Pediatric Nursing Grand Rounds

NURS 421 Nursing Care of the Pediatric Patient

Purpose of Assignment
The purpose of this assignment is to provide the student an opportunity to integrate
knowledge from the sciences, developmental theory, and physical assessment data to the care of
a pediatric client and family in the acute care setting. The student will utilize critical thinking and
independent judgements in presenting a holistic plan of care in a formal oral presentation.
Student Approach to Assignment
This is a presentation of a pediatric patient I had on a rehab floor in a childrens hospital.
My patient was a 32 month old male with trisomy 21 who was admitted for failure to thrive
related to decreasing weight. In this presentation, the patient is introduced and the medical
diagnosis and hospitalization are discussed, as well as the developmental and assessment data. A
plan of care is presented and nursing diagnoses including interventions and expected outcomes
are explained.
Reason for Inclusion of the Assignment in the Portfolio
This assignment is included in the portfolio because it highlights providing care at a population
and individual level and demonstrates integration of a wide variety of end of program behaviors.
Critical Thinking
Uses nursing and other appropriate theories and models to guide professional practice.
Example: Using Eriksons psychosocial theory and Piagets cognitive development, I
assess this patient to determine his developmental age in order to provide appropriate
care. In doing so, I was able to assess and determine that he did not meet norms. He
should be in autonomy vs. shame and doubt but was still in trust vs. mistrust, and he
is still in sensorimotor instead of sensorimotor/preoperational phase. These findings
affected the type of care I provided.
Nursing Practice
Applies appropriate knowledge of major health problems to guide nursing practice
Example: When working with patient, I knew that I was not able to treat him like a
developmentally normal 32 months old and instead, needed to treat him according to
his developmental age. Using this knowledge, I used age appropriate care by treating
him as a 10 month old because that was where he was developmentally.
Implements traditional nursing care practices as appropriate to provide holistic health
care to diverse populations across the lifespan.
Example: For this patient I would hold and rock him to calm him or swing him to
make him smile and laugh, I carried him around to take him places, would get on his
level when interacting, and sang or would blow on his face in order to calm him
down.

 Demonstrates an awareness of complementary modalities and their usefulness in

promoting health.
Example: Other therapies that were beneficial for this patient included occupational
therapy (to practice things such as feeding), physical therapy (to work on
developmental progression such as walking), speech therapy (to help swallowing),
nutrition (to create a diet that he can maintain), and pet therapy for emotional wellbeing.
Teaching
Uses information technologies and other appropriate methods to enhance ones own
knowledge base.
Example: When working with this patient, I performed research to learn more about
trisomy 21 related to poor feeding. Using that information to increase my knowledge
base of this patients condition, I created a more individualized plan of care for him.
Research
Applies researched-based knowledge from the arts, humanities and sciences to
complement nursing practice.
Example: Using a research study that found clinically stressed parents of children
with disabilities negatively impacts the relationship they have with their child, a focus
of my interventions for the parents included education about stress reduction as well
as a discussion of stress in their lives and ideas of how to manage and decrease those
stressors. In doing so, the parents can focus more attention and have more patients to
work with the patient and bond with him.
Culture
Integrates knowledge of cultural diversity in performing nursing interventions.
Example: Cultural considerations for this patient included his developmental delay,
being a special needs child, having parents who were distant (unable to get ahold of
via phone) and absent (did not come to see child for a prolonged period of time), has
been readmitted for the same problem (poor feeding), and has a twin brother with the
trisomy 21 and poor feeding as well.