Pediatric Cardiovascular System
V- Case Study: Pediatric Cardiovascular System
Michael is a 7-week-old breastfed infant who presents with a 2-day history of irritability and poor feeding.
Subjective Data
· Mom states patient has been “fussy” for past 2 days
· Only feeds for a “few” minutes at a time
· Breathing heavily and fast for 2 days
Objective Data
· Weight: 4.8 kg
· Vital Signs: T 36.8° C, P 250, R 65, BP 84/58
· Breath sounds clear to auscultation
· Oxygen Saturation 95%
· Central capillary refill 4 sec
Question 1
What is the treatment for an unstable patient with SVT?
Question 2
Decreased cardiac output from prolonged SVT will produce what complication?
Question 3
In this clinical situation what should the nurse do? Prioritize actions.
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VI- Case Study: Hematologic System
Liam is an 8-year-old male with a history of hemophilia. Liam presents today with a 1-day history of right elbow pain.
Subjective Data
· Right elbow pain for 1 day
· Patient states he hit his right elbow on desk yesterday
· Patient complains that he cannot move his elbow
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Objective Data
· Weight 31.6 kg
· Vital sighs: T 37.4° C, P 82, R 20, BP 108/68
· Rates pain 6 on scale of 10
Question 1
How should the nurse respond when Liam’s father explains that they watched and waited to see if Liam needed treatment after his injury?
Question 2
Why are neuro checks an important part of Liam’s physical exam?
Question 3
What should the nurse do in this clinical situation? Prioritize actions.
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VII- Case Study: Common Disorders of the Red Blood Cells
Susan is a 26-year-old G1P0 at 6 weeks of gestation with type 2 diabetes. Her BMI is 32. Her hemoglobin A1C is 9. She uses glyburide 10 mg PO daily. The physician has switched her to insulin at this time.
0. Question 1
What is the nursing priority at this time?
Question 2
What should Susan be taught about insulin needs during pregnancy?
Question 3
What additional risk factor does Susan have?
Question 4
How should Susan be counseled regarding weight gain in pregnancy?
Question 5
What advice can be given to Susan regarding exercise?
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VIII- Case Study: Pediatric Genitourinary System
Lilly is a 3-year-old female who presents with complaints of abdominal pain and fever since yesterday.
Subjective Data
· Complains of lower abdominal pain
· Fever for 24 hours
· Lilly has ‘wet her pants’ despite being recently potty trained
Objective Data
· Vital signs: T38.5° C, P 114, R 32, BP 104/62
· Urine positive for WBCs, nitrites, blood
Question 1
What risk factors does Lilly have for UTI?
Question 2
What might prevent Lilly from a recurring UTI?
Question 3
What should the nurse do in this situation? Prioritize actions.
IX- Case Study: Pediatric Neurologic System
Abby is a 1-year-old female who presents after a reported seizure at day care.
Subjective Data
· Fever for 1 hour
· Eating and drinking normally per mother
Objective Data
· Vital signs: T 40° C, HR 160, R 44, BP 104/68
· Awake and alert
· Skin hot to touch, otherwise normal physical examination
Question 1
How should the nurse respond to Abby’s mother when she asks if Abby has epilepsy?
Question 2
How should the nurse respond to Abby’s mothers question about brain damage?
Question 3
In this clinical situation what should the nurse do?
