Pediatric Assessment is a rapid evaluation tool that establishes a child’s clinical status and his or her category of illness to direct initial management priorities.

Case Study

Bruce is a 13-year-old boy with cystic fibrosis (CF). He lives with his parents and two younger siblings—Anna (9 years old) and Alicia (6 years old) in Merredin in Western Australia. He was diagnosed of CF very early in life and has since been attending the Perth Children’s Hospital (formerly Princess Margaret Hospital) for tune-up when CF symptoms exacerbate.

Apart from his CF, Bruce also has a history of procedural anxiety and pancreatic insufficiency as a complication of his CF. Bruce has been scheduled for a tune-up and he is expected to be in the hospital for a minimum of one week. Bruce is comfortable with receiving treatment at home, but because of his blocked Peripherally Inserted Central Catheter (PICC) and exacerbation of CF symptoms, he was brought into the hospital for insertion of a PICC and tune-up.

It took a lot of effort from Bruce’s parents to get him to the hospital as he was very reluctant. He has since been moody and withdrawn in this admission. His parents do most of the talking on his behalf. Bruce has been in the ward for a day. When you went in to check his observations, he was alert and they read:

• Temperature 38.7oC,
• HR= 120 beats per minute,
• Oxygen saturation 95% at Room Air
• RR= 26 breaths per minute with mild distress
• BP = 100/70mmHg.

He stated his cough has improved since he commenced antibiotics 24 hours ago. He appears fatigued and not interested in eating. Bruce’s parents have been very supportive with his CF cares.

Use the following Assignment guidelines

Word count = 1200 –1400 (No more +/-10% word count)  Your assignment should include the following:

1. An introduction summarizing pediatric assessment case study.

2. Discuss the pathophysiology of the presenting condition.

3. Discuss the assessments (Paediatric Assessment Tool and/or PrimaryAssessment Framework or CEWT) you will undertake to prioritize as well as manage care for Bruce.

4. Describe the nursing management of Bruce’s condition incorporating the child and family-centered care model.

5. How will you also prepare Bruce for transition into adult health care?

6. What discharge education and health promotion will you emphasize?

• An overview of the case study and definition of terminology Pathophysiology (approx 250 words)

Describe the presenting problem’s pathophysiology Nursing assessment and management (approx. 500 words)

Discuss the nursing considerations and management for this child. Additionally, incorporate examples of child and family centred care in assessment strategies and nursing action.

Discuss potential pediatric assessment findings, what range of assessments or preparations would be required and what appropriate assessment tools will you utilise/would be used.

Consider any potential changes e.g. deterioration/recovery and how this would impact on the care provided.

Identify, consider and briefly discuss nursing management– this should demonstrate the student’s ability to demonstrate clinical knowledge, critically think and incorporate evidence informed practice.

Students should also incorporate any holistic health considerations and rationales to demonstrate critical thinking. Health promotion (approx. 400 words)

How will you prepare Bruce for transition into adult health care?

Further, discuss the health promotion strategies you will put in place for Bruce and his family including community resources they can utilize to support Bruce’s CF. Conclusion (approx 100 words)