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BRINGING IT ALL TOGETHER: A CASE STUDY (at end of chapter in text)
Bradley is 5-year-old with a history of moderate asthma who was started on oral steroids yesterday after visiting his pediatrician for an asthma exacerbation. Additionally, he has been receiving aerosol treatments every 4 hours since yesterday. He received his last levalbuterol nebulizer treatment 3 hours ago. His mother has brought him back to the office because she is concerned that he does not seem to be getting any better.
Continuation
Considering the following questions will help develop your critical thinking and assessment skills. Your instructor has access to suggested answers to these questions.
1.    Bradley is pale in color, is holding his chest and is having difficulty breathing. The pulse oximeter reads 94%. Upon auscultation, no wheezes are noted. Should Bradley be placed on oxygen?
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2.    What other information should the nurse have noted when auscultating Bradley’s chest?
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3.    After being placed on oxygen, the nurse listens to Bradley’s breath sounds again. She notes there is no wheezing, but breath sounds are diminished throughout. After notifying the nurse practitioner, the nurse administers an albuterol nebulizer treatment and continues to provide supplemental oxygen to Bradley.
Instructions: Please read carefully Chapter 14: before answer the following case study: Nursing Care of the Child with an Alteration in Comfort-Pain Assessment and Management.
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1. Erek and Emily are the parents of 4-week-old Tara, who has just returned from surgery to correct pyloric stenosis. The nurse is obtaining Tara’s vital signs including her level of pain. Tara’s parents are closely monitoring the nurse’s actions and ask her how they will know that Tara is not in any pain. (Learning Objectives 1, 2, 3, and 4)
a. What are the different classifications of pain that the nurse should be familiar with?
b. What are the factors that influence pain in children?
c. What are some developmental considerations the nurse can utilize to properly assess pain in an infant?
2. Alicia and Mandy are accompanying their 3-year-old daughter, Esther, during her stay at the local children’s hospital for a displaced fracture of the left femur as the result of a pedestrian versus motor vehicle accident. Esther is in traction until such time that she can receive surgery to place orthopedic appliances to stabilize the fractured femur. (Learning Objectives 5 and 6)
a. What are some of the pain assessment or rating scales the nurse can utilize with Esther?
b. What are some nonpharmacologic interventions the nurse can utilize to manage pain in Esther?
c. What is the nurse’s role in pharmacologic pain management for Esther?
SCIENCE
HEALTH SCIENCE
NURSING
