Pediatric Nursing And The Respective Care †MyAssignmenthelp.com

Question: Discuss about the Pediatric Nursing And The Respective Care. Answer: Brief description of the clinical condition of the patient focussing on pathophysiology The current assignment focuses on the areas ofpediatric nursing and the respective care and support services rendered in this area. In this respect, John was an 8 months old child who was admitted to the hospital on account of dehydration. On preliminary investigation it was found that the child had inborn diabetes inspidus, which had become more severe in the long run. The boy was rushed to the hospital by his parents on account of certain symptoms such as the presence of a slight fever from a few days. Additionally, the child had depicted excessive need to urinate along with less energy and a constant lethargy. Diabetes Inspidus (DI) is a rare disease with a presence of 1 in 25 people and has debilitating effects (Bultas et al. 2014). It is also known as water diabetes and results in recurrent loss of fluid from the body. The disease is supposed to be caused by either less or an absolute lack of anti-diuretic hormone (ADH), which leads to an inability in concentrating the urine. As commented by de Cassia Sparapani et al. (2015), the blood serum is often raised to a concentration greater than 295milliOsmol/kg which can result in a constant feeling of dizziness and lethargy. The treatment of the disorder is mainly aimed at reducing the loss of water from the body and increasing the activity of the anti-dieuretic hormone (ADH) (Hanta et al. 2015). In most of the cases desmopressin, which is an analog of ADH is administered in the patients. However, for understanding the pathophysiological condition of the patient there is a need to undertake assessment tests and measures. The primary tests should begin with the assessment of the hydration status of the patient. The blood plasma concentration of the patient would help in confirming or ruling out the presence of hypernatria in the patient (excessive presence of sodium in the blood). Additionally, the patient history should also be considered for the presence of recurrent urinary tract infections. The loss of water and excessive salt deposition promote further growth of the opportunistic pathogens such as B.coli, which cause urinary tract infections (UTI) in children and adult. The diabetes inspidus could be further divided into three main types such as central, nephrogenic and primary polydypsia. It is necessary that the clinical conditions associated with each is understood first in order to design an effective treatment and care plan. The two main types of Di are mainly central and nephreogenic. In central DI, the vasopressin synthesis is impaired. In nephrrogenic response the renal tubule response to vasopressin is also impaired. The child here was seen to be suffering from a central dibetes inspidus. Rationale for the fluid management plan It is necessary to design an effective fluid management plan for the effective care of the patient. In this respect, the age of the child is a governing factor in deciding the dosage of the medicine. The symptomatic expression of the disease is different in the infants compared to the elder children (Al Nofal and Lteif 2015). In this respect, John depicted recurrent episodes of fever, vomiting along with excessive crying and irritability. Since, John is an infant who is less than two years old; therefore before the administration of an alternate medication his condition should be discussed with an endocrinologist. In this respect, desmopressin administration is one of the most plausible methods of controlling the fluid balance in the children. It acts on the distal tubules and the collecting ducts of the kidney by increasing water absorptions. It is provided as an intranasal solution to the children by dissolving 100 micrograms in one ml. However, for the treatment of the condition o f children below two years of age dose is usually 2-5 micrograms per ml. The hydration assessment depicted that John had hypernatria and therefore he was put under hypo-osmolar intravenous fluid. This would help in restoring the concentration of water in the blood serum of the patient a restore the normal well being in the patient by removing the feeling of dizziness. Nursing management strategies important to patient care It is important to design effective nursing management strategies for the utmost care of the patient. As commented by Hill et al. ( 2017), the post administration follow up is crucial for maintaining the health of the patient in the long run. However, lack of time and knowledge often deter the parents from taking their child to the nearby hospitals. Additionally, the idea that administration of home-made electrolyte solution is sufficient for management of the fluid imbalance in the child is wrong. This is because only after a proper blood examination the condition of hypernatria can be confirmed within the child. Depending upon the osmolarity of the blood the child should be put under further electrolyte administration. As commented by Jakubik et al. (2017), the lack of expert supervision can further deteriorate the condition of the patient. Thenursing priority which should be undertaken for managing the condition of John over here is maintaining a healthy electrolyte balance. Therefore, thenursing professional attending to the care concern of John need to develop a plan of action for maintaining the electrolyte balance in accordance with expert opinions of the nephrologists and endocrinologist. The administration of sterile water with dextrose would be undertaken for maintaining the electrolyte balance in the child. The serum sodium of the child needs to be monitored against 24 hours urinary volume specific gravity. A clear instruction should be given to the parents to avoid the administration of foods and liquids to the child that promotes dieresis. The parents should be given clear indications regarding the management of the medications of the child. In this respect, a blood test will be conducted by the healthcare professionals for accessing the condition of hypernatria in John on a quarterly basis. Additionally, pos t-hospitalization follow up for the patient very 6-12 months can help in managing the long term condition and health of the patient. The nursing professionals could personally follow up after the clinical condition of the patient by paying home visits to the patients after discharge from the hospital. Additionally, record keeping can also help in keeping a track of the clinical conditions of the patients (Djermane et al. 2016). The data could be referred to in times of need for designing of an effective support care plan for the patient. Additionally, maintaining an electronic health based data can also help in getting helpful referrals for the condition management of the child. References Al Nofal, A. and Lteif, A., 2015. Thiazide diuretics in the management of young children with central diabetes insipidus.The Journal of pediatrics,167(3), pp.658-661. Bultas, M.W., Hassler, M., Ercole, P.M. and Rea, G., 2014. Effectiveness of high-fidelity simulation for pediatric staff nurse education. Pediatric Nursing,40(1), p.27. de Cssia Sparapani, V., Jacob, E. and Nascimento, L.C., 2015. What is it like to be a child with type 1 diabetes mellitus?.Pediatric nursing,41(1), p.17. Djermane, A., Elmaleh, M., Simon, D., Poidvin, A., Carel, J.C. and Lger, J., 2016. Central diabetes insipidus in infancy with or without hypothalamic adipsic hypernatremia syndrome: early identification and outcome.The Journal of Clinical Endocrinology Metabolism,101(2), pp.635-643. Djermane, A., Elmaleh, M., Simon, D., Poidvin, A., Carel, J.C. and Lger, J., 2016. Central diabetes insipidus in infancy with or without hypothalamic adipsic hypernatremia syndrome: early identification and outcome.The Journal of Clinical Endocrinology Metabolism,101(2), pp.635-643. Hanta, D., Trer, B., Temiz, F., K?l?da?, H., Gke, M. and Erdo?an, ., 2015. Idiopathic central diabetes insipidus presenting in a very low birth weight infant successfully managed with lyophilized sublingual desmopressin.J Pediatr,57, pp.90-93. Hill, C., Knafl, K.A. and 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, pp. 55-85. Jakubik, L.D., Eliades, A.B. and Weese, M.M., 2016. Part 1: An overview of mentoring practices and mentoring benefits.Pediatric nursing,42(1), p.37.