Luke, is a one-week-old baby, born at 38 weeks gestation and weighed 3.3kg at birth to a first-time mother, Bec. He was brought to a family clinic for assessment and management as Bec was worried about Luke’s weight gain. She has no concerns with Luke’s feeding, just that he does not open his bowels daily but has no abdominal discomfort. As a health assistant, Bec is keen on providing the best care for Luke. Thus, she has a weighing scale at home that she plans to weigh Luke weekly until he is two years old. However, in his first week, Luke’s weight recorded 3.0kg which is less than his birth weight.
- As the practice RN on duty, explain what is happening to Luke (2 marks).
- Discuss four ways you will reassure Bec (8 marks).
- Two years later, Bec returned to your facility with Luke having a severe burns injury to her right arm, head, neck and chest in the home. Bec stated that the burns occurred from an accident with cooking oil in their kitchen. Luke is being prepared for escharotomy of her arm.
- Discuss two benefits Luke will derive from this surgery (3 marks)
- When managing burns, as a Registered Nurse, discuss your top three priority areas (6 marks)
- Discuss the three main classifications of rehydration solutions and give one example each (6 marks)
Chad, a 5-year-old boy, was brought to your ward after experiencing 24 hours of severe vomiting and diarrhoea. Upon assessment, Chad’ dehydration was assessed as 7%. He is to be prepared for intravenous fluid therapy (IVT) as he cannot tolerate oral fluid and diet.
- Calculate Chad’s expected weight (2 marks).
- Calculate his total fluid requirement in 24 hours (8 marks).
- Discuss strategies you will utilise to prepare Chad for IV cannula (5 marks).
- After IVT is commenced, discuss measures you will undertake to care for Chad while receiving IVT (10 marks).
Bernard is a 10-year-old boy with a moderate autism spectrum disorder. He was brought to your ward with a fracture of his right radius which occurred during one of his episodes at home. He was admitted to your ward post-operatively for immediate post-op management. He appears shy, non-engaging with minimal eye contact and distressed.
- Using two paediatric pain assessment tools, discuss how you will assess Ben’s pain
- If Bernard’s pain assessment score is recorded as 8/10, discuss two pharmacological and three non-pharmacological ways of managing his pain (10 marks).
- As a paediatric nurse, explain the impact of hospitalisation on Bernard and demonstrate two ways to support him (5 marks).
Michelle is a 15-year-old adolescent with a history of eating disorders and increasing deliberate self-harm. She was recently admitted to your ward as an involuntary patient. Michelle also has a previous history of sexual abuse when she was 13 years and appears to act inappropriately towards male nurses. Michelle’s mental health and risk assessment show the presence of suicidal ideations and a clear intent (overdose of paracetamol). She is also at high risk of absconding. As part of the nursing team caring for Michelle ane,
- Demonstrate four ways to ensure that Michelle is safe (10 marks)
- Discuss four measures you will put in place to ensure Michelle is safe in the community following discharge (10 marks).
- At lunchtime, Michelle was upset with staff and threatened to abscond, demonstrate two ways you will communicate with Michelle to de-escalate this? (5marks)
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