Assignment: Traumatic Vaginal Birth

Assignment: Traumatic Vaginal Birth

DISCUSSION B

Group B will complete the initial post. Group A will respond. Baby Leah had a very traumatic vaginal birth. After a vacuum extraction for fetal heart rate tracing changes and a resultant shoulder dystocia, Leah has a mild Erb’s palsy, some facial and truncal bruising. Pediatrician has ordered physical therapy for the palsy and the doctor expects routine care to be provided to her. In addition, do not forget the education you must give to the new parents regarding this injury. Due to the bruising there is an increase in bilirubin levels and some behavioral changes occur with Leah. Please describe what is different and what will you discuss with the family to ensure safety? The bilirubin level requires phototherapy. What precautions must you take? What is essential to manage and treat the elevated bilirubin in addition to phototherapy?

Group A Response Phototherapy is discontinued at the hospital, but at home the parents are encouraged to provide some ‘routine’ therapy for Hyperbilirubinemia. What would you suggest? Do not forget routine discharge instruction for this parent.

Module 6 discussion

Discussions A/B

Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.

DISCUSSION A

Robert and Jenna Smith’s 2nd child has Down Syndrome. Philip is 14 years old. He has a sibling that is older and one younger. 15 year old sister, Lucy and a little brother Danny who is 10 years old. As all 14 year olds he is becoming more interested in his sexuality and expressing that with curiosity. He has been known to have some overt aggression toward his sister and some classmates in his public school.

Discuss how you could help this family cope and guide Philip to learn appropriate behavior.

Group B Response

Will this behavior interfere with his interest in being in the local Boy Scout troop? His troop leader is his father.

DISCUSSION B

Toddlers have some very unique behavioral characteristics as they move from infancy to childhood. Identify these behavioral changes. Include the challenges that parents may face with these characteristics including identifying temperament, nutritional barriers, hygiene, activity, and sleep.

Group A Response

Can you help parents learn to deal with these behaviors and provide them some insight and guidance that will ease this transition for the child and parent?

You work in the pediatrician’s office.

Assessments and education are the focus of your work.

Module 7 discussion

Discussions A/B

Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.

Discussion A: Group A will complete initial post, Group B will respond to the post.

Bobby was hospitalized 6 days ago for appendicitis. After an appendectomy following a perforated appendix, he now has an open incision requiring BID dressing changes and contact isolation due to a hospital acquired MRSA infection. It is anticipated that he will be here for 5-10 more days for long term antibiotic therapy and wound care. He is 13 years old. He has been afebrile for 24 hours. The wound is open with minimal serous drainage.

He is withdrawn and relates “just tired” when you inquire about how he is this morning. Last week he shared his interest in school. Gets A’s in math, computer science and was supposed to be competing in the school science fair this week.

What do you know about the adolescent and the appropriate developmental level?

Keeping his diagnosis in mind, what about visitation?

Is socialization a need?

What other questions should you ask?

Group B Response

It is 10 pm and you make assessment rounds and find Bobby crying. You ask him what his pain level is. What pain scale are you using?

He says he misses his family and wonders when they are going to come to get him and take him home? He relates his dad told him to be brave but he couldn’t stay with him since

Bobby was going to be in the hospital for such a long time and his dad had to work. He has 2 other brothers older than him. You also notice that his tray is untouched.

In addition to Erikson’s theory of development, children have fear of loss. What is Bobby’s fear?

(do not forget the interdisciplinary team members)

Video: Pre-operative teaching

Discussion B: Group B will complete the initial post, Group A will respond to the post.

Tina is 5 years old, lives with her mother and grandmother. Mother works 2 jobs to help support her mother and her daughter. Tina is well cared for but is now admitted for a cardiac catheterization due to the Ventricular Septal Defect (VSD) that was noted at birth.

Tina has an extensive history of respiratory infections and a nursing diagnosis of ‘activity intolerance’. Her mother relates that she does not allow her to play organized or competitive games due to her health. Tina smiles broadly when you come in the room to begin the pre-operative checklist. She starts to ask you a question when her grandmother tells her she must stay in the bed. “The nurse knows what she is doing and you will just be in the way.” Tina continues to smile at you but moves back to the bed.

You have identified some unique family dynamics, please relate.

What is the Erikson developmental level that Tina should exhibit? And where do you think she is?

How can you assist in the developmental growth?

What education can you give to Tina and her grandmother pre operatively?

What will she expect post operatively?

Assignment: Traumatic Vaginal Birth