Aspen University Leukemia Pediatric Case Study Template Answer all questions in the Ariana Case Study. Ensure that all questions are correctly answered and

Aspen University Leukemia Pediatric Case Study Template Answer all questions in the Ariana Case Study. Ensure that all questions are correctly answered and the provided tables are filled. Ensure that all questions are accurate and follow the provided rubricThe attached materials and the “Maternal-Newborn Nursing: The Critical Components of Nursing Care” should be of assistance in answering it Pediatric Case Study
Name_____________________________
Purpose: The purpose of this assignment is to help you to achieve the following Course Student Learning
Outcomes. You will review Situation Awareness and Antibiotic Stewardship principles and put them into
action in the service of a pediatric patient.
Program SLOs
1 PatientCentered Care
Course SLOs
1.1
Uses components of the nursing process appropriate to the health care
needs of the pediatric patient and family.
1.4*
Provides holistic care that addresses the needs of diverse pediatric
populations.
2 Professionalism 2.2
Demonstrates an awareness of the professional standards of practice that
apply to the practice of pediatric nursing.
3 Leadership
3.2
Demonstrates critical thinking and problem-solving process when caring for
a pediatric patient.
7 Teamwork &
7.6*
Functions competently within own scope of practice as a student member of
Collaboration
the healthcare team.
8 Safety
8.1
Identifies factors involved in prevention of infection, injury, and errors in the
pediatric setting.
10 Evidence-based 10.1
Uses Evidence-Based Practice (EBP) as it pertains to patient care.
Practice
* Clinical Student Learning Outcomes
Situation: Ten-year-old Ariana Merchante’s parents bring her to the Emergency Department (ED). They
report to the triage nurse that for the last 24 hours Ariana has had a sore throat and a fever. The parents
appear to be anxious and very concerned about their daughter. Because Ariana’s attempts at movement were
weak and uncoordinated, her father used a hospital wheelchair to bring her into the ED from the car.
1. What are your first thoughts about Ariana’s situation?
A. SITUATION AWARENESS:
PERCEPTION1:
The Triage Nurse collects more information from the parents. Ariana’s fever has been as high as 100.4˚F
(38˚C). She has taken acetaminophen 325 mg by mouth every 6 hours since the onset of her fever, but it has
not had any effect.
Ariana was diagnosed with Acute Lymphoblastic Leukemia (ALL) three months ago, and she has been receiving
chemotherapy. Her last treatment in the Remission Induction Phase was completed ten days ago. She has a
Central Venous Access Device (CVAD) in place for the delivery of her chemotherapy. Her chemotherapy drugs
include Cyclophosphamide, Methotrexate, and Cytarabine.
Ariana is 51.5 inches tall and weighs 52 pounds (23.6 kg). BMI 13.8 is at 3rd percentile for age.
She has no known allergies to medications.
Vital signs are: TPR: 101.5˚F orally (38.6˚C)/112/24 BP 102/54.
Lungs clear bilaterally, nonlabored respiratory effort. Oxygen saturation 96% on room air.
Skin pale, cool. Capillary refill is 4 seconds on chest.
Pedal pulses 2+ and equal.
Three 1-to 2-centimeter inflamed lesions in the mouth and oropharynx.
CVAD site: no redness, swelling, exudate or lesions.
The nurse notes these behaviors:
Lethargic, slumped position in wheelchair.
“Can’t walk. No strength.”
Confused and drowsy. Parents answer questions.
Voided 80 mL on arrival. Last void was 4 hours ago, per mother.
COMPREHENSION1:
The Triage Nurse has just completed training on the ED’s new Sepsis Protocol, and quickly identifies aspects of
Ariana’s assessment that strongly suggest the presence of sepsis.
2. On the Sepsis Algorithm, highlight any of Ariana’s assessment data that you find there.
3. What elements of Ariana’s history indicate high risk for sepsis?
History
Significance to Risk for Sepsis
4. List here the assessment data that you have circled on the Sepsis Algorithm. From the Algorithm, state why
these assessments are significant for the presence of sepsis. I’ve done the first one for you.
Assessment Data
Oral Temp 38.6˚ C
Significance for Presence of Sepsis
A temperature of 38.3˚C is a criteria for Systemic Inflammation
Syndrome (SIRS) – precursor to Sepsis.
PROJECTION1:
5. What is the likely outcome of this situation if appropriate action is not taken?
DECISION/ACTION1:
The Triage Nurse fast-tracks Ariana’s admission to the ED. In collaboration with Ariana’s primary nurse and
the ED physician, the decision is quickly made to implement the Pediatric Sepsis Protocol.
6. Finish the table with the two remaining rescue interventions from the Initial Stabilization Phase of the PALS
Septic Shock Protocol. State the goals of care for these elements from the PALS Protocol.
Intervention
Monitor and support Airway,
Breathing, and Circulation.
Monitor heart rate, blood
pressure, and pulse oximetry.
Establish vascular access.
Goal
Assure adequate oxygenation and circulation. Monitor patient’s response
to therapy and quickly identify deterioration of her condition.
Monitor patient’s response to therapy and quickly identify deterioration of
her condition
Allow drawing of blood cultures and other labs. – ideally before starting
rescue interventions, but do not delay these interventions.
PERCEPTION2/COMPREHENSION2:
7. Lab results are quickly available. Analyze the results in the usual way.
Test
CBC
WBCs
Neutrophils
Bands
ANC*
Hemoglobin
Hematocrit
Platelets
Electrolytes
Sodium
Potassium
Renal Function
BUN
Creatinine
ABGs
pH
PaCO2
HCO3
Other
Glucose
ALT
PT
INR
Lactate
Urinalysis
Specific
Normal
Range
Result
4.5-11/mm3
40-60%
3-5%
> 1500
Critical
Purchase answer to see full
attachment