Missy is 3 years old. She enjoys being with mom and grandma in the kitchen. She pulls a chair close to the stove, climbs on the chair and looks inside the pot of boiling water. The steam is hot on her face, she steps back and as she falls off the chair, the boiling water is pulled down on her. Missy is rushed to the emergency department. Grandma has put some butter on her fingers, but her face was not treated.
Review the Rule of Nines
In the ED, the nurse discovers that her hands, face, chest and arms are burned. The Dr. believes it to be a partial thickness burn, but notes her hands are blistered and very edematous.
Questions:
Provide nursing care to this young patient that is complaining of pain, crying, and uncooperative. Educate the mother and grandmother on the extent of the burn and the on-going care that will be needed.
Include medication you may wish to request from the physician and the dosage.
Discussion B
Due to a fall from a second story townhouse, Jimmy sustained a fractured left femur and a mild head injury. Jimmy is 10 years old. He was reaching for a ball that had gotten lodged into the gutter over the small balcony of his parent’s bedroom. He thought if he stood on the railing and reached with the badminton racket he could get it.
Currently he is 2 days postoperative from repair of the left femur. He is being transferred out of the pediatric ICU where the Neurologist has stated he is stable but needs continued neuro checks every 2 hours. He has a full left leg cast. The Foley catheter is to be replaced today, or he can attempt to roll onto a bedpan if needed.
Question:
Please add the interdisciplinary team that needs to attend to this boy’s health care needs. Plan home care if appropriate. And continue the list of nursing diagnosis.
Answer preview
After the postoperative care in the hospital, the patient should require home-based care to recover completely. Before the patient is released, all the medication will be handed over to the parent. The parent will also be advised on the proper diet for the boy. For example, the boy should consume calcium-rich food, such as nuts and leafy greens, to improve fractured bones’ recovery. Moreover, the parent will be given hospital contact to call for help if the boy worsens. For example, when the leg starts to swell, the parent should call the doctor immediately. Finally, a home health nurse will be assigned to monitor the health of the boy regularly. The home health nurse should perform the following list of nursing diagnoses. First, the nurse should look for any infection on the wound. Secondly, the nurse should look for drains that might have been left on the wound during surgery.
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