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Requirement
Jay is a four-month old boy admitted to the paediatric unit via emergency with vomiting, decreased feeds, no bowel actions and intermittent spasmodic abdominal pains. During the spasmodic pain episodes, Jay draws his legs up and has a high pitched cry. After a diagnostic ultrasound, intussusception was thought to be the cause of the presenting symptoms and Jay was admitted to the ward. His treatment plan included observation, electrolyte monitoring and IV therapy until a contrast enema could be implemented to correct the intussusception. The approximate length of stay for Jay will be 2 days, during which time, Jay’s mother is informed that the rotavirus vaccine that Jay had at 4 months has increased the incidence of this condition amongst infants. Jay’s mother is now having serious doubts regarding future vaccines for Jay.
Address the following two (2) points on the basis of the above case study:
1. Describe the pathophysiology of the presenting complaint in the case study.
2. Evaluation of the nurse’s role to deliver developmentally appropriate nursing care in relation to your
chosen case study. Address:
• growth and developmental theories,
• family centred care and,
• the effects of hospitalisation of the child, on the child and family.
Solution
Introduction
The role of nurses is crucial to treat the children as often they neither express nor understand their problems properly. In addition, each child has different immunity and tolerance level and responds differently to the treatments. Therefore, every child need special attention while undergoing a treatment to ensure that her problems are understood clearly and the therapies are bringing positive outcomes only (Morton et al.2017). The nurses play an important role in this case as they help the other professionals as well as parents of the patients are having clear idea on the issues faced by the child and responding accordingly. The current essay deals with analysis on the health issues faced by a 4 month old infant, Jay and his treatment. Issues faced by Jay have occurred after he has gone through a rotavirus vaccine and the incident has made his mother doubtful about the future vaccines also. The current essay also includes discussion on the role of nurse to mitigate the misconception from the mind of Jay’s mother.
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The pathophysiology
Analysis on the case study indicates that Jay, the 4 month old boy is having a number of issues together. His feeding has been reduced which indicates that there is a loss in his appetite. In addition, he has been reported with vomiting and no bowel action. Along with it, Jay is having abdominal pain and during the period of pain he is observed to take the legs upward and crying at high pitch. The leg movement and the crying indicate that intensity of the pain may be quite high. Jay has been provided with the Rotavirus vaccine at his four months and according to the nurse such problems have been increased among the children.
The Rotavirus vaccination often causes several side-effects among the children. The common side effects of Rotavirus vaccination include the symptoms like the allergic symptoms and the issues caused by intestinal blockade such as vomiting, abdominal pain or reduced appetite. In case of allergic symptoms, the child may have problems such as fever , severe diarrhea, stomach pain , abnormal stool etc (Hockenberry et al.2016). However, occurrence of such issues may not happen in every child who is Rotavirus vaccinated. Only the child with weak immunity power is more vulnerable to the side effects.
Analysis on the Jay’s problems indicates that the physical issues among the baby boy have been occurred due to the side effects of the Rotavirus vaccine. It may happen that the immunity power of the baby was not strong enough to endure effects of the vaccine. Therefore, upon receiving the vaccination, his body started showing the side effects. Discussion on the diagnosis indicates that the healthcare professionals have found the side-effects are temporary in nature and it can take two days to improve condition of the child. The professionals suggested that the child just needs to be observed so that any degradation in his condition can be identified immediately. In addition , the professionals also suggested to use IV therapy and monitor the ORS in order to improve the bowel activities and control the vomiting.
Evaluating role of the nurse
In case of child care , the role of nurse is not limited to diagnosing the patient. In addition , the nurse also needs to ensure the overall health improvement of the child and guiding the parents so that they can take proper care of the patient later (McInerny et al.2016). In the current case also, the nurse has to ensure overall health improvement of the baby patient by diagnosing him and preventing creation of any misconception of his mother. In this essay, the role of nurse is evaluated on basis of her contribution in growth and development of the child.
Growth and developmental theories:
The discussion on the case study indicates that mother of the child is extensively concerned about his health issues especially which he has developed after receiving the Rotavirus vaccine. As the child is having severe side effect after the vaccination, his mother has become doubtful about effectiveness of the vaccine. She is giving more importance on preventing such issue in future. In other words, she is focusing more to get rid of the side-effect caused by Rotavirus vaccine instead of protecting her child from the Rotavirus itself. Clearly, this approach of Jay’s mother can interrupt his regular vaccination activities and so, can cause serious damage to his health in future. In this case, the nurse has to suggest the mother right ways to take care of her son and reduce the concern about side effects of Rotavirus vaccination. To achieve this, the nurse can take help of the Prevention model and the Ecological Systems Theory.
The Prevention model indicates that the prevention of health issues and child death can be ensured by implementing a three level prevention model (Hill et al.2016). The primary prevention deals with preventing the health problems and death of child by promoting awareness among the children and their families. In this case, the nurse needs to make Jay’s mother aware of the adverse effects of Rotavirus attack. Mother of Jay needs to understand that Rotavirus attack can cause more severe health damages than the side-effects of rotavirus vaccination. Taking such steps is expected to mitigate the misconceptions of Jay’s mother and such steps will also ensure that the mother is not showing any reluctance to continue the vaccination works in future. Thus, the role of nurse is important in this case to improve the present and future health of the child.
Every child does not suffer from the side-effects after receiving Rotavirus vaccine. Lack of immunity in the child enhances the risks of such issues. However, Jay is one of the few children who show any allergenic or intestinal blockade related issues after getting vaccinated. Although some side effects do not affect every child, such problems are growing (Hessels et al.2017). So, it can be stated that the health issues faced by Jay not abnormal, rather reflects his biological nature. To make the unique nature of Jay clear, the nurse can take help of the Ecological Systems Theory. As per the Ecological Systems Theory, some risk factors for well being of the child are biological in nature and so, such risk factors need to be managed according to the need of the child. In case of Jay also, the child is facing issues due to his biological nature. It indicates that his mother should be prepared to manage the health issues instead of being doubtful about effectiveness of the vaccination works.
Family centered care:
The well-being of pediatric patients can be maximized by adopting the family centered care approach (Shilkofski & Hunt, 2015). In this case, well-being of the child can be ensured when the nurse meets need of both the patient and the family. The family centered care for the pediatric patients depends on acknowledging the diversity among families. Each family is different and so, the nurses require understanding the uniqueness and influencing factors for the families in order to deliver the right healthcare services.
To foster the family centered care, the nurses need to provide the families with right information (Stayer & Lockhart, 2016; Gardner et al.2015). It will ensure that the child is getting proper care at home. Providing the unbiased information to family of the patient is another crucial part of the family centered care. In this case also, the nurse needs to inform Jay’s mother about the health issues of the child and take the preventive actions to ensure the optimum well-being of the child.
Effects of hospitalization of the child:
Sharing information is important for bringing out the positive outcome from the pediatric care (Michelson et al.2017; Hajibabaee et al.2016).As an effect of hospitalization, the child needs to stay away from the home for two days. During these two days, the child needs to go through a number of treatments. Mother of Jay needs to stay aware of the health condition of the child and the treatment process clearly. Sharing the information can help the mother to understand the acts behind illness of the kid. It can also help the mother to understand the preventive actions in future.
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The above discussion on health status of the 4 month old child indicates that the child has developed several issues as side effect of the vaccination. Although the health care professionals are considering that such issues are increasing among children, mother of the child, being concerned of the health issues, has become doubtful about benefit of the vaccination. Here, role of the nurse has become significantly important to mitigate misconception of the child’s mother and also for ensuring the current and future well-being of the child. The nurse can explain the Ecological Systems Theory and the Prevention Model to the patient’ mother and so can reduce the misconception among her. In case of child care, the participation of family is important for overall health improvement of the patient. In this case also, Jay, being a little child, needs special attention from his parents. In addition, the parents also need to have proper awareness on the health issues of the kid to ensure his overall improvement. As part of the treatment, the child needs to stay in hospital for two days. During his stay in the hospital also, proper care and support from the family is needed to ensure the well-being of the child.
Reference
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Gardner, S. L., Carter, B. S., Hines, M. E., & Hernandez, J. A. (Eds.). (2015). Merenstein & Gardner's handbook of neonatal intensive care. Elsevier Health Sciences.
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Hajibabaee, F., Najafvandzadeh, M., & Haghighizadeh, M. H. (2016). Job Satisfaction and its Effective Factors among Nurses Working in Pediatric Wards. Iran Journal of Nursing, 29(101), 57-66.
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Hessels, A. J., Darby, S. W., Simpser, E., Saiman, L., & Larson, E. L. (2017). National testing of the Nursing-Kids Intensity of Care Survey for pediatric long-term care. Journal of Pediatric Nursing: Nursing Care of Children and Families, 37, 86-90.
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Hill, C., Knafl, K. A., & Santacroce, S. J. (2017). Family-Centered Care From the Perspective of Parents of Children Cared for in a Pediatric Intensive Care Unit: An Integrative Review. Journal of pediatric nursing.
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Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2016). Wong's Essentials of Pediatric Nursing-E-Book. Elsevier Health Sciences.
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McInerny, T. K., Adam, H. M., Campbell, D. E., Foy, J. M., & Kamat, D. M. (2016). AAP textbook of pediatric care. American Academy of Pediatrics.
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Michelson, K., Clayman, M. L., Ryan, C., Emanuel, L., & Frader, J. (2017). Communication during pediatric intensive care unit family conferences: a pilot study of content, communication, and parent perceptions. Health communication, 32(10), 1225-1232.
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Morton, P. G., Fontaine, D., Hudak, C. M., & Gallo, B. M. (2017). Critical care nursing: a holistic approach (p. 1056). Lippincott Williams & Wilkins.
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Shilkofski, N., & Hunt, E. A. (2015). Identification of barriers to pediatric care in limited-resource settings: A simulation study. Pediatrics, peds-2015.
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Stayer, D., & Lockhart, J. S. (2016). Living with dying in the pediatric intensive care unit: a nursing perspective. American Journal of Critical Care, 25(4), 350-356.
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