NSG3202 Case Study Assessment 3

Subject Code :-  NSG3202
Written Assessment
Title :-  Case Study
Format :- Written case report
Length :- 1200-1500 words (1500 words maximum)
Mark loading :- 25%
NSG3202 Case Study Assessment 3

Learning Outcomes:
2. Describe models of care and relevant health care delivery frameworks and tools designed for paediatric nursing.
3. Analyse the effects of hospitalisation and illness on the younger person and their family in the associated domains of mental health family relationships pain management chronic conditions socio economic impacts.
4. Discuss the role of the nurse in supporting the younger person and their family who experience physical social and emotional health issues.
5. Describe effective communication techniques appropriate to the developmental stage of the younger person.
6. Apply a systematic approach to health assessment of the younger person that reflects the changes in growth and development across the child – adolescent continuum.
7. Utilise paediatric assessment data to plan implement and evaluate safe and effective care for children and families.
8. investigate common acute childhood illnesses/injury and describe the current evidence- based paediatric nursing care management.
9.Compare and contrast the illness trajectory of chronic and severe childhood illnesses.

NSG3202 Case Study Assessment 3

Case Study: Avah

Situation :-
5-year-old female who has come to the ward from PICU post VSD repair. She is day 1 post- operative. She has 2 redivac drains and 4 pacing wires in situ. She has a CVC with Morphine 10mcg/kg/hr infusion Normal saline KVO and Heparin at 10 units/kg/hr. Her PIVC is capped off. On arriving to the ward, it was noted she was febrile and blood cultures were taken. Her sternotomy dressing was changed as it was oozy and IVABs were commenced.

Background

Patient Name: Avah Jones     Gender: Female        Weight:20kg
Age: 5 years      Birth date: March 2                           Height: 85cm

Allergies: Angel cream
Immunisations: Up to date

Assessment
Vital Signs: T 37.2, HR 110, RR 26, BP 90/60 SPO2 95% on room air
General Appearance: Child appears of average height and weight for stated age. She presents
as shy and anxious.
Cardiovascular: Sinus rhythm, no murmurs. Capillary refill < 2 seconds.
Respiratory: No increased WOB, no cough.
GI: Active bowel sounds in all 4 quadrants. BNO for 4/7 days.
GU: IDC in situ draining 1ml/kg/hr.
Skin: Hot to touch, dry and pale. Good turgor.
Neurological: Alert and oriented to person, place and time as age appropriate; Pupils equal,
round and reactive to light and accommodation.
Pain: Score of 5 on FLACC pediatric pain scale (sternotomy site).

NSG3202 Case Study Assessment 3

Assessment instructions :-

1.Review the Case Study (Avah) provided above.

2. Provide a written response to each question/task as listed below including the Case Study Questions and Medication Knowledge.

3.Include in-text references (APA 7th style) for information from other sources.

4.Please include a reference list (APA 7th) at the end of the case study report.

Case Study Questions :-

a) Define VSD and Avah’s surgical procedure.
b) Describe three (3) focused paediatric assessments required for this patient post- operatively and based on the assessment data provided above.
c) What is the recommended post-anesthetic nursing management for this patient post- operatively? When will Avah be allowed to eat and drink again? Use RCH protocols and guidelines.
d) How can the nurse foster trust and cooperation with a 5-year-old while performing paediatric nursing assessments, including vital signs.
e) Outline the fluid balance documentation required for this patient including input and output.
f) The mother asks you what the medications are for. How would you explain each medication prescribed for her daughter?
g) How would you explain the medications to Avah?
h) What observations would you do prior to medication administration? What additional observations are required for patients receiving a Morphine infusion?
i) What education do you need to provide to Avah’s family before discharge.

Medication Knowledge
Copy and paste the table below into your written report. Complete the table as provided below finding the information for each medication in relation to paediatric administration. Refer to AMH Children’s Dosing Handbook and/or clinical practice guidelines.

Morphine IV infusion

IV Frusemide

IV Flucloxacillin

Spironolactone

Paracetamol:

Heparin infusion: