NUR2633 Module 6 Discussion A/B latest

Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.

DISCUSSION A

Robert and Jenna Smith’s 2nd child has Down Syndrome. Philip is 14 years old. He has a sibling that is older and one younger. 15 year old sister, Lucy and a little brother Danny who is 10 years old. As all 14 year olds he is becoming more interested in his sexuality and expressing that with curiosity. He has been known to have some overt aggression toward his sister and some classmates in his public school.

Discuss how you could help this family cope and guide Philip to learn appropriate behavior.

Group B Response

Will this behavior interfere with his interest in being in the local Boy Scout troop? His troop leader is his father. NUR2633 Module 6 Discussion A/B latest

DISCUSSION B

Toddlers have some very unique behavioral characteristics as they move from infancy to childhood. Identify these behavioral changes. Include the challenges that parents may face with these characteristics including identifying temperament, nutritional barriers, hygiene, activity, and sleep.

Group A Response

Can you help parents learn to deal with these behaviors and provide them some insight and guidance that will ease this transition for the child and parent?

You work in the pediatrician’s office.

Assessments and education are the focus of your work. NUR2633 Module 6 Discussion A/B latest

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NUR2633 Module 7 Discussion A/B latest

Discussion A: Group A will complete initial post, Group B will respond to the post.

Bobby was hospitalized 6 days ago for appendicitis. After an appendectomy following a perforated appendix, he now has an open incision requiring BID dressing changes and contact isolation due to a hospital acquired MRSA infection. It is anticipated that he will be here for 5-10 more days for long term antibiotic therapy and wound care. He is 13 years old. He has been afebrile for 24 hours. The wound is open with minimal serous drainage.

He is withdrawn and relates “just tired” when you inquire about how he is this morning. Last week he shared his interest in school. Gets A’s in math, computer science and was supposed to be competing in the school science fair this week.

What do you know about the adolescent and the appropriate developmental level?

Keeping his diagnosis in mind, what about visitation?

Is socialization a need?

What other questions should you ask?

Group B Response

It is 10 pm and you make assessment rounds and find Bobby crying. You ask him what his pain level is. What pain scale are you using?

He says he misses his family and wonders when they are going to come to get him and take him home? He relates his dad told him to be brave but he couldn’t stay with him since

Bobby was going to be in the hospital for such a long time and his dad had to work. He has 2 other brothers older than him. You also notice that his tray is untouched.

In addition to Erikson’s theory of development, children have fear of loss. What is Bobby’s fear?

(do not forget the interdisciplinary team members)

Video: Pre-operative teaching.

Discussion B: Group B will complete the initial post, Group A will respond to the post.

Tina is 5 years old, lives with her mother and grandmother. Mother works 2 jobs to help support her mother and her daughter. Tina is well cared for but is now admitted for a cardiac catheterization due to the Ventricular Septal Defect (VSD) that was noted at birth.

Tina has an extensive history of respiratory infections and a nursing diagnosis of ‘activity intolerance’. Her mother relates that she does not allow her to play organized or competitive games due to her health. Tina smiles broadly when you come in the room to begin the pre-operative checklist. She starts to ask you a question when her grandmother tells her she must stay in the bed. “The nurse knows what she is doing and you will just be in the way.” Tina continues to smile at you but moves back to the bed.

You have identified some unique family dynamics, please relate.

What is the Erikson developmental level that Tina should exhibit? And where do you think she is?

How can you assist in the developmental growth?

What education can you give to Tina and her grandmother pre operatively?

What will she expect post operatively?

Group A Response

You begin to explain that the first thing you will need to get done is an I.V. Tina’s grandmother doesn’t give you a chance to ask her to help. She excuses herself and says she can’t watch. She will go to the cafeteria and return later. Tina starts to cry and begins to suck her thumb.

What tools have you brought with you?

How can you comfort Tina?

What methods of communication might you use to help relieve anxiety?

Can you give Tina choices?

How can you successfully get the IV in?

NUR2633 Module 8 Discussion A/B latest

Discussion A

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 found on page 1021.

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.

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.

Group B Response

After several days the doctor begins discussing grafting of the hands and face. Can you educate the parents on the care the child will need. What is the home care situation for this child? Please also discuss long term issues, physical, emotional, how will she relate to peers?

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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 q2 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.

Please list the systems that are affected by this boy’s injuries.

List the nursing interventions now that he is on your nursing unit.

Start a list of nursing diagnosis match the system you are presenting.

Group A Response

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.