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Maternal Child

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.

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.

Sample Solution

ader-member relations, if the group are familiar and trusting of the leader policy implementation becomes much simpler. Similarly to leadership, understanding and adapting to the situation is key to a leader being able to implement policies that ensure a group work as a team. Teamwork is a product of good leadership, and is again the responsibility of the leader to ensure the group are working successfully together. Highly functioning teams are essential within organisations to increase productivity and member satisfaction, by utilising the talents of all group members effectively within the constraints of the task, personal relationships and the group goals (Pettinger, 2007). Figure 2: Tuckman’s Model of Group Development (Agile Scrum Guide, 2019) Tuckman in his Model of Group Development provides easily identifiable stages that a groups performance can be measured against, making it useful for monitoring performance, Figure 2 shows Tuckman’s model. Ranking group performance against this scale can provide leaders with a clear understanding of how the group are functioning, allowing them to implement policies to change this if performance is unsatisfactory (Pettinger, 2007). Within organisations, the theory can be loosely applied to creating teams by grouping familiar individuals with the aim that they will reach the norming and performing stage of the model quicker. For short and simple tasks this is an extremely effective way of organising groups, due to the increased short term productivity. However there are significant issues with grouping individuals in this manner, particularly when tasks become more complex, and ultimately the model should mainly be used for monitoring the progress of groups (Pettinger, 2007). Figure 3: Belbin’s Team Roles (PrePearl Training Development, 2019) A more functional approach of grouping individuals is to utilise Belbin’s Team Theory (Belbin, 2017). Belbin identifies 9 key roles that must be fulfilled within a group to ensure success, the roles are summarised in Figure 3. The roles cover a wide spectrum of skills that need to be presen
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