Discussion: Health Conditions Affecting Children Across Developmental Stages

GH2140 | [Group Member Name, Student #]

Type of Seizures: Otitis Media & Febrile Seizures.
Children 6-36 months (Keenan-Lindsay & Leifer, 2020, p. 533) will have a bulging, reddened TM, fever, and will
pull at their ear. Diagnosis: acute pain due to inflamed middle ear. Plan: Decrease pain/fever; prevent hearing loss.
Intervention: antipyretics and warm compress and full course of antibiotic treatment (Keenan-Lindsay & Leifer, 2020,
p. 534). The patient's temperature was normal, the pain had disappeared, and the hearing was normal. In children aged
6 months to 5 years, febrile seizures are associated with a sudden increase in temperature (Keenan-Lindsay & Leifer,
2020, p. 533). Diagnosis: risk for injury during seizure; caregiver anxiety. Plan: child remains injury free, caregiver
knows how to manage fevers. Consultation with other professionals: the GP, health visiting team, and school
[Link] with other professionals: GP, health visiting team, school nurse. Evaluation: caregiver shows
proper technique.
Musculoskeletal: Fractures
Due to children's softer bones, greenstick fractures may occur and are characterized by pain, swelling and restricted
movement (Keenan-Lindsay & Leifer, 2020, p. 565). Diagnosis: acute pain, risk for neurovascular dysfunction. Plan –
circulation/sensation and pain control. Intervention: neurovascular checks (pain, pulse, pallor, paresthesia, paralysis,
pressure) at regular intervals, limb elevation, and care teaching about the care of the cast (Keenan-Lindsay & Leifer,
2020, p. 569). Evaluation: normal circulation and sensation distal to injury with control of pain.
Respiratory: Asthma, RSV, Croup
Asthma is a disease of reversible bronchospasm, wheezing, impaired gas exchange is the diagnosis, bronchodilators
and trigger avoidance is the plan/intervention, and improved air entry is the evaluation. (Keenan-Lindsay & Leifer,
2020, p. 602) RSV bronchiolitis: Infants under 7 months who have tachypnea and feeding difficulty; diagnosis is
ineffective breathing pattern; care is semi-Fowler's positioning, oxygen, and contact precautions; evaluation is done
with stable oxygen saturation; (Keenan-Lindsay & Leifer, 2020, p. 606). Croup results in a barking cough and stridor;
treatment involves use of steroids or nebulized epinephrine if severe; assessed by resolution of stridor (Keenan-
Lindsay & Leifer, 2020, p. 594).
Gastrointestinal: Gastroenteritis, Vomiting, Dehydration, Appendicitis
Diarrhoea and vomiting can lead to dehydration quickly – indicated by drier than usual skin turgor and/or sunken eyes
(Keenan-Lindsay & Leifer, 2020, p. 668). Diagnoses: Deficient fluid volume, Risk for impaired skin integrity.
Prescribe: rehydrate and preserve perineal skin. Intervention: Oral rehydration solution, strict intake/out, perianal skin
care (Keenan-Lindsay & Leifer, 2020, p. 676). Evaluation: increased skin turgidity and undamaged skin. Symptoms
of appendicitis include periumbilical pain which shifts to the right lower quadrant with rebound tenderness (Keenan-
Lindsay & Leifer, 2020, p. 678). Care Plan: to prevent the likelihood of infection due to possible [Link]:
acute pain; risk for infection from possible rupture. Intervention: NPO status, monitoring for signs of perforation,
postoperative pain/infection control (Keenan-Lindsay & Leifer, 2020, p. 679). Evaluate: Pain well controlled, no signs
of peritonitis.
Genitourinary: Urinary Tract Infection
Girls are more likely to get UTIs because the urethra is shorter and infants may only have fever (Keenan-Lindsay &
Leifer, 2020, p. 693). Impaired urinary elimination, risk for recurrent. Plan: prevention of recurrence and clearing of
infection. Intervention: obtain urine culture prior to antibiotic treatment, complete antibiotic treatment and educate
perineal hygiene (Keenan-Lindsay & Leifer, 2020, p. 694). Evaluation: Without fever and negative follow-up culture.
Communicable Diseases & Immunization
Chicken pox has a vesicular rash and is managed with airborne precautions (Keenan-Lindsay & Leifer, 2020, p. 751);
measles has Koplik spots and a maculopapular rash and is also managed with airborne precautions (Keenan-Lindsay
& Leifer, 2020, p. 752); pertussis presents with paroxysmal coughing and a whoop during inspiration and is managed
with droplet precautions, with erythromycin given to unvaccinated, exposed contacts (Keenan-Lindsay & Leifer,
2020, p. 753). The symptoms of meningitis are nuchal rigidity, fever, and/or possible petechiae, and the intervention
is 10-21 days of isolation and IV antibiotics, confirmed by a lumbar puncture (Keenan-Lindsay & Leifer, 2020, p.
751). In all four, the focus of evaluation is on fever/rash resolution and no complications. Nurses can assist in
preventing disease through immunization by providing education to families about the immunization schedule,
assessing contraindications, and respectfully counselling people about vaccine hesitancy based on evidence (Keenan-
Lindsay & Leifer, 2020, p. 754).
Reference
Keenan-Lindsay, L., & Leifer, G. (2020). Leifer’s introduction to maternity and pediatric nursing in Canada (1st ed.).
Elsevier.