Nursing Diagnosis Student Nurse Journey护理诊断学生护士之旅.pptVIP

Cystic Fibrosis Case Study Gender: 1 Male 1 Female Age: 12 yrs 11 yrs old Setting: 4N at MAMC Ethnicity: Irish, Scottish, German (Western European) Cultural considerations: none Nursing Diagnosis Ineffective Airway Clearance Nursing Diagnosis Nutrition imbalance: less than required -Encourage 3 meals and 2 snacks daily (or as directed) History Cystic Fibrosis 2 weeks of increasing cough Had viral URI 3 weeks before and cough evolved into dry hacking cough. Did not respond to short course of Ciprofloxacin. Cystic Fibrosis 3 weeks of worsening cough Prior admission pt. diagnosed with S. aureus and Pseudomonas in culture. (Nov 2007) Recently discontinued insulin for DM. Lightheaded with insulin and now thought to be normoglycemic. Pharmacologic needs and pain management Pancreatic enzymes Albuterol nebs Dornase (pulmozyme) 1 vial Megace Azithromycin Ceftazidime (fortaz) Ticarcilin + clavulanate Ibuprofen Developmental level Appropriate development status for age. Mental intelligence is extremely high for age. Girl: Appropriate social skills demonstrated through constant talk about friends and engaging in long conversations. Boy: Extremely knowledgeable for a 12 year old, excellent communication skills and curious about politics, government, and wants to be a doctor. Knew more correct answers than student nurses in the game, “So you think you are smarter than a 5th grader”. Socio-economic -Health care barriers Very fortunate that father is in military where health care is readily available and mostly everything is paid for. Father is a doctor in the hospital However being from a family of 8 and only one income puts a strain on finances, but he and siblings are very grounded. Communication Language barriers- No noticeable barriers except when a flair-up occurs and is unable to speak due to coughing Level of communication for the best understanding by patient and family: -Open conversations, tell them the truth, use medical terms; pts very comfortable with