X.

PEDIATRIC MANAGEMENT

Ideal Pediatric Nursing Management

In receiving patient, offer and perform morning care and bedside care. Provide
an environment that is suitable for the patient. Take Patient XYZ's vital signs every 4
hours. In taking vital signs the nurse should wash her hands, gather the equipment,
identify the patient, explain the procedure, and assist the patient in a comfortable
position. Thorough assessment should be performed. Monitor patient XYZ's urine and
stool, intake and output. Administer medications ordered by the physician. When
administering medications, check and select cards for the mediation to be given at the
time they are to be given. Should contain patient name, name of the drug, drug usage,
time and route of administration, and signature of the person writing the order. Regulate
patient's intravenous fluid flow and monitor patient's oxygen inhalation, and O2
saturation. The nurse should also make sure that she is using face mask to protect
herself since the patient has pneumonia and clean gloves while in contact with the
patient. The patient is in a protected environment thats why asepsis is very important
since the immune system of the patient is weak. Build rapport with the patient and
patient's family through therapeutic communication and nursing care to address their
needs and concerns. Provide and emphasize health teachings to the patient. Patient
should be asked about their emotional well-being, what family and social support they
have and their usual coping strategies for dealing with day-to-day matters

Ideal Medical Management

Administer medications as ordered by the physician. Infusion pump is important
for the medication to limit visitors and to have an asepsis environment. Chemotherapy is
also observed to cover the needs of the patient. Complete Blood Count should also be
monitored in order to know the progress of the blood components of the patient.

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Actual Pediatric Nursing management

Upon the duty morning care were done to Patient XYZ such as taking a bath,
combing the hair and brushing the teeth. Bedside care was also given by changing the
linens into a new one then tacking it in properly and neatly. Arranging of things on the
bedside table and in the bed was also done in part of bedside care. Assessment was
also performed in the first day of duty including the over-all condition of the patient.
Patient XYZs vital signs were taken every 2 hours, at 6 oclock, 10 oclock, 12 oclock in
the morning during the shift which were then plotted in the TPR sheet. Stool and urine
were also monitored and recorded from 8 hours of duty. Medications were given by the
nurse on duty as ordered by the physician. Intravenous fluid (PNSS 1L) was monitored
and regulated in 20gtt/min. The diet implemented was DAT or Diet as tolerated as
ordered by the physician. The student nurse established rapport with the patient and
watcher through therapeutic communication and nursing care. Health teachings were
given such as increase fluid intake, proper nutrition needed by the patient and adequate
rest and sleep. Patient XYZ was also educated about proper positioning for its benefits
and importance. Patient XYZ was encouraged to discuss his feelings and fears related
to his condition with the watchers participation, and concerns about complications was
answered. Student nurse provided encouragement and support for the restoration of
health from the disease. Student nurse have attended to his concerns, needs and
problems like fear, anxiety and emotional distress that the patient is feeling or may feel.

Actual Medical Management

Patient XYZ has limited visitors, at November 30, 2015 CBC was taken in the
morning as ordered by the physician. In the afternoon patient was given Nystatin syrup
1mL swish and swallow TID for pain in the patients lips. On December 1, 2015 in the
morning CBC was taken IVF follow-up (PNSS 1L) regulated at 20gtt/min, and also in the
afternoon CBC was again taken for monitoring of the changes in the patients condition.
Certain medications were ordered which includes Zinc Sulphate syrup, 5mL, PO to
prevent low levels of zinc. On December 2, 2015 IVF follow-up D50.3NACL regulated at
15gtt/min. Hidrasec (Racecadotril), 10mg sachet + 10mL water, TID, PO as relief for
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acute diarrhea, Paracetamol 250mg/5mL, 4mL, q4h, PRN, T>37.8C, O2 inhaln @ 2

lpm via IVC. To secure and transfer 1 unit PRBC of patients blood type properly
received and cross match to be seen for 4 hours. On December 4, 2015, the attending
physician ordered for a protected environment.

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