1.

Monitor signs and intensity so as to seek early intervention

 Expected Outcome for Powerlessness
The patient will:
1. Begin to identify ways to achieve control over personal situation
2. Begin to express sense of personal control
3. Make decisions regarding care as possible
 Expected Outcome for Risk for Delayed Growth and Development
The patient will:
1. Receive environmental stimulation
2. Express interest in people and activities around him or her
3. Attend school setting that is as free of restrictions as possible.

LEARNING OBJECTIVE 6. Using the nursing process, plan nursing care that includes the six
competencies of Quality & Safety Education for Nurses (QSEN): Patient-Centered Care,
Teamwork & Collaboration, Evidence-Based Practice (EBP), Quality Improvement (QI), Safety,
and Informatics.

Competencies of Quality & Safety Education for Nurses with checkpoint questions:

• PATIENT-CENTERED CARE - focuses on including patients in all decisions and

providing compassionate care that's based on a patient's needs and values.
- Question: Dexter’s mother asks the nurse about the potential risks and benefits of
immunotherapy, stating that some websites she has consulted convey dire warnings
against the practice. What potential benefit could the nurse describe to Dexter’s mother to
alleviate her anxiety?
a. Dexter will recover more quickly from infections.
b. Dexter will be protected against secondary infections.
c. Dexter’s level of helpful immunoglobulins will be increased.
d. The overall health of Dexter’s immune system will be increased.
- Ans. C. The nurse should teach that hypo sensitization increases the number of IgG
immunoglobulins, which then block the action of IgE immunoglobulins that are involved
in an allergic response. Immunotherapy does not improve the broader function of the
immune system or protect against infection.

• TEAMWORK AND COLLABORATION - relates to interdisciplinary collaboration

and shared decision making among the healthcare team.
- Question: Any child can have an anaphylactic reaction to a food, drug, or insect sting,
and Dexter is at risk because of his allergy history. If Dexter, who weighs 48 kg, had an
anaphylactic reaction after a bee sting, what is the correct dose of epinephrine for a
school nurse or staff member to give him?
a. 0.03 mg
b. 0.15 mg
c. 0.3 mg
d. 3.0 mg