Ped Assignment
Ped Assignment
would be used to help the nurse build a therapeutic relationship with the child and
her aunt.
There are different therapeutic communication techniques in nursing, some of them active
listening, sharing empathy, and using touch (Sonya et al.,2019). Active listening means being
focused on what the patient is saying both in words and non-in words (Sonya et al. 2019) Sharing
empathy is also the expertise to understand another person’s situation emotionally and
intelligently to truly perceive unspoken feelings. Using touch is one of the appropriate
therapeutic communications for many patients understand feelings of isolation related to their
personal and social context (Sonya et al.,2019). The nurse should try to emphasize and reduce
the aunt ‘s anxiety that Yasmin is in a common situation according to vital signs information can
be improved easily. Also, the nurse should try to touch Yasmin so that, she will not feel she is
alone because only her aunt is with her that is why needs more active listening and touching
giving her more attention with playing to build trust and for more comfort of Yasmin (Sonya et
al.,2019).
developmental stage.
The first safety concern is the aunt must watch Yasmin from the risk of falling as she is 20
months old, and she needs more attention. Yasmin is already dehydrated according to the case
study information so probably she is going to have an IV line Therefore, there is a second safety
concern because IV tubing commonly gets twisted as it rolls about. The third concern is
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infection. As Yasmin is 20 months old, she can grab some unclean equipment from the room or
eat something so infection is the main concern (Leifer & Keenan ,2020).
are of concern.
temperature is 39.0 so this one concern is high, and she has a fever. Because Yasmin is 20
months old at her age this is a concern (Leifer & Keenan ,2020).Yasmin’s aunt anxiously reports
that the child has been having diarrhea for the past two days and “is not her usual self”. This is
also a concern because diarrhea is a serious issue in children it causes severe dehydration.
Yasmin is also not drinking well and is not getting enough electrolytes which is a big concern
4. Identify two early and two late signs and symptoms of dehydration in pediatric
patients.
Dehydration in children is relatively uncommon, but it can quickly escalate into a significant
medical risk if not treated promptly. Fortunately, it is generally cured by simply feeding your
infant more frequently (Younis et al.,2015). However, they must consult with their pediatrician
to ensure that their hydration levels soon return to normal. Signs and symptoms of dehydration in
pediatric patients, the early signs and symptoms are Dry mouth, lips, and dry skin Less wet
Constipation, hard or fewer bowel motions (if dehydration is caused by a lack of liquids).
The late signs and symptoms of dehydration in pediatric patients also dry mucous membranes,
pediatric patients.
Dehydration is defined as a lack of fluid in the body that prevents it from performing its
regular tasks. Babies and little children are more likely to get dehydrated because their bodies
contain a larger proportion of fluid. Because children have a high metabolic rate, their bodies
require more water. The kidneys of a youngster do not save water as efficiently as the kidneys of
characterized by a dry mouth and lips as well as increased thirst, and children may pee less
regularly. Moderate dehydration causes children to be less engaging or lively, to have a dry
mouth, and to pee less regularly. Moderate to severe dehydration might produce a racing heart
and lightheadedness (Younis et al.,2015). Severe dehydration causes children to become tired or
sluggish, indicating that they should be assessed by a doctor or transported to a hospital or urgent
care clinic as soon as possible (Younis et al.,2015). They do not cry. They may acquire a bluish
hue on their skin (cyanosis) and have fast breathing. Dehydration can cause the concentration of
salt in the blood to fluctuate irregularly. Changes in salt concentration can exacerbate
dehydration symptoms and aggravate lethargy. In extreme circumstances, the youngster may
6. Outline four priority nursing actions based upon your assessment of Yasmin
As Yasmin has been diagnosed with severe Diarrhea, nursing interventions should be
focused on managing her electrolytes balance, keep comfort and monitor her fluid intake and
1. Encourage to take clear liquid every two hours while awake. As diarrhea requires
bowel rest, clear or full liquid diet is important to give rest for the intestine (Leifer,
2021). A bland diet with low fiber is needed to bulk the stools. This includes soft
foods without added sugar or spices such as white rice, white toast, crackers, and
eggs. Potassium riches foods such as potatoes, bananas and fruit juices and yogurt
with active bacterial cultures are required (Ward & Hisley, 2009).
2. Yasmin may need oral rehydration solutions due to her severe dehydration. Drinking
more water may not be enough for a patient with severe diarrhea. Aside from fluids,
the patient is also losing important minerals and electrolytes that water can’t supply.
We need to keep giving oral rehydration solution until diarrhea is less frequent. If this
20-month-old refuses ORS by the cup or bottle, we need to give this solution using a
medicine dropper, small teaspoon or frozen pops (Ward & Hisley, 2009). These can
also be served through a mixture of water, sugar, and salt to replace lost fluids. When
vomiting decreases, it’s important to have the child drink the usual formula or whole
3. Monitoring vital signs is an important aspect for this patient, considering her
tachycardia and respiratory situation. Her temperature and respiration rate must be
need to monitor intake and output by assessing the number of wet diapers. Frequent
diarrhea can cause skin breakdown to the perianal area. Frequent diaper change and
try to keep the perineum dry should give her a little comfort. We should also monitor
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4. We should send stool for culture to identify possible symptoms to determine whether
diarrhea is due to a parasitic or bacterial infection (Ward & Hisley, 2009). The
Diarrhea occurs when organisms attacking and terminating intestinal mucosal cells,
decreasing intestinal superficial area and impairing the intestines capacity to absorb fluids and
electrolytes (James et al., 2013, p. 347). Its results vomiting or extreme emission of stool, which
effects emptying intestines and stomach. This high motility and sudden emptying causes in
impaired absorption of nutrients and ultimately leads towards electrolyte imbalance. Dehydration
in intestine causes stool to pull water, sodium, potassium and bicarbonate from extracellular
space. It consequences electrolyte depletion and metabolic acidosis. The increased motility and
rapid emptying of the intestines result in impaired absorption of nutrients and water and an
Oral Rehydration Therapy (ORT): This oral method of drinking electrolyte containing
solution works as a rehydrating agent. These are commercially available over the counter
solution or drinks and have shown to be more effective for fluid and electrolyte replacements.
This solution is low in osmolality and helps quick regaining of imbalance of electrolyte from
Parenteral Fluid and Electrolyte Therapy: This is intravenous infusion therapy and
may be given continues or in boluses as required. It’s an emergency intervention and consists of
either lactated ringer’s solution or 0.9% sodium chloride solution. This helps quick return of
Medications: Diarrhea can be caused from bacteria, parasite or fungal invasion. Based on
stool culture, medication can be provided to prevent it. If diarrhea is caused by a pathogen, then
no medication may be prescribed considering body’s own effort to fight back the intruder.
However, doctor may order antibiotics if the cause of the diarrhea is suspected to be bacterial,
parasitic or fungi. It is to be note that antidiarrheal medications are not recommended for
9. Describe the proper administration technique that should be taught to the aunt to
help her to administer an oral antipyretic to Yasmin on discharge to prevent her from
spitting it out
If Yasmin hates the taste of the antipyretic and keeps on spitting out, then medication can
be sneak into a small bowl of applesauce or can be mixed with a little bit of water or juice. It
should be noted that Yasmin drinks the entire amount and does not leave a portion of it. It would
be wise to mix with a small amount of juice or sauces so that the child can finish the medication
and doesn’t fill up before. For liquid or suspension, medicine dropper can also be used. If
medication can be aimed towards the cheek as close to her throat as possible, then it is less likely
that she will spit. Gently holding the child’s cheek together once medication is in her mouth, can
ensure that she has swallowed it. Yasmin’s aunt must ensure that medication has been given
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while Yasmin is sitting in upright position and never to give extra medication if she spit a little
out.
child
Yasmin should gradually response more with normal respiratory rate. She should have
more urine output measured by wet diapers numbers. The skin should look more elastic and
softer. Pathological reports should show serum pH and electrolyte levels are within limit.
References
Leifer, G., & Keenan-Lindsay, L. (2020). Leifer's Introduction to Maternity & Pediatric Nursing
Younis, J. R., Mabrouk, S. M., & Kamal, F. F. (2015). Effect of the planned therapeutic
James, S. R., Nelson, K. A., & Ashwill, J. W. (2013). The child with fluid and electrolyte
alteration. In Nursing care of children: Principles & practice (4th ed., pp. 336-352). St.
Leifer, G. (2021). Introduction to maternity & Pediatric Nursing. Missouri: Elsevier Saunders.
Ward, S. L., & Hisley, S. M. (2009). Maternal-child nursing care: optimizing outcomes for