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.

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


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.

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?

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?