need help

Nursey103, ADN, RN · Mar 20, 2009

I think it's a bit weird asking an 8-year-old, "Do you have a fever?"

Think of it realistically...don't just take directly from your textbook!!

Just off the top of my head, I'd be asking when she started feeling 'bad', what she ate that day, etc. You would also do VS besides just listen to her belly. She's probably dehydrated and I think a better nursing dx would be nausea, risk for imbalanced nutrition, risk for fluid volume deficit.....this is all off the top of my head.....no books in front of me so don't know the exact wording of the nursing dx's.

Just try to really think of what you would do....don't just copy from the book....

Daytonite, BSN, RN · Mar 20, 2009

you do not have my permission to copy and use this as your answer to these questions. . .it would be plagiarism.

1. list your history questions - a child probably isn't going to be able to tell you if they have a fever or a change in their appetite unless you form the question in a way they can understand.

did you get sick to your stomach before you just vomited?
is this the first you vomited or did you vomit before you got here to my office?
do you have any pain in your tummy? where?
have you had any burping? farting? does your tummy feel bloated?
did you have anything to eat today? what was the last thing you ate?
when was the last time you went to the bathroom and pee'd and pooped?
are you taking any medicine?

2. list the elements of the physical exam you plan to perform

vital signs
inspect the abdomen for distension
inspect mouth and oral tissues to determine hydration status
have child lie down on an exam table. auscultate and describe the bowel sounds and any bruits
palpate abdomen for any type of pain or tenderness

3) outline 1-2 nursing diagnoses

nausea r/t irritation of gi system
risk for deficient fluid volume r/t decreased intake

4) ann’s mother comes to pick her up. she asks you for your suggestions

it is important that lina stays hydrated and gets electrolyte replacement, so she needs fluids. as long as she still having episodes of vomiting, give her one ounce or less at a time of clear fluids such as clear soup broth, juice, lemon-lime soda, tea, apple juice. you can also give her popsicles. if she will drink it, you can give her small amounts of pedialyte.
ginger ale may help settle the nausea.
wait an hour or two after she vomits before giving her any fluids.
don't give milk or dairy products because they tend to make nausea worse.
if she is tolerating the clear fluids and not having any more vomiting you can try giving her something more soft and solid such as jello, oatmeal, yogurt, or something similar. if she starts vomiting again, go back to the clear liquids.
if she has gone for 24 hours without any vomiting you can try a brat (bananas-rice-applesauce-toast) diet. pasta and potatoes are also ok on a brat diet.
call your doctor if she develops a fever.
call your doctor if she hasn't improved in 3 days.
if she gets abnormally drowsy during the daytime while she is having nausea and vomiting, call your doctor

kikibibi · Mar 20, 2009

Thank you so much for your help..