Kate, age 18 months, is admitted to hospital with fever, pallor, bruising, lethargy, and anorexia.

Kate, age 18 months, is admitted to hospital with fever, pallor, bruising, lethargy, and anorexia. She weighs 11.8 kg. After examination by her physician, Kate is ordered a chest X- ray and complete blood count. As well, she is to have acetaminophen (Tylenol) 15mg/kg q6h prn for fever. Your pharmacy stocks acetaminophen liquid 160mg/5ml strength. Kate’s parents are anxious about her admission and diagnosis of leukemia. They state that they live on a First Nations Reserve and are waiting for the completion of their new home which is due to be finished in three months. In the meantime, Kate and her parents live in the home of Kate’s grandparents along with several cousins 200 km from the local hospital.

Preparation of client

1) How should the practical nurse prepare Kate for the tests that have been ordered?

Teaching required on admission

2) What teaching is required on admission for Kate and her parents?

Parental involvement

3) How can Kate’s parents be involved in and reinforce the health teaching the practical nurse provides?

Supports

4) What kind of support will Kate’s parents need during her hospitalization?

Incorporation of cultural and spiritual care

5) Kate’s parents have requested that their healer visit Kate. What is the action of the practical nurse to this request?

Safety precautions

6) What safety precautions will the practical nurse need to take while caring for Kate?

Play

7) List three toys that you would give Kate considering her age and diagnosis, and give a rationale for each of your choices.

Nursing care plan

8) Develop a 3-part priority nursing diagnoses, one SMART goal, and three nursing interventions with rationale.

Pathophysiology

9) Explain the pathophysiology of leukemia in terms the parents will understand. Include references used.

Alteration in health status

10) The day following admission, Kate’s temperature is 39.2 degrees Celsius. Explain the significance of this and describe the priority nursing action.

Medication administration

11) Calculate how much Tylenol would be given to Kate for one dose. Acetaminophen is available as 160 mg/5 mL

Discharge teaching

12) What health teaching would Kate and her parents need regarding protection from infection and injury when she is discharged home? Why?

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