn and interventions that must be initiated when distress occurs. The nurse responsible for this teaching must require both verbalization and return demonstration of skills learned to ensure proper reception of the information. Once skills are developed by the adults within the home, the remaining children should then be educated on the signs and symptoms as well and actively participate in care. Involving the entire family will bring a cohesive thinking, and allow the family to work as a unit. A marriage counseling referral should as be provided to Maria and Jamie in order for them to work out their existing issues improving their likelihood of a successful marriage. Routine “check in’s” (phone calls, visits, etc.) should be in place for the family both by social services and pediatricians. In addition, community outreach programs (food banks, cultural organizations, etc.) are designed to support families like the Perez’s, nurses working within the community should tell these families about these resources
Craven , D., & Hjalmarson, K. (2010). Ventilator-associated tracheobronchitis and pneumonia: thinking outside the box. Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America , 1, p.S59-66. Retrieved from http://ehis.ebscohost.com/eds/detail?sid=44b983f2-9b91-407c-a053-fd8507d9a657@sessionmgr4002&vid=9&hid=116&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ==
Mrs. Farrington was constantly worrying about allowing him out of the house or be with other kids. The hospital constantly kept correcting this behavior by stating that she needs to allow him to be like other kids but sometimes it was her first instinct to prevent hospitalization. Mainly Cody is hospitalized due to weight loss or to clean mucus out of his lungs completely. Unlike Mrs. Farrington who has to deal with the medical treatments daily, her husband is in more denial. When Cody becomes sick he understands to call the hospital but Mr. Farrington has no understanding of Cody’s medicine and such. Though studies have shown that children who are cared by their mother recover faster and are discharged earlier, Mr. Farrington behavior is very concerning (Family-Centered Care and the Pediatrician’s Role, 692). He avoids the topic overall by working constantly. Mrs. Farrington finds this behavior to be strange because if something negative happened to her, Mr. Farrington needs to know these treatments, so they aren’t neglected or performed incorrectly. However, this arrangement between the parents is not very healthy because the stress of Cody condition is completely Mrs. Farrington burden. This makes Mrs. Farrington struggle giving her other children the fair attention they deserve as
At Cook Children’s Hospital, NICU parents are not only seen as the parents of the infants, but they also incorporate them as part of the team. Parents are highly encouraged to spend as much time as they possibly can with their premature infants, to have physical contact with them by giving them kangaroo time, which allows parents to have skin-to-skin contact with their infant, as soon as the infant reaches the stage in which he or she is a suitable candidate to be in physical contact with their parents. Siblings who are over 3 are allowed to visit their siblings at the NICU at specific times of the day, and child life specialists help siblings understand what is going on with their baby brother or sister who is in the NICU. If they have any specific questions, the child life specialist is there to assist them. Families are referred to other institutions that will be able to help them if their facilities aren’t able to fulfill their needs. One of the institutions that...
Neonatal nursing is a field of nursing designed especially for both newborns and infants up to 28 days old. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin”. Neonatal nurses are a vital part of the neonatal care team. These are trained professionals who concentrate on ensuring that the newborn infants under their care are able to survive whatever potential life threatening event they encounter. They treat infants that are born with a variety of life threatening issues that include instances of prematurity, congenital birth defects, surgery related problems, cardiac malformations, severe burns, or acute infection. Neonatal care in hospitals was always done by the nursing staff but it did not officially become a specialized medical field until well into 1960s. This was due to the numerous advancements in both medical care training and related technology that allowed for the improved treatment and survival rate of premature babies. According to the March of Dimes, one of every thirteen babies born in the United States annually suffers from low birth weight. This is a leading cause in 65% of infant deaths. Therefore, nurses play a very important role in providing round the clock care for these infants, those born with birth defects or other life threatening illness. In addition, these nurses also tend to healthy babies while their mothers recover from the birthing process. Prior to the advent of this specialized nursing field at risk newborn infants were mostly cared for by obstetricians and midwives who had limited resources to help them survive (Meeks 3).
Certainly, every nurse carries their own duties and responsibilities. As well as neonatal nurse practitioner, in cooperation with other health care professional, are responsible for diagnosing and managing the care of new-borns with significant health problems. In addition, they also provide a safe, comfortable and therapeu...
The patient is a 55-year-old man admitted to the hospital for dehydration secondary to vomiting. The physical examination of the patient revealed dry mucous membranes and vital signs as follows: Pulse 110, blood pressure 100/60, and respirations of 20.
I believe this can only benefit the hospital and patient care, and have a new way that the patient is cared for. Treating the whole family, instead of just the patient is what the future is all about. Implementation of this type of care requires creating a partnership between the patient, physicians, nurses, and patient’s families. This can only improve performance improvement, and treat the patient the way we would want to be treated. My goal is to decrease the patients and families anxiety throughout their hospital experience, and keep the whole family informed of the patients treatment plan.
Neonatal intensive care units are normally thought as a safe place for a neonatal to be, but there are instances where the neonatal develops an infection in their fragile bodies. This paper examines the ways that they could develop infections that harm them. The ANA states, “individuals who become nurses are expected to adhere to the ideals and morals norms of the profession and also to embrace them as a part of what it means to be a nurse.” (Code of Ethics, n.d.). German NICUs participated in a study of very low birth weight infants (VLBW) from 2006-2011 and found that an outbreak of severe neonatal infection occurred within a period of time in the same center in four different patients (Schwab, 2014).
Ayden has a tracheostomy and a feed tube. He has nursing care from 3pm-11pm, and from 11pm-7am. From 7am-3pm, Ayden is in the care of his mother (Porsha), and grandmother (Angel). According to the Director of the nursing care, staff members noted concerns of Ayden not being suction in the home. Porsha and Angel have been trained to care for him, but they are not doing so. They are also not putting him on his oxygen. Ayden was hospitalized in December for an infection in his trachea. On 12-25-15, a staff stated he had not been fed at 11pm. Porsha tried to get the nurse to run two feedings through his tube, so they he could be fed. In July, when Ayden nursing services were starting, Porsha and Angel got mad when a staff could not go to the home
Peto, R. (2008). Why did you do it like that? Examining clinical decisions. Paediatric Nursing,
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Hockenberry, M. J., & Wilson, D. (2013). Wong’s nursing care of infants and children + study guide: Multimedia enhanced version. Philadelphia, PA, United States: Elsevier Mosby.