Clinical Care Pocket (Pediatric): Reflux Nephropathy

In My clinical rotation. my patient is a toddler she is 21 month old. She is admitted for Reflux Nephropathy and reflux vesicouriteral. She had a surgery 3 days ago for cystoscopy, right and left reimplant, posible stent. She is on general aneshesia. Her procedural history she had reinplanted ereter (bilateral).. First question: i need to be trended is the vital sign, the previous BP is 83/43 is low for her and the current BP is 82/41 is still low for her. Also the temperature, the previous is 37.7 degree Celsius is high for her and the current temperature is 37.1 is normal. Number 2 question. Before the end of my shift, the doctor proscribe a new order modify the morphine order into lower dosage from 1 mg to 0.5 mg IV push. The patient is current taking medications such as ceFAZolin, Ketorolac, and morphine. Put the answer to small paragraph each, 7 question 7 small paragraph.

1. What clinical assessment data did you just collect that is RELEVANT today that needs to be TRENDED because it is clinically significant to detect a change in status? (state specific VS and assessment data you collected and WHY relevant/ important) (Labs will be discussed in section 18)

2. Does your nursing priority or plan of care need to be modified in any way after assessing your patient?

3. After reviewing the primary physician's note for today, what is the RATIONALE for any new orders or changes made today? If there are no new orders, what physician orders might you anticipate for the day?

4. What educational and discharge priorities have you identified and how will you address them this shift? Explain what teaching you provided and evaluate your patient's understanding of the teaching you provided.

5. What is the patient/family likely experiencing/feeling right now in this situation? Identify ways to assist the families in coping with the loss of a “perfect” child as they work through the process of adjusting to a child with a chronic illness/disability.

6. What can you do to engage yourself with this patient's experience, and show that they matter to you as a person?

7. Examine and discuss cultural/spiritual preferences and considerations for you patient.