I am working up a full care plan for a pediatric patient that I had. This is a 6yo male, who has a duodenal hematoma after falling from monkey bars. He has an ng tube with low continuous suction, and a picc line. His doctor was ordering TPN for him, but he hadn't started it yet (I had him 2 days after admit date). IV fluids D 1/4 NS KCL BP 111/58 HR 63 RR 14 T 79.9 axillary His mom was staying with him, but was sleeping all day because she stayed awake all night to make sure he didn't pull his ng tube out again. He does not report any pain. His abdomen was slightly distended, but going down a LOT according to the nurse. He was happily playing all day, and was okay to get out of bed and sit in a chair for a sponge bath. His lab abnormals were slightly low RBC (3.9) Hct (31.3) and Hgb (10.9) He was on Morphine, Pepcid, and Zofran. He says he doesn't like the ng tube and how it looks on his face. He has eczema and was scratching at it a few times. When I cleaned him up, he was really dirty! Dirt behind his ears, clumps of it between his toes, feet were black, dirt was everywhere really. His mom said she didn't know he had that much dirt everywhere, that it must have been from playing at the monkey bars and she didn't want know she could ask for bathing supplies or ask for him to be bathed.
I have to come up with 10 diagnoses, and list in order of priority.
The diagnoses I have come up with aren't in order yet, and are:
1. Risk for caregiver role strain r/t sudden trauma and unpredictability of illness course
2. Risk for infection r/t broken skin secondary to eczema
3. Risk for loneliness r/t social isolation caused by hospitalization and little interaction with sleeping mom
4. Risk for trauma r/t pulling out ng tube
5. Deficient knowledge r/t hospital policies aeb client expresses she did not know she was allowed to ask for child to be bathed
6. Disturbed body image r/t placement of ng tube aeb pt reports he doesn't like how the tube looks on his face.
I don't know if these are any good, and can't think of more for him. Please help.
I'm sorry to hear that. I'm good now, finished ADN 6 years ago and currently working on BSN with hopes to continue to NP. But man, it sure would've been nice to have you around then! I hope these students and new nurses can see how valuable your help is!
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I'm sorry to hear that. I'm good now, finished ADN 6 years ago and currently working on BSN with hopes to continue to NP. But man, it sure would've been nice to have you around then! I hope these students and new nurses can see how valuable your help is!
Thank you:thankya:.......funny they very seldom come back and say Thanks, at least it keeps me busy. good luck in school!
just keep swimming
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I'm sorry to hear that. I'm good now, finished ADN 6 years ago and currently working on BSN with hopes to continue to NP. But man, it sure would've been nice to have you around then! I hope these students and new nurses can see how valuable your help is!