Roslyn is complaining of severe pain. She is 6 years old and has been placed in public school for the first time. Now she is complaining of her legs hurting. She is so excited about being in school finally, but her parents report that she is not participating in play time, seems weaker, and is pale. She is diagnosed with sickle cell anemia, parents undergo genetic testing as well as all her siblings and it is found that she is the only child with the disease. 

 Once the crisis is over what education will you provide to Roslyn and her parents?
Discharge teaching should include?
Is it appropriate that Roslyn stay in school? What about activities? 

300 words

 

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What challenges do current reimbursement models pose for nurse leaders in their obligations to promote quality, cost effective patient care. What strategies can effective nurse leaders use to overcome those challenges? Discuss any specific examples you may have witnessed a leader implement in the practice environment in your response. 250 words

 

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Missy is 3 years old. She enjoys being with mom and grandma in the kitchen. She pulls a chair close to the stove, climbs on the chair and looks inside the pot of boiling water. The steam is hot on her face, she steps back and as she falls off the chair, the boiling water is pulled down on her. Missy is rushed to the emergency department. Grandma has put some butter on her fingers, but her face was not treated.

In the ED, the nurse discovers that her hands, face, chest and arms are burned. The Dr. believes it to be a partial thickness burn, but notes her hands are blistered and very edematous.

1.  After several days the doctor begins discussing grafting of the hands and face. Can you educate the parents on the care the child will need. What is the home care situation for this child? Please also discuss long term issues, physical, emotional, how will she relate to peers?  300 words

 

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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?

300 words

 

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