Problem
Charlie is a 5- year-old Native-American boy and his sister Cindy is a 4-month-old girl. They live in Northern Arizona on the Kaibab-Pauite Reservation. Charlie and Cindy have both been brought into the local community clinic by their mother. They are both exhibiting symptoms of cough, fever, runny nose, and sneezing. Tests have confirmed that they positive for Influenza A. The clinic nurse gathered some health information and recorded the assessment findings below.
A. Explain specific physical, psychological, social, cultural, and spiritual nursing implications to consider when caring for pediatric patients such as Charlie (5-year-old) and Cindy (4 month-old) as opposed to an adult patient.
B. Identify differences in how you would carry out physical head-to-toe assessments for Charlie and Cindy (be specific for both), as opposed to how you would assess an adult patient.
C. Identify all the abnormal findings in the case study.
D. Which patient (Charlie or Cindy) would you be most concerned about and why? What risk factors have caused one to be sicker than the other? Why do you think the other is not as sick?
E. Chose your favorite or most known developmental theorist. Describe what stage Charlie is in according to that theorist. How does this developmental stage influence how you would interact with the child?
Charlie - 5 years old
BP= 95/52 (low)
T= 38.3 (oral)
P= 150, irregular (Apical) palpable
R= 30
02 sats = 94% on R/A via pediatric finger pulse oximetry probe
Weight = 17.9 kg (39.5 pounds)
Height = 108 cm (42.5 inches)
Lying on the stretcher quiet, anxious and scared
Nasal flaring with suprasternal and intercostal retractions noted upon breathing
Chest has audible coarse wheezes throughout
Skin is dry, flushed, and warm to the touch
Unable to palpate anterior or posterior fontanelles
Nasal mucosa and throat are both red
Abdomen soft, not distended, tender, with bowel sounds hyperactive in all 4 quadrants
Has had 3 large loose brown stools in the last 24 hours
Appetite is poor, not drinking sufficient amounts due complaints of a sore throat
History of asthma
Cindy - 4 months old
BP= 94/50
T= 37.9 (axilla)
P=168 (Apical)
R= 40
02 sats= 96% on R/A via infant foot pulse oximetry probe
Weight = 7.0 (15.4 pounds)
Height = 64.0 cm (25.2 inches)
Lying in the crib crying and restless
Is abdominal breathing
Chest has decreased air entry to the bases
Skin is dry, flushed, and warm to the touch
Anterior fontanelle is palpable, diamond shaped; Posterior fontanelle is not palpable
Nasal mucosa and throat are both red
Abdomen is soft, distended, with bowel sounds in all 4 quadrants
Has had 3 small mushy yellow stools in the last 24 hours
Continues to be exclusively breastfed adequate amounts every 2 hours
No history of any prior illnesses.