NUR355 Children And Young People Assessment – Australia.

Instructions:
Answer all questions associated with the three clinical scenarios on the provided template.
Academic integrity is taken very seriously. Answers must be your own work,written in your own words.
Answers that are not your own work include:
 An answer that is a cut and paste from MyLO content or an external website or other resource
 An answer that is made up of multiple small quotes taken from MyLO content or external sources
 An answer that is closely matched to an answer from another student.
NUR355 Children And Young People Assessment – Australia.

NUR355 Children And Young People Assessment - Australia.

Any answer that is not your own work, written in your own words, will be given a mark of zero and the remainder of the paper will not be marked.

Clinical Scenario 1 – Lucy

I – Identification
Lucy is a 4-month-old infant, who has been brought into the Emergency Department (ED) by her mother at 1000hrs.

S – Situation
Lucy has a three-day history of rhinorrhoea, temperatures and generally being unsettled. Her mother has brought her to the ED because she is concerned Lucy is getting worse and her breathing is ‘funny’.

B – Background
Lucy was born at term and had no birth complications. She lives with her mother and grandmother. Lucy is a breastfed baby and is up to date with her immunisations.

A – Assessment
T 38.4
HR 165
BP 85/50
RR 55
SpO2 93%

R – Recommendation
Lucy has been diagnosed with bronchiolitis and will need to be admitted to the paediatric ward.

Use the information presented in the clinical scenario about Lucy to answer the following three (3) questions.

Question 1:
Describe how you would assess HR, RR, work of breathing, and oxygen saturation in a 6-month-old infant.

Question 2:
Lucy has a respiratory rate of 55 breaths per minute, HR 165, an oxygen saturation of 93% in room air with increased work of breathing.
How do Lucy’s vital signs compare to the normal range in a 4-month-old infant?

NUR355 Children And Young People Assessment – Australia.

NUR355 Children And Young People Assessment - Australia.

Question 3:
Why is the bronchiolitis causing these presenting signs and symptoms in Lucy?
Your answer should include the pathophysiology of bronchiolitis.

Clinical Scenario 2 – Amal
I – Identification
Amal is a 3-year-old boy who has been brought to the Emergency Department by his mother at 1600 hours.

S – Situation
Amal started vomiting at approximately 0500hrs and has continued vomiting throughout the day – he is thirsty, but every time he has a drink he vomits. He last passed urine at 1100 hours, but his mother said it was a smaller amount than usual.

B – Background
Amal lives with his mother, father and two older sisters. He is normally well and is up to date with his immunisations.

A – Assessment
T 37.4
HR 140
BP 100/60
RR 32
SpO2 99%

R – Recommendation
Amal has been diagnosed with moderate dehydration caused by viral gastroenteritis. He has been prescribed ondansetron and is for trial of oral rehydration. If this fails over the next hour, Amal will require NG rehydration.

Use the information presented in the clinical scenario about Amal to answer the following two (2) questions.

Question 4:
Amal has been diagnosed with moderate dehydration. He has a HR of 140 and a BP of 100/60. Why does Amal have an elevated heart rate, but a normal blood pressure? Include in your answer information on the compensatory mechanisms occurring in Amal.

Scenario 3 – Triage
Daiyu and Jack are 2 years old and have been brought into the emergency department (ED) at 2 am by their parents. They have been diagnosed with croup.

Daiyu is sitting on her mother’s knee. She is becoming increasingly agitated and has an audible stridor, but this is becoming quieter. She has visible chest wall retractions.

Current observations: T37.6, HR 94, RR 26, SpO2 96% RA

Previous observations:
T 38.0 C , HR 146, RR 34, SpO2 99% RA Intermittent stridor at rest, visible chest wall retractions.

Jack is resting back against his father. He opens his eyes but appears tired. He has audible stridor at rest and visible chest wall retractions.

Current observations: T38.2 C , HR 142, RR 36, SpO2 99% RA

NUR355 Children And Young People Assessment – Australia.

Previous observations:
T 38.0 C , HR 134, RR 32, SpO2 99% RA Intermittent stridor at rest, visible chest wall retractions.

Question 6:
Based on the information presented above for the two children, which child are you currently most concerned about. Please provide a detailed explanation for your answer.

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