In this scenario, the nursing student is presented with the task of developing a discharge plan for 5-year-old Gabriel. The discharge plan should include three goals listed in order of priority, along with nine nursing interventions to meet these goals. Additionally, the nursing student should provide the exact dosage for acetaminophen, ibuprofen, and cefuroxime to Gabriel’s mother and explain the importance of precise dosing.
Goal 1: Manage Fever and Discomfort
Rationale: Managing fever and discomfort is the most immediate and essential goal in Gabriel’s case. By effectively managing his fever, the risk of febrile seizure recurrence can be minimized. Furthermore, ensuring comfort promotes the overall well-being of the child.
Nursing Interventions:
1. Administer acetaminophen every 4-6 hours, as prescribed by the physician, to reduce fever and discomfort.
2. Monitor Gabriel’s temperature every 4 hours to evaluate the effectiveness of the intervention.
3. Encourage Gabriel’s mother to monitor and record his level of discomfort on a pain scale (e.g., visual analog scale) at regular intervals.
Goal 2: Ensure Healing of the Fracture
Rationale: The fracture of the right ulna requires appropriate care to facilitate healing. Proper management of the fracture will contribute to the child’s long-term well-being and prevent complications.
Nursing Interventions:
1. Educate Gabriel’s mother on the proper application and use of the immobilization device (e.g., cast, splint) to ensure stability and alignment for optimal healing.
2. Promote healthy bone healing by encouraging Gabriel to consume a calcium-rich diet and take any prescribed calcium supplements.
3. Teach Gabriel’s mother about signs and symptoms of infection or complications related to the fracture, such as increased pain, swelling, or foul-smelling discharge, and emphasize the importance of immediate medical intervention if these occur.
Goal 3: Prevent Recurrence of Febrile Seizure
Rationale: Preventing the recurrence of febrile seizures is crucial for Gabriel’s safety and well-being. The nursing interventions under this goal aim to equip Gabriel’s mother with the necessary knowledge and skills to manage future seizures effectively.
Nursing Interventions:
1. Provide comprehensive education to Gabriel’s mother regarding seizure precautions and seizure management, including maintaining a safe environment, recognizing seizure prodromal signs, and appropriate response during a seizure.
2. Teach Gabriel’s mother basic life support techniques, including recovery position and CPR, in the event of a prolonged seizure.
3. Instruct Gabriel’s mother about the importance of educating Gabriel’s school or daycare personnel about his condition to ensure a safe and supportive environment.
Dosage of Medications:
Acetaminophen: 10-15 mg/kg/dose every 4-6 hours as needed for fever or discomfort. The exact dosage will depend on Gabriel’s weight, which is 48 lbs. As a nursing student, it is essential to obtain Gabriel’s weight in kilograms to calculate the precise acetaminophen dosage.
Ibuprofen: 5-10 mg/kg/dose every 6-8 hours as needed for fever or discomfort. Like acetaminophen, the exact dosage for ibuprofen will depend on Gabriel’s weight in kilograms.
Cefuroxime: The exact dosage for cefuroxime should be determined by the physician and provided to Gabriel’s mother upon discharge, as it is a prescription medication.
Precise Dosage Importance:
Providing the exact dosage of medications to Gabriel’s mother is crucial for several reasons. First, pediatric doses are weight-dependent, and using an accurate weight measurement ensures adequate dosing. Secondly, precise dosing minimizes the risk of therapeutic failure or overdose, both of which can have significant consequences on Gabriel’s health. Adequate dosing also upholds medication safety standards, promoting optimal outcomes for the child.
In conclusion, the nursing student’s discharge plan for Gabriel should prioritize goals such as managing fever and discomfort, ensuring healing of the fracture, and preventing the recurrence of febrile seizures. By implementing nursing interventions under each goal, the student can promote the child’s well-being and provide the necessary knowledge and skills for Gabriel’s mother to care for him at home. Precise dosage instructions for acetaminophen, ibuprofen, and cefuroxime are crucial to ensure safe and effective medication administration.
