Emergency Room Scenario and Pediatric Patient Education: Nursing Priorities

QUESTION

1. You are working in the emergency room when an elderly lady runs in with a child in her arms. The child is awake but drowsy and not talking.  The lady states she was babysitting her 3-year-old -grandson when she noticed he was quiet.  When she went to check on him, she found him on the bathroom floor with empty vitamin and medication bottles beside him.  She said she grabbed her grandson and drove the 10km to the hospital.  When you asked what the medication was, she stated she did not know because they were her deceased husbands’ old medications. As you are directing the grandmother to the trauma room, she informs you she made the boy vomit by sticking her fingers down his throat.

A. After laying the child in the trauma room, connecting him to the cardiac monitor, and starting an IV, who should you call?  List 2 priority nursing assessments and explain how they are done. (4 points)

2. You are working on the pediatric unit and tending to a 5-year-old with a new diagnosis of congestive heart failure post-secondary to a respiratory virus.  She is going down to have an echocardiogram and her parents are at work.  Explain how you will describe what an echocardiogram is to your patient and why it’s important. You can use quotations and dialogue as an example

ANSWER

Emergency Room Scenario and Pediatric Patient Education: Nursing Priorities

After laying the child in the trauma room, connecting him to the cardiac monitor, and starting an IV, several important actions need to be taken immediately to ensure the child’s safety and well-being. The first step is to call for medical assistance and notify the pediatrician or emergency physician on duty about the critical situation. Simultaneously, the nurse should inform the healthcare team, including respiratory therapists and pharmacists, to gather the necessary resources for managing the child’s condition.

Priority Nursing Assessments

Airway and Breathing Assessment: The nurse must prioritize the assessment of the child’s airway and breathing to ensure adequate oxygenation. This involves closely monitoring the child’s respiratory rate, rhythm, and depth, as well as assessing for signs of respiratory distress or cyanosis. The nurse should also auscultate lung sounds to detect any abnormal breath sounds, such as crackles or wheezes, which may indicate pulmonary involvement.

Neurological Assessment: Since the child is drowsy and not talking, a thorough neurological assessment is crucial to evaluate his level of consciousness and neurological function. The nurse should assess the child’s pupillary response, motor strength, and ability to follow commands. Additionally, any signs of altered mental status, such as confusion or disorientation, should be documented promptly.

As a pediatric nurse, it is essential to use child-friendly language and age-appropriate explanations when describing medical procedures to young patients. When explaining what an echocardiogram is to the 5-year-old with congestive heart failure, the nurse can use a playful and comforting approach to ease the child’s anxiety. For example:

Nurse: “Hey there, sweetie! I’m here to tell you about a cool test called an echocardiogram. It’s like taking a picture of your heart to see how it’s doing. We’ll use a magic wand (ultrasound probe) that doesn’t hurt at all, and we’ll put some gel on your chest to help us see your heart clearly.”

Child: “Is it like a camera?”

Nurse: “Yes, just like a camera! It’s going to show us how your heart is pumping blood and if there’s anything we can do to help it feel better. Your heart is like a superhero, and we want to make sure it’s strong and healthy!”

Explaining the importance of the echocardiogram is equally vital

Nurse: “The echocardiogram is important because it helps us see inside your heart and find out how we can best take care of it. It’s going to give us lots of useful information to make sure your heart is happy and can do its job properly.”

Child: “Will it hurt?”

Nurse: “No, not at all! It’s a painless test, and you can even watch your heart on the screen if you want. I’ll be right here with you the whole time, and we’ll make it a fun adventure together!”

By using a child-friendly and reassuring approach, the nurse can help the 5-year-old patient feel more at ease about the upcoming echocardiogram and foster a positive and trusting relationship between the child and the healthcare team.