1500 words essay.

For this assignment you are requested to read all of the clinical scenarios and select one to review. You must use an essay format in your response to the scenario you have chosen. In your response you are required to:

Critically analyse, synthesize and evaluate a range of literature, particularly research based literature, on treatment modalities and nursing interventions available for the child or young person experiencing acute or chronic illness identified in your chosen scenario.

Utilising the evidence from your literature review, develop a plan for the care of the child to address the issues identified in your chosen scenario.

Include in your plan:

Assessment/ problem

Nursing intervention

Rationale

Evaluation

This can be presented in a table format but must be referenced in the table.

Considering a family centred and family strengths approach, identify how you would meet the needs of the family in each stage of the plan.
In your discussion you are expected to demonstrate a sound knowledge of the literature and your ability to critically analyse it in relation to the issues incorporated in the selected scenario.

Scenario 1

You are a registered nurse working on the afternoon shift in the Emergency department. Milo is a 24month old boy with Down s syndrome, brought to the A&E department by his mother. He has had diarrhoea and vomiting for 1 day. In the last 8 hours he has drunk 200ml of milk, vomited 5 times and passed six liquid stools. It has been hard for mum to determine if he is passing urine because every nappy is soiled. No cardiac problems or other medical problems. He is miserable and lethargic. His heart rate is 120 beats/min, respiratory rate is 25 breaths/min, and his temperature is 37.7. He has dry mucous membranes and his eyes are slightly sunken, his skin turgor appears normal and his cap refill is less than 2 seconds.

Scenario 2

You are a registered nurse working a morning shift on the children s surgical ward. Jonathon is a 4 year old boy on the surgical unit. He has had an open reduction and internal fixation (ORIF) of his fractured right radius. He returned to the ward from recovery 4 hours ago. He has vomited once and is miserable. He cries every time a nursing or medical staff member goes near him. His fingers are very swollen and red, capillary refill is greater than 3 seconds. Dad is with Jonathon as mum is home with their newborn daughter. Dad says he doesn t think Jonathon will take oral pain relief as he doesn t like taking medicine at home. Jonathon is eating and drinking small amounts.

Scenario 3

Chang is a 10 year old girl who presents to the emergency department. She is a known asthmatic and this is her third attendance with an acute wheeze in the last 3 months. Her mother reports that last time she was nearly transferred to ICU. She has developed a cold and become acutely breathless, she is using her salbutamol inhaler hourly. Chang is sitting up in bed; her oxygen saturation reading on admission was 90% in 8L s of Oxygen. She is quiet but able to answer questions in short sentences. Respiratory rate is 60 breaths per minute and a tracheal tug and intercostal recession is evident. Temp of 37.6 and pulse is 180 beats per minute.

Scenario 4

You are a registered nurse working a night shift on the paediatric medical unit. Jayda is a 14 yr. old girl admitted to the ward yesterday for stabilisation of her diabetes. Jayda was diagnosed with type 1 diabetes when she was 4 years of age. She presented to her outpatient appointment and was found to have a HBA1C of 12. Jayda uses a Medtronic veo insulin pump. This is the first clinic she has attended in 12 months. When you take her routine BSL at 2am she has a BSL of 15mmol/L.