Maria Hernandez peds ALL ANSWERS 100% CORRECT FALL-2021 SOLUTION GUARANTEED GRADE A+

Maria Hernandez Scenario 1 Assessment reveals: left knee swollen, red, and tender to touch. Pain is rated 9/10. Temperature is 102.3, RR 49, B/P 130/74, HR 110 pulse oximeter is 86% on room air. Maria is crying, unable to be consoled. Her mother is very anxious. ord er Step Explanation 1 Start O2 per face mask at 4 L/min Sickle cell crisis occurs and limits oxygenation of tissue resulting in hypoxia and increased pain 2 Obtain urine specimen for urinalysis and culture and sensitivity Should be taken prior to trauma of needle stick (lab draw) 3 Start IV and draw CBC, BMP This avoids multiple sticks (related to IV fluids altering lab values) and gives baseline lab work to determine other issues or infections 4 Initiate IV fluids d5 ½ NS at 75 ml/hour 5 Administer Morphine Sulfate 4 mg/IV per MD order IV hydration is needed to prevent dehydration Relieve intense pain of sickle cell crisis Six hours later, on the pediatric floor, the mother is asking how they could have prevented this crisis from happening. Vital signs are improved, the child states pain is now a 2/10 in her left knee. Urinalysis comes back positive for bacteria. ord er Step Explanation 1 Ask the mother what she knows about sickle cell crisis and triggers for this disorder 2 Assess the child’s nutritional status through a 24- hour diet recall (child prefers chicken nuggets, French fries, and soft drinks for lunch) Obtain baseline information before initiating teaching Poor nutrition can play a role in a sickle cell crisis 3 Ask the child what she most likes to drink Caffeinated drinks can cause dehydration 4 Provide additional information on nutrition, hydration, prevention of illness to the mother 5 Based on education, provide the child with healthy options for fluid intake The assessment of the mother and child demonstrates the need for further teaching and reinforcement of teaching The child needs to stay hydrated to reduce change of another sickle cell crisis