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Week 7 Amanda Blaire Pediatric Clinical 2

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Week 7 Pediatric Clinical Amanda Blaire Room 301 Amanda Blaire, 14-year-old female, who was in an ATV accident and now has a fractured tibia and fibula. Her vital signs are Temperature 98.6 F, 37.0 C, HR 87, BP 111/72, RR 18, PaO2 97%. She is post-op day 1 with continuous traction and skeletal pins to immobilize leg. You responded correctly to 5 out of 6 evaluations: Category Your response Educational Needs Increased acuity Health Normal acuity LOC Normal acuity Pain Increased acuity Psych Normal acuity Safety Increased acuity Explanation Status Assessment reports fracture and surgery and rehabilitation needs. Status Assessment reports fractures, major surgery, and rehabilitation needs. Status assessment reports no indication of increased LOC acuity Status Assessment reports fractures, major surgery, and rehabilitation needs. Status assessment reports no indication of increased Psychiatric acuity Status Assessment reports fractures, major surgery, and rehabilitation needs.Jonathan Gibbons Room 302 Jonathan Gibbons, 13-year-old male diagnosed with asthma since he was 3 years old. He uses a rescue albuterol inhaler (PRN) on an "as needed" basis. Jonathan presents to the clinic with what his mother calls a “bad cold and cough” that has been present for 3 days. Vital signs and assessment: B/P 110/65 T100.8 F, 38.2 C, HR 110 RR 26, PaO2 92%. Bilateral wheezing can be heard throughout all lung fields. Jonathan is seen in a tenting position and using accessory muscles to breathe. He has been using his rescue albuterol inhaler q 2 hours for the last 6 hours with minimal relief. Orders: Admit to the pediatric unit at Children’s hospital, IV methylprednisolone 40mg q day, Ampicillin 250 mg IV q 6 hours, Tylenol 500 mg PO q 6 hours prn Temp/Pain, Xopenex 0.63 mg q 6 hours per nebulizer and PRN. You responded correctly to 6 out of 6 evaluations: Category Your response Educational Needs Increased acuity Health Increased acuity LOC Normal acuity Pain Increased acuity Psych Normal acuity Safety Increased acuity Explanation Status assessment reports patient waited longer than expected. Needs education regarding treatment elapse tim Status assessment reports patient with bad cough and abnormal vital signs. Status assessment reports no indication of increased LOC acuity. Status assessment reports patient is in tenting position and using accessory muscles to breathe. Status assessment reports no indication of increased Psychiatric acuity. Status assessment reports patient has IV therefore making him a fall risk. Select patient: Jonathan Gibbons, acuity 7 (room 302)Select room: Selected patient Jonathan Gibbons  DOB: 5/18/2007  MRN: 82911040 Patient in room  Room: 302  DOB: 5/18/2007  MRN: 82911040 You correctly diagnosed 5 out of 6 options: Physiological Room 302Description Your Response Communication, impaired for verbal False Impaired gas exchange True Pain, at risk Acute True Respiratory distress True Explanation Status assessment reports no indication of Communication, impaired for verbal Status assessment reports patient is in tenting position and using accessory muscles to breathe with abnorm signs. Status assessment reports tenting position and using accessory muscles to breathe result pain Status Assessment reports patient bilateral wheezing throughout all lung fields and seen in a tenting position using accessory muscles Safety Description Your Response Anxiety True Knowledge deficit True Explanation Patient is at risk for Anxiety. Status assessment reports patient waited 3 day to seek medical attention.

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