Specific and Unique Needs of Children Seeking Emergency Which Need to Be Addressed Appropriately - Case Study Example

Case Study Analysis Name Course Lecturer Date Background Febrile seizures are convulsions that are as a result of fever in small children and infants. During this seizure, children in most cases shake and moves limbs on the sides of the body, and lose consciousness. It has been established that in every 25 children, approximately one is likely to have febrile seizures. In addition, a third of these infants and children tend to experience additional febrile seizures prior to outgrowing a tendency of having the seizures. It is important to note that febrile seizures occur among infants and children of 6 months to 5 years. However, it is quite rare for a child to develop its first seizure before 6 months and 3 years. If the first febrile seizure occurs in an older child, it is highly likely that the child will have less febrile seizure before the age of 5. Of important to note is the fact that there are various factor that prone children to recurrent febrile seizures including frequent fevers, occurrence of the first febrile seizure at a young age, and family history. In most cases, it has been reported that febrile seizures are not harmful since they are short and no evidence that may result to brain damage; however, long seizures may result to epilepsy even after the child recovers. As such it is important to have an excellent nursing plan care in therapeutic intervention so as to provide the intended care and ensure good development of the children. In the case study presented, a 15 month old girl, Yasmine has been taken to the emergency department by her parent and on admission, the child is assessed. She is diagnosed with febrile convulsion characterized by dry mucous, paleness, and high temperatures. He parents had noted that that staring, limbs and body rigid while clenching her fists rhythmically. Purpose of the Assignment With the above understanding of febrile seizure, this paper will seek to focus on the knowledge of assessment and therapeutic intervention that are relevant to the presented case. As such, the paper will use clinical practice guidelines; that is, form Australian and United States of America, and other clinical supporting literatures in planning and organizing care for the Yasmine. It will therefore, establish priority for nursing and the development for the sick child, communication strategies with health professionals, families and children in the presented case. In addition, a comparison of clinical practices guidelines in relation to the case will also be carried out. Search methods In order to locate practice guidelines and other literature, online database were used. The Medline-PubMed which is an excellent resource for medical and other related literature; provided useful biomedical and health information for the presented case study. Free Databases (ScHARR) also gave relevant information used by health professionals in handling the presented case. In searching for the guidelines, search engine were used whereby search terms were entered in the search box. Immediate and important nursing care It is important to note that Yasmine may be between intermediate and high risk judging from the presented assessment. The fact that the child is pale and has a temperature of 39 o C present a high risk while signs of dry mucus membrane is an indication of an intermediate risk. Therefore, there is a need to address the above immediately and appropriately (NSW 2011). In addressing the above, the following plan is appropriate; Antipyretic therapy should be carried out in order to avoid a reoccurrence of the seizure. Under this it is important to note that antipyretic medication is administered to reduce a child temperature especially in cases where the temperature are above 38.5 o C. In the presented case, this is appropriate given that Yasmine temperature is quite high placing her in the high risk level (Walsh et al. 2007).The drugs may be administered rectally given that the child is asleep. However, the child may be woken up if need be for the drug to be administered orally. In addition to this, other non-pharmacological measures may be taken which include removal of warm clothes and blankets, feeding the child with a cold drink, sponging or fanning the child, preventing the parents from cuddling her for long hours (Sahib et al. 2009) Indeed, the aforementioned issues are significant in order to regulate the body temperature. However, it is important to note that the cold sponging should not be done on the whole body; it should be limited to the forehead and the wrists (Ronald et al. 2006). Notably, it is important that the nurse continue observing the temperature in order to register any fluctuations regularly even when the child is asleep. While administering the antipyretic drugs, it is significant to consider influences of the child; that is, the child may be uncooperative and this is evident when the child screams, spit or vomit. Such issue in most cases calls for the parents’ assistance (Walsh 2008). It is also important to note that antipyretic drugs should not be generally used in reducing the body temperature on children who have fever but are well. The wishes and views of the cares and parents should also be considered. It is important to note that after administering antipyretic agent, a pediatric nurse should not rely on a drop on temperature within a period of two hours to be a basis for differentiating between non-serious and serious illnesses. However, a child with amber or red features should be re-assessed after every two hours (Rennie & Boylan 2003). Generally, given the fact that child has one or more ‘red’ features, it is important for the following to be performed in order to establish any serious diseases or infection; a full blood count, C-reactive protein, blood culture and a urine test to check for urinary tract infection. Still as guided by clinical assessment the following investigation should also be considered; blood gas and serum electrolytes, lumbar puncture, chest x-ray. Of important to note is that if the child has a fever with no apparent source there is a need for the carer to consider an observation period in the hospital (Edwards et al 2003). Given the fact that febrile seizure may develop to be a serious illness, it is important that development procedures are considered in nursing care. In addition, despite the fact that a simple febrile as in the case of Yasmine has low probability if developing into epilepsy, it is important that nursing care towards development of the child is considered. As such, there is a need to prevent and have an alternative for treating a recurrent febrile convulsion. As asserts Cameroon et al. (2006) administering antipyretic agents and cooling an infant does not guarantee that febrile seizure will not reoccur. This is despite the fact that the antipyretic will generally make the child comfortable. With this is mind, it is important to dissuade the parents from using these drugs aggressively. In relation to this, several medications have been suggested that may reduce the risk of a recurrent febrile convulsion; however, it is significant to consider the side of effect of the treatment (Barnes et al. 2004). Despite the side effects, reduction of seizure will reduce stress on the parents. In case of a history of febrile seizure, prophylactic treatment may be considered. In addition, it may be used if the child lives in remote areas where medical help takes time to be accessed It is also important for the nurse to educate and support parents regarding febrile convulsion. This should be accompanied with reassurance in respect to benign nature of the seizure. In addition to this, the nurse should counsel parent on how to control the fever in case of a reoccurrence; ways of keeping the child safe when a seizure occurs and offer demonstration and instruction of how to administer antipyretic agents such as rectal diazepam at the initial stage of a febrile seizure; that is, if applicable. It is important to remind the parent to call a pediatric physician when need be (Upfal 2006). As such, it is significant to reinforce that any activity of a prompt reoccurrence requires medical attention. Of important to consider is the fact that this kind of care calls for the nurse to put into consideration the needs and preference of the child, cares ad parents. This is attributed to the fact that many practice guidelines argue that carers and parents need to have an opportunity of making decision regarding the treatment and care of a child while partnering with the health professionals (Isaacs 2003). Comparison of the practice guidelines Of most important to note is the fact that most guidelines were established in order to offer direction to health professionals on how to achieve excellent pediatric care in the countries where they are used. In addition, they reflect the current approaches that are regarded as appropriate and cheap in relation to a sick child or baby. One may not fail to note that both practice guidelines call for every health professional to use them as a guide and not an authoritative statement that displays clinical judgmental. Both have been prepared by the departmental health of the respective countries. In both guidelines, it is important to note that they argue that the probability of children with simple febrile seizure, as seen in the presented case have low chance of developing epilepsy. In addition, they have noticed that the use of antipyretics agents does not have an effect in preventing a recurrence of febrile seizure but continuous anticonvulsant may reduce the recurrence. Another similarity is that both guidelines have zone which are characterized with specific features that depicts the risk facing a sick child; that is, each zone has characteristics that show at which stage the disease is at (ACEP 2009). Effective Communication Effective communication, in health involves reaching at a share understanding of a particular situation or action. As such it is necessary to have excellent strategies of communication not only with families but also the patients and their families. It is important to note that in order to have good strategies of communication, there is a need to have a range of communication skills, which includes listening, negotiating, assertiveness and goal setting. In addition, it calls for the nurses to access adequate information that is related to the role they perform. Conclusions Indeed, children seeking emergency have specific and unique needs which need to be addressed appropriately. This is so especially in cases where the needs are life threatening. In regard to the presented case, febrile seizure is a common illness among children aged between 3 months and 6 years. Febrile seizure is either simple or complex; according to the duration the seizure affects the child. In the presented case, this is a simple febrile seizure since it lasted for 1 minute. Given that it occur even in healthy children, it causes terrifying and unfamiliar event for the parents and the caregivers. As such, it is important to clinical guidelines that clearly depict nursing care that is appropriate for the presented case. One of the appropriated strategies in relation to communication is related to cultural competency. This is attributed to the fact that most individual interpret health issue basing it on their cultural background. As such, it is important for a health professional to understand and identify a particular individual in relation to his or her culture. Indeed, without this understanding, challenges emerge on how to relay important health information not only to the patient but also to the carers and other health professionals. Another strategy is by engaging the parents, as seen in the presented case in assuming their role in promoting decision through reviewing the information obtained from the assessment carried out. Under this, the health professional encourage them to answer question on areas that require clarification. Among the health professionals, effective communication is ensured by reflecting critically on the assumptions that they hold on each other. As such, the health professionals will be able to build trust and respect amongst themselves, resulting to effective communication. In addition to the above, it is important for the health professional to consider the language and jargon they use while communicating. This is attributed to the fact that in order to communicate effectively, it is important that terminology used in communicate reflect professionalism especially with the parents. This results to an understanding that reflects clear understanding of information to be passed. In the discussion it has been established that Yasmine has simple febrile seizure and two immediate priorities that require attention are related to her paleness which has been described as lethargic and the high body temperature recorded. In regard to the body temperature, it is important that the forwarded plans as discussed in the paper to be considered. In addition, there is a need to carry out some assessment as the paleness observed falls in the ‘red’ high risk level. This include urinary test, C-reactive protein, total blood count; in order to establish any infection. In addition, it is also important to establish the cause of the fever so as to administer appropriate drug. Equally enough, the paper has stated the need to have effective communication strategies not only with the health professionals but also with the children and their parents. Indeed, this important given that only when communication is effective, protocols and treatment in the health is successful. Such strategies as discussed in the paper include, correct use of language and jargon, cultural competency, and clear and good assumptions of other individuals. References ACEP, 2009, Guidelines for care of children in the emergency department, American Academy of Pediatrics Barnes, M., Walsh, M., Courtney, Mary D., & Dowd, T 2004, School based youth health nurses' role in assisting young people access health services in provincial, rural and remote areas of Queensland, Australia. Rural and Remote Health, 4(4), 279 Cameroon, P., Jelinek, G & Everitt, I 2006, Textbook of pediatric emergency medicine. Melbourne: Elseiver Health Science Edwards, H., Courtney, Mary D., Wilson, Jennifer E., Monaghan, Sarah J., & Walsh, Anne M. 2003, Fever management audit: Australian nurses' antipyretic usage. Pediatric Nursing, 29(1), pp. 31-38. Isaacs, D 2003, Evidence based pediatric infectious diseases. Sydney: Wiley NSW, 2011, Children and infants-recognition of a sick baby or child in the emergency department, NSW Health Rennie J & Boylan B, 2003, Neonatal seizures and their treatment. 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