What are some of the prepubescent changes school-age children experience that the nurse can share with Kris? b. What are some of the issues regarding body image that the nurse can teach Kris about? c. What can the nurse teach Kris regarding self-esteem in school-age children to address her concerns?  

Chapter 28: Growth and Development of the School-Age Child

1. Gina has come into the primary care center with her mother Kris for an 11-year-old wellness examination. As the nurse prepares Gina for her examination, Kris asks to speak to the nurse outside the examination room. Kris shares with the nurse her concerns about recent changes she has noticed in Gina. She explains that Gina’s body is beginning to change and she has made a number of comments about her body image. Kris is concerned about Gina’s self-esteem and emotional development. (Learning Objectives 1, 2, and 3)

a. What are some of the prepubescent changes school-age children experience that the nurse can share with Kris?

b. What are some of the issues regarding body image that the nurse can teach Kris about?

c. What can the nurse teach Kris regarding self-esteem in school-age children to address her concerns?

2. Don is a 10-year-old boy who is being seen by the school nurse today for a fall he experienced on the school’s playground. Don’s mother, Kandis, has arrived and expresses some concern regarding Don’s recent behavior. She explains that he has engaged in more risk-taking behavior and has had more injuries lately. Kandis then asks the nurse what Don’s weight is and asks her if she thinks Don is overweight. Don is 5’1” and weighs 130 lbs. His body mass index (BMI) is 24.5. (Learning Objectives 4, 5, and 6)

a. What can the nurse teach Kandis about promoting a safe lifestyle for Don?

b. What can the nurse teach Kandis regarding Don’s weight and corresponding BMI?

c. What can the nurse teach Kandis regarding Don’s nutritional needs, promoting nutritional healthy intake, and preventing overweight/obesity?

Chapter 29: Growth and Development of the Adolescent 

1. Jeff, a 14-year-old boy, is being seen at the local health department for a required physical examination in order to play organized sports with his high school. He is accompanied by his mother, Betty. Before the examination Betty tells the nurse that Jeff is her only son and only teenager. She is not sure what is happening with his body but is aware of the recent dramatic changes Jeff has experienced. (Learning Objectives 1 and 2)

a. What can the nurse teach Betty and Jeff about puberty and the changes it is responsible for in adolescents? 

b. What are some of the integumentary changes that occur in adolescence and that Jeff may be experiencing?

c. What can the nurse teach Betty about the psychosocial and cognitive stages of adolescence? 

2. Teresa is a 15-year-old girl who is being seen by her physician today at the request of her parents, Bob and Peggy. They have brought Teresa in today because of some concerning changes in Teresa’s behavior and appearance recently. They explain that up to about a year ago Teresa was a typical teenage girl who was a good student in school. Since then, she has been running with a new group of friends who wear dark or black clothing and dye their hair black. Teresa has followed this trend and has recently shown up with several new body piercings and has asked her parents for permission to get a tattoo. Her parents have refused but are afraid that she will do this without their permission. Teresa is listening to loud violent music and spending less time at home with the family. When she is home she often fights with her parents over the rules of the house. They are afraid Teresa has become sexually active. (Learning Objectives 3, 4, and 6)

a. What can the nurse tell Bob and Peggy about the influence of Teresa’s peer group?

b. What can the nurse teach Bob and Peggy regarding dating and sexuality for adolescence?

c. What can the nurse teach Bob and Peggy regarding the occurrence of violence in adolescence? 

Chapter 37: Nursing Care of the Child With an Infectious or Communicable Disorder

1. Mrs. Acton, the mother of 6-year-old Christina, calls the physician’s office to speak to the nurse. Mrs. Acton is concerned because Christina went to a birthday party 8 days ago and was exposed to the chickenpox. (Learning Objectives 4 and 5)

a. What information would be appropriate to give to Mrs. Acton?

b. What data would be important for the nurse to gather when speaking with Mrs.

Acton?

2. Six-month-old Joshua is brought to the acute care center by his parents. The parents tell the nurse that Joshua has become “very fussy,” seems to be pulling at his right ear, and is running a fever. The nurse finds the infant’s temperature to be 100.2°F axillary. His weight is 7.7 kg and he is crying inconsolably. Joshua’s anterior fontanel is flat when he is crying and his skin feels hot to the touch and dry. Joshua’s mother tells the nurse that when the infant saw his physician 10 days ago he weighed 8.1 kg. (Learning Objective 3)

a. Based on the data obtained during this assessment by the nurse, what interventions should the nurse expect to provide?

b. What child/family teaching would the nurse be expected to provide?

Case 2: Six-month-old Joshua is brought to the acute care center by his parents. The parents tell the nurse that Joshua has become “very fussy,” seems to be pulling at his right ear, and is running a fever. The nurse finds the infant’s temperature to be 100.2°F axillary. His weight is 7.7 kg and he is crying inconsolably. Joshua’s anterior fontanel is flat when he is crying and his skin feels hot to the touch and dry. Joshua’s mother tells the nurse that when the infant saw his physician 10 days ago he weighed 8.1 kg.

a. Based on the data obtained during this assessment by the nurse, what interventions should the nurse expect to provide?

Incorrectly analyzed case study.

High fever in children is normal.. and 100.2 is not a high fever.

Based on the data obtained, the nurse should expect to monitor vital signs and neurological signs, initiate seizure activity,  monitor for signs of meningeal irritation, assess for signs of increasing ICP, and assess peripheral vascular status. The nurse should also help the baby maintain neck or head in midline position by providing a small comfortable pillow to support the baby’s head and neck.

b. What child/family teaching would the nurse be expected to provide?

The nurse is expected to provide teaching about the dangers of the symptoms presented by their baby and how to react to them. Very high temperatures may lead to seizures or fits if not attended to. Therefore incase a child has extremely high temperatures; she should be taken to the hospital immediately. They should also watch out for symptoms like vomiting, stiff neck, baby holding back the head or arching the neck, vomiting, drowsiness, and high pitched cry because those are signs and symptoms for meningitis and it can be dangerous if not treated in time.

References

Duncan, D. L. (2019). Chickenpox: Presentation, transmission, complications and prevention. British Journal of School Nursing14(10), 482-485.

Rohlwink, U. K., Figaji, A., Wilkinson, K. A., Horswell, S., Sesay, A. K., Deffur, A., … & Levin, M. (2019). Tuberculous meningitis in children is characterized by compartmentalized immune responses and neural excitotoxicity. Nature communications10(1), 1-8.