Pediatric Case Study

NURS 451- Clinical Management of Adult Health Nursing III

Purpose of Assignment
The purpose of this case study is to integrate knowledge from the humanities and
sciences, including nursing research and theory, to plan, provide, and evaluate holistic care
provided to a client selected during this clinical rotation.

Student Approach to Assignment

The patient I chose for this case study was a 5 week old infant diagnosed with Neuroblastoma.
He was born to a 16 year old gravida 1 para 0. He presented with respiratory distress and
shoulder dystocia. While in the hospital he presented with a mass on his right flank which was
later biopsied by CHKD. This biopsy showed that the mass was Neuroblastoma located on his
right kidney. The reason for this case study is to see what Neuroblastoma is and how to
potentially treat it.
Reason for Inclusion of the Assignment in the Portfolio

This assignment is included in the portfolio because it highlights the care that I gave to a
complex patient and demonstrates integration of a wide variety of end of program behaviors.
Nursing Practice
Applies the appraise knowledge of major health problems to guide nursing practice
Example: In this presentation and case study I explained and examined the patients
primary diagnosis. My patients primary diagnosis was Neuroblastoma which was
located on his right flank. I broke down the diagnosis, treatment, management, and
outcomes and used this to develop a plan of care best suited to my patient.
Establish and or utilizes outcomes measures to evaluate the effectiveness of care
Example: The patients desired outcomes were to come off the gavage feeding, for his
cancer to go into remission, and for him to gain weight. We were able to evaluate this
by using the growth tools available at CHKD. He also went home cancer free after all
of his chemotherapy treatments were over.

Teaching
Use information technologies and other appropriate methods to communicate health
promotion, risk reduction, and disease prevention across the life span
Example: Throughout the stay of the baby boy information was gathered on patients
with or whom have Neuroblastoma. This was communicated to the mother of the
baby. The communication was more about the expectations and what to expect for
him in the future.
Uses information technologies and other appropriate methods to enhance ones own
knowledge base
 Example: Throughout the clinical I was able to use technology like the data bases
provided by CHKD and ODU to look up information that would enhance my
knowledge of Neuroblastoma, what it is, the diagnosis, and outcomes. This
information helped me in providing better care for my patient.
Communication
Expresses oneself and communicates effectively with diverse groups and disciplines using
a variety of media in a variety of context
Example: I was able to communicate with the other staff. I was able to do this my
either a phone call to the resident when something had to be adjusted to the patients
IV fluids. I was also able to communicate and other nurses to help with caring for the
infant.
Research
Applies research-based knowledge from nursing at the basis for culturally sensitive
practice
Example: I was able to apply research when providing care for a patient whose
culture was different than my own. I had a patient who parents were from the
Philippines and had some different beliefs. The nurse and myself took their beliefs
into consideration and worked with the family to provide the best possible care
for the patient.

Leadership
Delegates and supervises the nursing care given by others while retaining the
accountability for quality of care given to the patient
Example: My patient had some more in depth needs than other patient that fellow
classmates had. One of my classmates came over to help and assist me in the NG tube
feeding and she had not done it yet. I walked her through the steps on how to set up
the pump and where to place everything.

Professionalism
Demonstrates accountability for ones own professional practice
Example: My patient was giving only gavage feeding due to his inability to suckle
and feed. I had to set up the pump that would feed him. I took responsibility on how
to set up the pump, the rate to set the pump at, and how much to give the patient. I
was check with my nurse because I am not able to do such a think alone yet.

Culture
Integrates knowledge of culture diversity in performing nursing interventions
Example: Cultural diversity was performed because the patient was an infant and not
an adult. The plan of care had to be revolved around him being only 5 weeks old. This
 care included what to set the IV pumps hourly rate to, what to set his gavage feeding
to, and what kind of attention given to him.
Considers the impact of research outcome and, the effects of health and social polies, on
a persons from diverse backgrounds
Example: I had to research care for baby boy and I had to research Neuroblastoma. I
know that his parents are both working two different jobs to support and pay for his
medical bills. This research outcome effects the parents differently than it would
affect me and I took that into consideration when the nurse and I were talking to the
patients mother.