Nursing Placement: Pediatric Client - Case Study Example

Name : xxxxxxxxxxx Institution : xxxxxxxxxxx Title : Case study from emergency Nursing placement: Paediatric client Tutor : xxxxxxxxxxx Course : xxxxxxxxxxx @2010 Introduction Emergency nursing involves caring for patients in situations where every minute of the treatment counts, especially in the early stage of heightened illness and trauma. The emergency nurses must do various task with much professionalism and should be caring to the patients. For the emergency nurses to achieve this, they must be well equipped with both specific and general knowledge on the type of health care to offer to the people in all age groups and in all disease conditions (Ramsden & Friendship 2007). The case study is an emergency nursing for a pediatric patient who is traumatized after being involved in an accident. The client is a child aged ten years who has fallen down the stairs of their house. Form the health history of the child, she was of good health and had no health complains before the accident took place. The child had normal body weight and height for her age, and had no presentation of bad health. The accident occurred as she was playing on the stairs where she lost control of herself and fell down. The child’s left hand experience a fracture, the head was hit and she was bleeding profusely. The child was very frightened and from the observation, she was in serious trauma. This is a case of emergency paediatric nursing that bears in mind that children are mostly affected by trauma. This is because they are young and trends to be more scared by things that happen to them. The situation therefore needs an emergency paediatric nurse who understands them properly. In such a case, the nurse should work closely with the members of the child’s family to achieve maximum care for this child. The nurse should also be open minded to the child’s family and be able to relate well with them. In this situation, the nurse will also manage stress form both the child and the parents. This is because they are all anxious, helpless, and have a feeling of guilt. The paediatric nurse must therefore be able to help them overcome this crisis (Bevan, Officer & RCH 2004). TRAUMA Trauma is an injury to a person that can be inflicted both physically and emotionally. In this case, the child is experiencing physical trauma inflicted by the injuries from the accident. The parents on the other hand are experiencing emotional trauma due to the guilt that they are feeling because of their child’s situation. Some of the components of trauma include high anxiety, severe depression, acute psychosis and overwhelming guilt and shame following the traumatic event. High anxiety in this case is due to the worry that is building in the child especially after looking at herself. The anxiety is high due to the pain that the child is feeling and the condition she is in. the child is trying to psychologically cope with the situation and is also faced with fear and worry over the impending danger. Severe depression is caused by pain that the child is experiencing. This accident is a painful experience and also the hospital environment the child is in. she is depressed and worried. The trauma that has faced this child may also put her in a state of acute psychosis because she is frightened. The child may become violent due to the pain and also due to the bad experience of being in such a situation. On the other hand, the parents of the child may be feeling guilty due to what has befallen their child. This is because most of the children accidents are associated with bad care of the parents. The parents may therefore be feeling guilty because they have failed in their role of looking after the child. Effects of trauma and multisystem injury Children who face traumatic experiences usually suffer from some symptoms and mental or physical problems afterwards. However, the severity of these symptoms and problems depends on several factors such as the past experience, the ability to cope with the trauma, the severity of the trauma and the support offered to the victim. Children may develop long lived fear where they may tend to avoid the act that led to the accident for the rest of their lives. The treatment they get for the injuries may also develop further fears that may make them avoid the action that may make them go through the treatment one again. Multisystem injury may affect the functioning of the child and may result in disability. The child may hate herself and all that led to the accident. In this case, the child experienced fractures I her arms and this may result in improper functioning of the arms. However, with proper care and treatment, all this can be avoided. Physical and psychosocial effects of trauma Traumatic experiences may have physical impacts on an individual or a child which include some undesirable reactions when they are reminded of the trauma. Some especially children may have trouble falling asleep when something reminds them of the accident they experienced. The child may keep feeling nervous most of the times and always keeping watch for danger. In such a situation the child may not be able to play freely due to fear for danger. The child may also tend to avoid areas such as the stairs where the accident occurred and may avoid playing on them. One may also keep feeling shaky and sweaty most of the times, and always having a pounding hear. These experiences may last long for a child if she does not receive proper therapy that may help her cope with the experience. Trauma may also result in varied psychosocial effects in the life of the affected child. The child may have upsetting memories when she thinks of the traumatic experience. These memories may remain in her mind for quite some time. Bad dreams may also be experienced after the experience and they may disturb her ability to sleep well. The child may always feel upset when other people reminds her of the experience and may be unable to control her emotions when reminded of the trauma. Triage and disaster nursing required The triage nurse in this case will be required to identify the serious results of the trauma. In this child, the triage nurse should be able to identify the fractured arms and the bleeding head. The nurse needs to identify the point on the head where the blood is coming from and the arms that are suffering fracture. From there, disaster nursing involves ensuring that what the nurse has observed is valid. Tests must be done on the arms and proper observation on the head to ensure that the head is truly bleeding. This therefore calls for thorough assessment of the child. Other areas in the body where there are symptoms of injury such as the legs must be properly assessed to ensure that they in free from injuries. Another disaster nursing activity is to ensure that the child’s situation is not life threatening. This is done by assessing the general condition of the injuries. The past medical history should be taken into account and the fears and worries of the child. This will equip the health care provider on how to tackle the whole situation (Baren & Rothrick 2007). Short-term (acute) and long term care The short term treatment that can be done on the trauma patients is that which will enable her to reach to the main treatment center. In this case, the child will need blood transfusion to replace the blood that is lost through head bleeding. The child will also require minor surgery on the fractured hand to stabilize it and prevent further injury. The child will also require pain reduction drugs to prevent further pain. The long term treatment required for this child is proper surgery on the head and the fractured hand to restore their condition. When no proper surgery is done on the hand, it may develop a permanent problem that will require amputation. The hand of this child therefore needs treatment by an orthopedic doctor to ensure that it will function normally and does not develop future problems (Wesson 2005). Cultural implications for the client Nursing care offered to a patient should take into account the cultural uniqueness of the client. This is because the doctor may prescribe some health care practices that the cultural background of the client may not support. This child may experience post trauma impact such as night mares that may keep arousing strange reactions in her. If the family and those around her are not ghiven proper guidance on her care, they may interpret this differently. Some people may interpreter such reactions as evil spells or a mental illness. The child may therefore have difficult time whne left under the care of people who are not informed of her condition. Post trauma behaviours may appear similar to mental illness and where the culture does not recognize that as a normal condition, the child may experience negative cultural implications. Care for the family and significant others A child who has had a traumatic experience can easily go through if given proper care from the parents and others who are around her. However, for the family and significant others to be able to offer proper care to the child, they must also receive proper counseling and health care form the nurses. The family should be on the first line to help the patient recover from the trauma. In this case, the parents should get help on how to avoid their emotional feelings concerning the affected child. This is because if the parent continues to show emotions, the child will feel as if her situation is worsening. The parents should also hide their feeling of guilt form the child. This can e possible where the nurses explains to them that whatever they are experiencing is normal and whatever befell the child is not their fault. The situation must be made to appear normal so that other well wishers who visit the child do not get emotional (Langstaff & Christie 2000). Summary Discharge Management At the discharge of the child, the mother or the care giver is issued with a discharge summary on how to take care of the child. The child is issued with pain reduction drugs and others to help the bones regain back their strength. However, because this is a child, the fractured hands are expected to heal faster and the child may continue with her normal activities within a short time. For recovery from the trauma, the child is given some tips by the nurse to help her overcome. These include not to isolate form other children. This will make the situation worse and should be encouraged to keep connected with people around. Another tip is to ask for support in case of any need. The child should always be open to the parents and the parents should also be encouraged to remain open to the child. The child should take good care of her health. Starting to play vigorously before she fully recovers will be doing harm to the body. The parents should also ensure that the health of the child is kept at watch to help in quick recovery. Bibliography Bevan, C., Officer, C., & Royal Children's Hospital (Melbourne), 2004, Paediatric trauma, Royal Children's Hospital, Melbourne. Wesson, D., 2005, Pediatric trauma: pathophysiology, diagnosis, and treatment, CRC Press, Boston. Baren, J., & Rothrick, S., 2007, Paediatric emergency medicine, Elsevier Health Sciences, New York. Ramsden, C., & Friendship, J., 2007, Emergency and Trauma Nursing, Elsevier, Austria. Langstaff, D., & Christie, J., 2000, Trauma care: a team approach, Elsevier Health Sciences, New York. Read More