Clinical Reasoning Questions

Collaboration
Accidents to children are a significant health issue, being a major cause of
preventable death, serious injury and long-term disability. A couple who has a 6-month-
old son went to a restaurant to have their lunch. The infant was placed on the table as
he could sit without assistance. The couple were busy looking at the menu and ordering
their food to the waiter. The infant was reaching for a toy in the bag which was placed
beside the mother’s seat. The infant was outbalanced and fell from the table. The infant
cried aloud and the couple were so worried, they rushed their son to the hospital. What
is your best action regarding this?

I know that we want what’s best for our patients, so I would like to share a
concern. Is that ok with you? I am concerned about the 6-month-old infant
C
patient who came in due to falling straight from the table while reaching for a
toy and the infant cried so loud and won’t stop crying.

I am uncomfortable that his condition might be worse since the body of a 6-

U month-old is still fragile and not yet fit or prepared from any physical trauma,
especially from falling.

Still, I am uncomfortable from what happened to the patient because it might

also affect the emotional state of the parents for not giving sufficient attention
S to their child. I am asking you this to evaluate the situation more closely so
that the condition of the patient would turn back to normal and there will be no
future complications. This is to ensure a safety issue.
Ethico-Moral-Legal
A student nurse was assigned to an 8-month-old patient in the pediatric ward.
She was assisting the nurse in giving an oral medication to the patient but the patient
was crying and was difficult to handle. The patient threw up the medication and stained
the nurse’s uniform. The nurse got mad and scolded the patient and said “BAD BABY!”,
she also pinched the baby’s thighs.

The nursing action in the scenario is to help clean up the

mess and the infant for the medication that he threw up as
well as the nurse about her stained uniform. After cleaning
up, the next nursing action is to prepare a new set of oral
medication for the patient. Then calm the patient so that he
Nursing Action will not be cranky and cry again while assisting the nurse to
administer the oral medication to the patient. And make sure
that the patient is still and in the proper position so that it will
not throw up again. Right after administering the medication
without any problems now, as part of the medical team and
for collaboration, the student nurse will tell the medicating
nurse that her action is way too overboard for a small infant.

Ethical principle
upheld
There is no ethical principle that is upheld in the scenario
because the nurse violated the principle of beneficence,
nonmaleficence, and fidelity. According to the code of ethics,
beneficence is doing good and the right thing for the patients.
Nonmaleficence is doing no harm, whether if it is intentional
or unintentional. Fidelity is being faithful and true to
responsibility by providing high-quality and safe care. The
nurse who gave the medication to the infant got mad, shouted
at the patient, and even pinch the thigh. But the only reason
for the nurse to do that kind of bad behavior is because the
patient threw up, and it got the uniform stained.