Pediatric Nursing Rounds

NURS 421 – Clinical Management of Children of the Family

Purpose of Assignment

To provide the student an opportunity to integrate knowledge from the sciences, developmental
theory and physical assessment data to the care of a pediatric patient and family in the acute care
setting. The student will utilize critical thinking and independent judgments in presenting a
holistic plan of care in a formal oral presentation.

Student Approach to Assignment

I completed my pediatric nursing rounds assignment on a 6-year-old Caucasian male brought to

the emergency department for anaphylaxis. The patient was having difficulty breathing, and I
integrated my knowledge from the physical assessment and from the sciences and developmental
theory to develop a plan of care. After identifying the priority problem and obtaining health and
psychological histories, five nursing diagnoses were established and prioritized. Interventions,
expected outcomes, and discharge planning was also created for this patient. Additionally, I
applied cultural and developmental considerations and evidenced-based research to my plan of
care – which was all organized in the format of a PowerPoint presentation for the purpose of this
oral assignment.

Reason for Inclusion of this Assignment in the Portfolio

This required portfolio assignment shows my growth understanding the depth and breadth of
nursing practice as I develop the framework that will guide my career. The following program
objectives are highlighted:

v Nursing Practice
Ø Performs therapeutic interventions that incorporate principles of quality management
and proper safety techniques.
§ Example: My patient’s priority diagnosis was ineffective airway clearance. However,
fear and interrupted family process were also diagnoses for this patient. Therapeutic
interventions were incorporated into the plan of care to treat these problems.
Providing comfort measures, maintaining a quiet environment, providing adequate
periods of rest, avoiding false reassurances, and educating the patient on
developmentally appropriate coping strategies were all included in the care plan. Each
therapeutic intervention was effective and served a dual purpose of providing comfort
and promoting healing. Additionally, these interventions incorporated core principles
of quality management – such as prioritizing the therapeutic relationship and
optimizing holistic health. Each intervention also minded the safety of the patient. For
example, promoting rest in a patient with fear and interrupted family process
minimizes the patient’s risk for irritability, ineffective coping, or unsafe behaviors.
 Also, communicating well and engaging with the patient and supporting their culture
are strategies that I utilized to improve safety.

v Communication
Ø Expresses oneself and communicates effectively with diverse groups and disciplines using
a variety of media.
§ Example: During this patient’s repeat anaphylactic reaction, I was required to
communicate effectively with several disciplines and individuals – including the
nursing staff, physician, respiratory therapist, and family members. These
professionals/individuals are diverse in their specializations and scope of practices. A
variety of techniques and media were utilized to communicate within the hospital –
including the hospital alert system, hand-held unit communication devices, and face-
to-face communication. Furthermore, this patient was separated from his parents
because they were deployed in the military, and he was brought into the emergency
department by his Aunt. Therefore, it was necessary to communicate with the
patient’s parents on media devices via information technology services provided by
the hospital.

v Research
Ø Applies research-based knowledge from the arts, humanities and sciences to complement
nursing practice.
§ Example: I applied research-based knowledge from the arts and humanities –
specifically on informatics, sociology, and psychology – to care for this patient.
These disciplines were carefully considered in my assessment of the child’s
developmental stage. The patient was between pre-operational and concrete
operational stages; therefore, my understanding of the child’s intuitive thought
process and ability to interpret present situations drove my communication and
teaching strategies. Additionally, knowledge from the sciences was applied to my
plan of care – because the treatment plan for ineffective airway clearance was in
accordance with evidenced based research on anaphylaxis and the pathophysiology of
that condition. Essentially, the biology of the human body produces the signs,
symptoms, and complications that we see in anaphylaxis.

v Culture
Ø Integrates knowledge of cultural diversity in performing nursing interventions.
§ Example: The patient’s religion (Catholicism) and parents’ military background was
brought up several times while I provided care for this patient. Religion and
occupation are two major components to one’s culture. In pediatric populations,
especially, one’s upbringing is a primary force that will drive their thoughts, values,
and attitude on health. Knowing that this patient was Catholic, I encouraged him to
 pray with his Aunt if he was feeling fearful. Additionally, due to the parents’
occupations, the patient verbalized that he moved frequently and was separated from
his other family members and friends. So, I coordinated strategies to communicate
with his parents using information technology throughout his hospitalization. Also, I
considered how moving frequently would impact his psychosocial health and values,
and I established a therapeutic relationship with this patient to address these needs.
.
 Honor Pledge

I pledge to support the Honor System of Old Dominion University. I will refrain from any form

of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a

member of the academic community it is my responsibility to turn in all suspected violations of

the Honor Code. I will report to a hearing if summoned.

Signature: Taylor N. Brunke