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Nursing, Essay

Nursing interventions when caring for pediatric clients with health disorders-Gabriel 

Nursing interventions when caring for pediatric clients with health disorders-Gabriel

  1. Discharge Plan

Goal 1

The most important goal is to maintain the body temperature within normal limits. Febrile seizures are caused by hyperthermia which is when the body temperature goes beyond 102.2 degrees Fahrenheit. Even though febrile seizures are usually harmless, they should still be controlled as they may injure the child. The expected outcome of maintaining the body temperature to normal limits is that there will be no subsequent seizures and any sequelae that may arise from the seizures.

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Nursing interventions include:

  1. Administration of antipyretics. Antipyretics are usually NSAIDs. Examples are Tylenol and ibuprofen. NSAIDs are agents that reduce body temperature by reducing inflammation and promoting vasodilation which helps with the redistribution of heat (Doenges et al., 2019).
  2. Regular monitoring of the body temperature; which is important as it will help the nurse to know when to take the appropriate actions that will ensure the temperature does not go beyond 102.2 degrees.
  • Assessment of the child’s hydration status is important as high body temperature increases the insensible fluid loss through sweat. Sweat is a homeostatic response meant to cool the body. Fluids should therefore be administered to keep the child hydrated (Doenges et al., 2019).

Goal 2

Another goal is to ensure the child doesn’t develop any complications that may arise from otitis media. Infections can cause fever which may result in febrile seizures. Ear infections can also spread to cause complications such as meningitis which can be fatal. The desired outcome is that the child remains afebrile.

The nursing interventions should be to:

  1. Start antibiotic treatment. Cefuroxime should be administered. The nurse should educate the parent on the benefits of finishing the dose as this will help prevent recurrent infections.
  2. The nurse should assess the parent’s knowledge of ear infections. This includes the risk factors, symptoms, and prevention (Doenges et al., 2019).
  • The nurse should also administer analgesics, i.e., Tylenol and ibuprofen as prescribed

Goal 3

The third goal is to ensure proper care for the ulna fracture and timely wound healing. Fractures can lead to impaired neurovascular function, which can slow down the healing process. Wounds can act as sites of entry of infections. The pain caused by fractures can also cause discomfort and stress to the child. The desired outcome is to maintain adequate tissue perfusion. The presence of palpable peripheral pulses will evidence this. Another expected outcome is that the child will be free of pain.

The nursing interventions

  1. The nurse should perform an assessment of the right arm for swelling and edema. This should then be compared with the uninjured arm to note any changes in appearance and diameter. Tenderness and an increased diameter may be a sign of compression syndrome, which should be treated as a medical emergency (Doenges et al., 2019).
  2. Pulses distal to the fracture should also be assessed. An absent pulse can be a sign of vascular injury.
  3. The nurse should check the skin for any breaks. These can act as sites of entry for infections that can disseminate to cause complications such as cellulitis and sepsis. Touching areas around the broken skin should therefore be avoided. the nurse should educate the parents on the merits of practicing hand hygiene when handling areas around the fracture.
  • The nurse should also administer analgesics i.e., Tylenol and ibuprofen as prescribed (Guiner et al., 2020)
  1. Rationale

Managing hyperthermia is the priority to prevent subsequent febrile seizures. This is followed by managing the ear infection, which can lead to meningitis. Meningitis can also present with convulsions as one of the symptoms. Finally, proper care of the fracture is third on the priority list. This will help in managing the pain and facilitating wound healing.

  1. Dosage

Acetaminophen (Tylenol):

Recommended dosage would be 13 mL or 6.5 mL per dose in 125mg/5mL or 250mg/5mL oral suspension respectively. Exact dosing is essential for safety. Overdosing can lead to hepatotoxicity and nephrotoxicity.

Cefuroxime:

Recommended dosage would be 26 mL or 13 mL per dose in 125mg/5mL or 250mg/5mL oral suspension respectively. Underdosing of antibiotics can lead to treatment failure and the development of antibiotic resistance.

Ibuprofen:

Recommended dosage would be 9 mL or 4.5 mL per dose in 125mg/5mL or 250mg/5mL oral suspension, respectively (Vallerand et al., 2019)

References

Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nursing care plans: Guidelines for individualizing client care across the life span (10th ed.). Philadelphia: F.A. Davis

Guiner, A., Street, M. H., Oke, O., Young, V. B., & Hennes, H. (2020). Pain Reduction Emergency Protocol: A Prospective Study Evaluating Impact of a Nurse-initiated Protocol on Pain Management and Parental Satisfaction. Pediatric Emergency Care.

Vallerand, A. H., Sanoski, C. A., & Quiring, C. (2019). Davis’s drug guide for nurses (16th ed.). Philadelphia: F.A. Davis

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