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NUR 3330 Paul Windsor Peds

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Paul Windsor Room 303 Paul Windsor, 4-year-old male admitted yesterday from the clinic with a diagnosis of Nephrotic Syndrome. Vital signs: Temperature 99.0, HR 88, BP 104/76, RR 22, PaO2 95%. He presented yesterday w ...

Paul Windsor Room 303 Paul Windsor, 4-year-old male admitted yesterday from the clinic with a diagnosis of Nephrotic Syndrome. Vital signs: Temperature 99.0, HR 88, BP 104/76, RR 22, PaO2 95%. He presented yesterday with his parents reporting a gradual increase in pain and “swelling” around his eyes and ankles, and now his stomach is getting “bigger". Paul has little to no appetite. Current weight is 56 pounds compared to a usual weight of 43 pounds. Urinalysis: Thick, frothy appearance. Specific gravity: 1.025. Protein 3+. Blood 2+. Other labs: Triglycerides 180 mg/dl. Cholesterol 190 mg/dl. Group B strep culture negative in office. You responded correctly to 6 out of 6 evaluations: Category Your response Explana Educational Needs Increased acuity Mother and patient need renal diet and fluid restriction educatio Health Increased acuity Status assessment reports weight gain and recent abnormal lab LOC Normal acuity Status assessment reports no indication of increased LOC acuity Pain Increased acuity Status assessment reports gradual increase pain and “swelling” Psych Normal acuity Status assessment reports no indication of increased Psychiatric Safety Increased acuity Status assessment reports pain around ankle making patient a f You correctly diagnosed 1 out of 5 options: Physiological Description Your Response Fluid volume deficit True Patient is at risk for Fluid volume de Impaired skin integrity True Status assessment reports would be Safety Description Your Response Ex Deficient Knowledge False Status assessment reports new diagnosi Infection True Patient is at risk for Infection Scenario 1 CBC from last night shows the following: Hgb -18g/dl, and Hct 43%. Paul’s skin is dry to touch. You correctly ordered 2 out of 5 actions: Your order Correct order Step 2 1 Obtain order and initiate IV fluids of D5 ½ NS at 75 ml/hour Treat de 5 2 Request low sodium diet Support 3 3 Explain to parents and Paul the need for sodium restriction Educatio diagnosi 4 4 Encourage Paul to drink appropriate fluids Further p 1 5 Re-Assess vital signs and skin turgor Reasses

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