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  • Subject Name : Nursing

Child and Family Nursing Practices

Introduction to Cooper Merino Case Study

Nursing is basically the understanding of people’s experience of health and illness where nurses also collaborate with the families which help in further reduction of physical and emotional suffering from illness which is also called as nurse care. In the case study, Cooper a 5 year old boy is suffering from asthma and this is his third admission in the last 6 months with this same problem. Besides this problem he is not suffering from any other problem. Renee and David lives in Pimpama, and they have only 2 children, Cooper a 5 year old boy and Ella a 3 year old girl. David, works with Fly in fly out in western Australia and he stays away from his family for about 6 weeks at a time while Betty and Tom, Reene’s parents are only closer to them when-ever they need some help. Whenever Cooper is hospitalized Ella stays with Reene’s parents but David does not like leaving their children with them. Grandparents find it very difficult to navigate to the hospital due to high parking charges and it becomes sometimes difficult to visit Cooper daily. There are different types of nursing process such as assessment, diagnosis, outcome, implementation and evaluation. The purpose of this case study is to work on the issues and provide best nursing go al to each problem and then implement and evaluate the nursing care to them (Rachelle & Susan, 2014).

Issues

  1. Ella Missing out On ‘normal’ Routine when Cooper Admitted to Hospital

In the above case study when Cooper was hospitalized, Ella his sister stays with her mother’s parents if David is at work and for her it is very difficult to drive her to day care so she stays with their Grandparents instead. Though their father David has problem with it but they also have no other option left with them. Because of which Ella’s find it very difficult to contact her family and also her routine and family life is also disrupted. She is also not able to attend the day care properly. As she is spending more time with her Grandparents than her mother therefore, she is having more attachment towards them. She is also facing the problem of lack of discipline while staying with her Grandparents as they cannot check every moment of her. There are 3 stages of development of a child which are early childhood (Birth to Eight Years), Middle childhood (Eight to Twelve Years) and Adolescence (Twelve to Eighteen years). In the given case the father disagrees with his wife for letting Ella stay at her grandparent’s home as he believe that they are too old to keep on top of kids and they do not discipline the kids appropriately.

Nursing Goals

 In the given issue the best nursing goal is providing some amount of comprehensive care that helps the patient’s social, emotional, cultural and physical needs that are vital for the wellbeing of the patient that will work in this situation. Therefore, in this case the Child and the parents should work together with the nurse which helps in improvement of the child’s asthma. (Glyn,etal., 2013).

Implement Nursing Care

A nursing intervention is a task that a nurse does for the patient which leads further to the patient outcome. She uses all her knowledge and experience to decide which intervention is more suitable. The main areas where the nurse intervenes are sleep pattern control, mobility therapy, energy conservation, alcohol control, infection control. The most relevant nursing intervention is that a nurse should provide careful planning and avoiding asthma triggers. If suppose the patient has an inhaler, then they should use it to gain respiratory control which relieves hypoxia and inflammation. The nurse should also help the patient to be calm and explains them that the anxiety and agitation will subside if they can try to relax their breathing. A person suffering from asthma has a limited quality of life and the factors that affect are patient’s inability to sleep, physical activities. If possible a nurse should monitor vital signs. Breathing heavily during attack can drain energy and cause dehydration therefore it is recommended to offer fluids to help maintain their fluid balance (Glyn,etal., 2013).

Evaluate Nursing care

This is the most important stage to evaluate whether the intervention has worked for the child or not, If it has worked then what is the progress of it and if not then what other intervention would be suitable for the problem to achieve best outcome. There are several measures to evaluate the nursing care which is to create client database by gathering all the health information, then analyze the data, formulate nursing diagnoses, setting priorities, establishing client goal and outcomes. The nurse can evaluate nursing care by checking the hospital records whether the asthma attacks are reduced or not.

  1. Issues Regarding Medication Administration

In the given case study Cooper is admitted in the hospital third time in the past 6 months where the problem is still not rectified. Therefore they face lack of understanding about asthma. A proper understanding should be provided to their parents about what asthma is, type of asthma, how asthma is cured, symptoms, causes and also treatment so that they can have a clear vision of it. Mother is also not providing with the correct procedure regarding the spacer and why is it important to cooper. They are also not familiar with providing the correct medication dose that is causing them to hospitalize again and again. Also if Cooper does not want to take a medication then her mother ignores it which is wrong. It might happen that Mother is only working and understanding the situation of her child while father is away from them for a very long time causing uncontrolled asthma (Joy & Betty, 2013).

Nursing Goals

 In the given case the best nursing goal should be that suitable care should be given to patients with serious and lingering illnesses, facilitating liberation planning, and also giving them suitable care and offering patient education, illness anticipation services and health upkeep care’. This will further help the parents to have a deeper understanding of the problem and how it can be rectified (McCaffery,etal., 2013).

Implement Nursing Care

In the given case a nurse should work on different areas such as sleep pattern control, mobility therapy, energy conservation, infection control. A nurse should influence the patient to do exercise daily, quit smoking, asthma medication and to use inhaler regularly. A nurse should ensure that suitable and correct medication is given to the correct patient. Also it should be administered in the correct dosage via the correct route and also it should be timed correctly. Nurses must compare this aspect to the medication administration record (MAR). Often it happens that not all the elements of a medication record are available for informal proof, but it is of supreme importance and consideration to verify this thing with every possible source, including the liquidation or shifting institution/unit, the patient or patient’s family, and physician—to prevent possible errors related to improper settlement. There are several forms for medicational reconciliations that are available from various types of vendors. It is of utmost importance to document everything which includes medicinal labeling, legible certification and proper copy of prescribed medication.

Evaluate Nursing care

With the help of proper documentation it will be easy for the nurse to track the progress of the patient. Moreover there are various policies implemented by government such as safe infant co-sleeping and bed sharing guidelines, protecting children is everyone’s business, guidelines for mandatory reporting and national immunization strategy for Australia 2013 (Downar,etal., 2015).

Conclusion on Cooper Merino Case Study

The idea behind the case study is to understand the nursing process in detail, implementing nursing care, evaluating them. Child and family nursing practices will help the nurse to provide valuable insight into the structure and function of the family. It help the nurse to identify the family’s healthy characteristics and protective factors after which a nursing goals comes into the picture where the desired outcome of the patient is accessed and then nursing intervention that will support the family is achieved to the desired goal and finally the evaluation process takes place which shows how will the effectiveness of the interventions be evaluated, what type of data will be collected and will others need to be involved.

References for Cooper Merino Case Study

Rachelle,B, & Susan,B., (2014). Communication about serious illness care goals: a review and synthesis of best practices. JAMA internal medicine.174.pp.1994–2003. 

Glyn,E., Amy,L., Natalie,J,M., Emma,C., Richard,T., Anne,D,M., Adrian,M., Option Grids (2013). shared decision making made easier. Patient education and counseling. 90.pp.207–212. 

Elwyn,G., Scholl,I., Tietbohl,C., Mann,M., Edwards,A,G., Clay,C., Frosch,D,L., (2013). “Many miles to go...”: A systematic review of the implementation of patient decision support interventions into routine clinical practice. BMC Medical Informatics and Decision Making. 2013.13(2).p.14. 

Joy,G., Betty,F., Elaine,W,L., Sandra,L., (2013). Palliative care communication in oncology nursing. Clinical journal of oncology nursing. 2013.17.pp.163–167.

Robert,G., Mechelle,D., Susan,L., Sally,A., Ronald,E., Stewart,C., (2015). Goal Communication in Palliative Care Decision-Making Consultations. Journal of pain and symptom management. 50.pp.701–706. 

NAPNAP position statement on the integration of mental health care in pediatric primary care settings. Journal of Pediatric Health Care.(2013).p.15.16. https://www.jpedhc.org/article/S0891-5245(13)00078-3/pdf

Stanik,J., Newhouse,R,P., White,K,M., Johantgen,M., Zangaro,G., Weiner,J,P., (2013). The quality and effectiveness of care provided by nurse practitioners. The Journal for Nurse Practitioners. 2013; 9: 492-500 https://www.npjournal.org/article/S1555-4155(13)00410-8/fulltext.

Downar,J., Fowler,R,A., Lamontagne,F., Jayaraman,D., (2015). Canadian Researchers at the End of Life Network Barriers to goals of care discussions with seriously ill hospitalized patients and their families: A multicenter survey of clinicians. JAMA Internal Medicine. 175.pp.549–556. 

(2020). Coronavirus: Impact on young people with mental health needs. Retrieved, from https://youngminds.org.uk/media/3708/coronavirus-report_March2020.pdf.

Glyn,E., Amy,L., Natalie,J,M., Emma,C., Richard,T., Anne,D,M., Adrian,M., Option Grids (2013). shared decision making made easier. Patient education and counseling. 90.pp.207–212.

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