Respiratory Medicine

Background
Sophia is a 6-month-old infant of jasmine and Mahjid. She has an older sibling Harry who has Down syndrome. She is a happy baby who is thriving. She can sit up and enjoys playing with toys. Her favourite toy is a Teletubbie soft toy.
Patient information
Name: Sophie Tehrani
DOB: 14/0X/XX 6 Months
HT: 65cm
WT: 8kg
HC: 43
Eye Colour: Brown
Hair Colour: Brown –
Medical team: Dr Andrew Waradale, Respiratory Medicine
Social History: Live at home with both Parents and older sibling- Harry, who has Downs Syndrome.
Religion: Muslim
Birth/medical History: Conceived by IVF, born at 35 weeks via Caescarian section, required for phototherapy for jaundice and NGT feeds
Immunisation: UTD
Allergies: Nil Known
Progress Summary
6-month-old baby presented to the paediatric Emergency Department with her Parents. Following a febrile convulsion at home, lasting approx.3mins. First febrile convulsion as stated by parents. Has been unwell for 3 days with a runny nose, cough and fever, seen by her GP and was diagnosed with otitis media. Amoxicillin commenced. On examination, has a respiratory wheeze and mild subcostal recession, mother has stated she has not been interested in breast feeds, refused solid foods and has decreased wet nappies. Second child, born prematurely and 35 weeks gestation, for maternal pre-eclampsia. Has been breast fed, growing well and meteing developmental milestones. Live with both parents at home, father smokes in the house, mother has a history of asthma as a child. Immunisation are up to date, NKA.
NPA sent for RSV, came back negative for RSV.
Plan:
Admit to the ward
Cardiorespiratory and oxygen saturation monitoring
Administer oxygen to maintain oxygen saturation 93%
Insert NGT
Offer smaller, regular breast feeds with formula/EBM top ups
Continue Amoxicillin for otitis media
Paracetamol Prn
Weigh Nappies
FBC
Care Plan
Partnership in care: As a parent/ caregiver you are an important part of the patient care team and we welcome your involvement in caring for your child. We believe families should feel free to participate in the caring for their child and also feel confident to leave them in our care at the HHHS.
Do you wish to be involved in your child’s care? Yes.
Nutrition: Breast fed Commenced on Solids
Elimination: Nappies
Sleep routine: Bath at night time, swaddle and pats to sleep with dummy
Hygiene: Bath at night by mother and wears own clothes
Development: Sitting up and rolling, Commenced on solids
Infection alerts: Nil
Allergies: NKA
Medications: Amoxicillin 200mg orally TDS
Complex additional needs: N/A
Community based disability service: N/A
Communication/equipment needs: N/A
Family SA client: No
Aboriginal /Torrens Strait islander: No
Handover
Identify: Sophia Tehrani (6 months)
Situation: Bronchiolitis, RSV negative, bilateral otitis media
Background: Presented to Horizon Hospital Paediatric Emergency Department, following 3 days of increased work of breathing, fever, irritability, runny nose and poor oral intake. Mother Jasmina is rooming in, as baby is breastfeeding on demand.
Assessment
• Temp 37.0
• HR 130
• RR 44
• Spo2 94% on 1 litre of oxygen via nasal specs. Marked work of breathing extended expiratory phase, comfort breastfeeds.
Recommendations:
Respiratory assessment, oxygen to keep SpO2 above 93%, nasogastric tube management and feeds, continue with oral antibiotics.
Scenario
It’s 0800 hours in the morning and you are the student nurse looking after the patient. Mother has stated that Sophia is still breathing quickly and has lots of discharge from her nose. She also states that it appears that she doesn’t like the nasal prongs on her nose and asks if they are necessary. She also wasn’t sure of what RSV was, can you explain that to her? Sophia is also due for a dose of Amoxicillin and mother has also asked for some Paracetamol as she feels “Hot”.
Assignment
Assessment 1: Essay (written assignment of 1000 words)

The purpose of this assignment is to demonstrate your understanding of the role of the registered nurse in relation to issues of consent and mandatory reporting for infants, children and young people.

Choose a scenario from the HHHS Paediatric Ward. Using your chosen scenario, discuss the role of the Registered Nurse (RN) in relation to Consent and in relation to Mandatory Reporting. Refer to the NMBA Registered Nurse Standards for Practice (2016) and relevant legislation to assist your discussion.
ASSESSMENT DETAILS
This assessment is to be submitted in a WORD document via Learn online and presented as a scholarly essay (guide provided below) in keeping with the Academic Writing Requirements.
Introduction (100 words)
Introduce the purpose and structure of the essay. Introduce the chosen scenario. Outline how you will address the essay topic.
Body of essay (800 words)
Define the legal constituents of consent for infants, children and young people and use relevant criteria from the NMBA Registered Nurse Standards for Practice (2016) to demonstrate your knowledge of the role of the RN using your chosen scenario as an example. Demonstrate your knowledge of the role of the RN in mandatory reporting using your chosen scenario. Discuss the legal requirements and process of making a report in your state. Use relevant criteria from the NMBA Registered Nurse Standards for Practice (2016) to assist your discussion.
Conclusion (100 words)
Summarise the purpose and content of the essay in a logical and succinct manner.
REFERENCES:
A minimum of 8 contemporary and relevant references, for example, peer-reviewed journal articles, text books and reputable websites, not more than 10 years old are to be used in support of your essay.