Prioritize Nursing Interventions When Caring for Pediatric Clients with Health Disorders

Prioritize Nursing Interventions When Caring for Pediatric Clients with Health Disorders

The case study is of a five-year-old male patient who was presented to the emergency with his mother after falling out of his bed after seizures. After a medical evaluation, he is diagnosed with a right ear infection, right ulna fracture, and acute febrile seizure. He is discharged with medications. This paper will design a discharge plan for this patient. It will have three goals listed from the top to the lowest priority with a rationale for each goal. Three nursing interventions in line with three goals will also be discussed. Finally, the mother will be instructed on the right doses to give to the child with explanations of the importance of giving the exact dosage.

Discharge Plan

Goal #1

The mother and patient will implement infection prevention strategies.

The patient has been diagnosed with acute febrile seizures, ear infections, and broken ulna. The febrile seizures which the patient had may have been a result of the ear infection. Febrile seizures are convulsions in children as a result of fever (Francis et al., 2016). Fevers are most often caused by infections, and these seizures occur in young, healthy children. This is thus the primary goal since the infection is the one that led to all these conditions.

Nursing Interventions

Educate the patient on proper handwashing techniques. Ear infections may result due to proper handwashing techniques. The child will be advised on the benefits of washing their hands and taught how to wash their hands.

The mother will be advised to vaccinate their child against the flu. Ear infections are caused by bacteria, and they occur after children have gad upper respiratory infections, sore throats, or cold (Meherali et al., 2018). They can also be secondary to viral infections, hence the importance of vaccinating the child against flu.

The mother will be advised to avoid exposing the child to smoking. Smoking increases the risk of ear infections since the smoke can lead to the inflammation of the Eustachian tubes, reducing the ear’s clearing mechanism (Meherali et al., 2018). The parent should also ensure that no one smokes near their houses and that daycare and the child’s school are tobacco-free zones.

Goal #2

The mother and patient will demonstrate strategies that will facilitate the healing of the fractures and prevent skin breakdown. The rationale for this goal is to prevent any skin integrity complications as a result of the ulna fracture.

Nursing Interventions

The mother will be instructed to massage the bony prominences. The bed linens should also be kept dry with no wrinkles. In addition to this, she should place paddings under the elbow to facilitate healing.

Repositioning the patient frequently. This is important since it will reduce pressure on the affected areas and minimize the chances of skin breakdown.

Instruct the patient not to insert objects inside the casts. Even if he feels itchy, he should not scratch the affected area under the cast since it can result in skin breakdown.

Goal #3

Proper understanding of discharge instructions. The mother should understand all the discharge instructions that will be given to her by the nurse, including medication dosages and frequency. This is important since proper medication administration and adherence will result in quick healing of the ear infection (Scialli et al., 2021). Compliance with treatment results in faster recovery.

Nursing Interventions

The nurse should instruct the mother on how to use all the medicine that has been prescribed to the child. This will include the indications, dosages, route of administration, and frequency. This will enable the mother to understand the benefits of the drugs and the importance of adhering to the schedule to promote infection healing and pain relief.

Asking the mother to verbalize the instructions provided. By asking the mother to repeat the instructions that have been given to her, the nurse will determine if she has understood them. If she cannot verbalize them, then the nurse will repeat the instructions in a clear and simple manner.

The nurse should compile a list of the take-home drugs. This list should include the name, dosage, route of administration, and frequency. This is important since it will give the mother an easy time administering the drugs to the patient. She will not also forget or forget the administration instructions.

Dosages for Drug Administration

Acetaminophen

Acetaminophen 15mg/kg orally every four hours for pain or fever.

15mg X wt of the patient 15 x 22

=330 mg.

The exact dose will be =  330/160 x 5

= 10.3 MLS

Give the child 10.3mls of acetaminophen every four hours for pain for three days.

Ibuprofen

Ibuprofen 10mg/kg orally for six hours PRN for fever and pain for three days.

10mg X weight of patient = 10 x22

=220 mg

The exact dose = 220/100 x 5

= 11mls

Give the child 11 mls of ibuprofen every six hours whenever the patient has pain or fever for up to three days.

Cefuroxime

30. mg/kg/day suspension orally BD for ten 10 days, not to exceed 1000mg/day.

30 mg X weight of patient 30×22

= 660mg/day.

This is divided into two doses. Which is 330mg per administration.

If available in 125mg/ 5mls= 330/125 x 5

=13.2 mls

If available in 250mg/5mls = 330/250 x 5

= 6.6 mls.

In conclusion, the exact dose is important since it prevents underdose or overdose. Underdosing can result in negative patient outcomes and possible rehospitalizations. Overdose can result in adverse drug effects.

References

Francis, J. R., Richmond, P., Robins, C., Lindsay, K., Levy, A., Effler, P. V., Borland, M., & Blyth, C. C. (2016). An observational study of febrile seizures: The importance of viral infection and immunization. BMC Pediatrics, 16(1). https://doi.org/10.1186/s12887-016-0740-5

Meherali, S., Campbell, A., Hartling, L., & Scott, S. (2018). Understanding parents’ experiences and information needs on pediatric acute otitis media: A qualitative study. Journal of Patient Experience, 6(1), 53-61. https://doi.org/10.1177/2374373518771362

Scialli, A. R., Saavedra, K., & Fugh-Berman, A. (2021). The Benefits and Risks of Adherence to Medical Therapy. The Journal of Scientific Practice and Integrity, 3(1), 21386.