NURSING

Nursing

Table of Content

PART A1

Provide a brief overview of the patient's condition and the underlying path-physiology1

Explain the relationship between the patient's condition post-operatively and the signs and symptoms described in the case study2

Outline further relevant assessment data that the nurse would collect to determine the patient's clinical condition, providing a rationale for each area of assessment.4

PART B9

Nursing Priority Problem9

References19

Appendices20

1. Assessment20

2. Diagnosis20

3. Outcome Identification20

4. Planning21

5. Implementation21

6. Evaluation22

Nursing

PART A

Provide a brief overview of the patient's condition and the underlying path-physiology

Belle is a 22 month old girl who has been brought to the emergency department by her mother after a fall. She had been jumping on the bed with her older sibling and her mother was alerted to the fall by a loud scream. Belle has a 4cm scalp laceration lateral to her right eyebrow which has a moderate amount of fresh blood at present. The laceration is adhered with glue and a small dressing is applied. Belle is crying and distressed and calling for her mother during ther procedure. Her mother also reports that Belle vomited and was a bit sleepy following the fall and so the emergency department registrar has decided to admit Belle overnight for neurological observations. Her current modified (paediatric) Glasgow Coma Score is 14.

Scalp lacerations are uncommon when helmets are worn properly. Cuts may occur when an overlying branch penetrates a vent hole in the helmet, or when a the biker's head hits sharp rock just below the helmet. Most scalp lacerations are caused by a blunt hit. The scalp "bursts" when it's pinched between the skull and another object. If the cut is gaping, it usually does better with stitches. A small scalp cut can be managed at home. (Cornwell, 2002, 41)

Explain the relationship between the patient's condition post-operatively and the signs and symptoms described in the case study

Skin staples are ideal for pediatric scalp laceration closure because of their rapidity of placement and economy and ease of use. We report two cases of rotatory staple migration necessitating improvised removal techniques. Clinicians should be alert for ther complication, which may result from a combination of staple design, local anatomic factors, superfical placement, and prolonged delay prior to removal. (Dangman , 2000, 115)

In a busy clinical setting, rapid, safe, and inexpensive methods of wound repair are desirable, particularly for the pediatric patient in whom behavioral considerations pose additional challenges. In animal studies, stapled and sutured wounds have similar mechanical and hertologic characteristics, and contaminated wounds incur lower infection rates with staples. In ED studies, the rapidity of staple placement has been observed in adult and pediatric ~ patients. Equipment costs and personnel time are decreased with the use of staples. Cosmetic results are comparable to those of sutured repairs, with no differences in complication and infection rates. Despite a greater incidence of discomfort on removal, ~ patient satisfaction with staple closure is high, even when anesthesia is omitted. (Douglas, 2000, 45)

The type of complication described in ther report is unique in the published wound repair experience and in the experience ...