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Pediatric Nursing and Gastroenteritis Case Study

Pages:11 (3217 words)

Sources:7

Subject:Health

Topic:Gastroenteritis

Document Type:Case Study

Document:#91020805


Gastroenteritis

Gastroenteritis only shows relatively mildly in children and lasts for a few days. On many occasions of the illness, parents manage it at home and may not even seek professional help. While many children who develop gastroenteritis do not need specialized care, still, they end up in hospital facilities and are admitted as inpatients. Such patients are kept in hospital for a significant period. This is a notable strain on the health sector. Admitting these children in the hospital also poses a risk of infecting other children who have been admitted on other issues at the hospital. Some of these at-risk may be highly vulnerable due to their health conditions (Hockenberry & Wilson, 2019).

The recommended approaches for managing Gastroenteritis keep evolving. There are new management strategies and treatments proposed every day. Some of the proposals could be controversial. New approaches are being tested for fast rehydration using intravenous fluids. There have been several assessments of the severity of dehydration and consequent computation of fluid deficits in patients proposed. Several therapies, such as antidiarrheal and anti-emetic methods have been suggested for Gastroenteritis treatment. However, uncertainties exist regarding the safety and efficacy of such agents (Hockenberry & Wilson, 2019).

It has been found that the pediatric Intensive Care Unit often places children under the risk of psychological and behavioral difficulties after they have been discharged. Although medical technology has advanced a lot, 25% of the admitted to PICU show negative behavioral and psychological outcomes within the first year after they have been discharged. Thus, it is important to explore a broader spectrum of risk factors and indicators of outcomes when looking out for long term psychological morbidity so that the areas that need health enhancement and healthcare interventions can be pointed out (Caplin& Cooper, 2007).

Critical illness for children exposes them to stressors in the end. They are subjected to invasive procedures, separated from their families, exposed to other children who are critically ill, and even some who are dying. These are true extremes for people of such tender age. They are further subjected to light changes, multiple strangers having to administer complicated medical procedures to them, and more. The children, in turn, show their stress through the loss of sleep through numerous awakenings. Once children are admitted, they are exposed to a completely new environment. They are removed from familiar territory. The attachment to parents and other caregivers at home is severed. It does not matter how friendly the hospital may be; it is still a highly strange and discomforting territory to be in for children; a different routine, a different bed, and even bed position- generally little they are used to happens. Children react to stress through varying behavior changes, which can be drastic sometimes (Caplin& Cooper, 2007).

One of the common reactions by children to hospitalization is that their development tends to regress. It involves losing some of what they had gained and learned earlier. It also happens to be a predictable reaction across the range of ages and is expected by medics. It is said to be a healthy reaction to hospitalization by children. It helps them cope with the hospital experience. The regression is usually reversed as soon as the hospitalization term ends. A continuum of development is shown when an approach that is tied to the age of the hospitalized patient is used (Caplin& Cooper, 2007).

Children in pre-school tend to tolerate separation from their parents more, compared to toddlers. It has been observed that at the pre-school stage, the children's cognitive repertoire is more developed and can understand that the pare3nt who is absent will come back. Still, though, the advanced memory and imagination could lead them to think of extraordinary aspects regarding their illness. They may create a casual hypothesis of what their ailment is about and what their role in it is. Things like: "I fell sick because I deserved it" "If I behave well, I will recover." ” (Caplin& Cooper, 2007).

The effect of hospitalization on the entire family

Both the hospitalized child and the family are subjected to undue stress. Such children and their families may experience fear and loss of control. Such emotional upheavals interfere with the healing process. The focus of healthcare workers should now be on how to develop a hospital environment that facilitates the healing process and allows for family control. Where possible, both the child and family should be prepared in advance for hospitalization. Thus, they will have been informed about the details of care that will be accorded at the hospital. The physician will also have a chance to know the expectations of the family regarding the hospitalization (Hockenberry & Wilson, 2019).

If hospital care does not involve the primary care physician going round to see patients, the family should be informed of who will provide such care and how the communication from physicians will be managed and coordinated. There should be effective communication between physicians at admission so that there will be satisfactory care. If possible, allow the child and family to make a pre-visit to the hospital where the child will be admitted and even shown who will be providing the care. A proactive child life service should be in charge of pre-hospitalization events (Hockenberry & Wilson, 2019).

Assessment

A lot of children with gastroenteritis conditions do not need any lab exams. Many children and infants commonly experience short episodes of diarrhea and are attended to by their parents. They usually do not seek medical advice for the same. Even when parents seek such advice, healthcare personnel usually believe that clinical evaluation is what will portray the right picture. However, there may be cases when it is helpful to conduct a diagnosis. There is usually no attempt to conduct stool investigations to establish the specific particular enteric pathogen that has caused gastroenteritis in a child. Some situations call for microbial investigation though (National Collaborating Centre for Women's and Children's Health,…

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…time and the nature of the play. The VAS was used to measure the level of anxiety. The VAS is made of a 10 cm drawing on a card. It has varying facial expressions inscribed with the wording: "I have no anxiety at one end" and "I have a lot of anxiety" at the other. The higher the score, the higher the level of anxiety on the measure. She was assessed for emotional balance using CEMS, the observation scale. It has five categories, calibrated from 1 to 5 with scores that are summed, ranging from 1 to 25. Higher scores on this scale indicate intensifying emotional status (Li et al., 2016).

When asked to comment on the play interventions at the hospital, she confessed that they learned a lot about hospital procedures through the games. The children also confessed that they felt less anxious because of the games. Parents also expressed similar views. The reported that Eva settled more after she was engaged in the play interventions. She was also much more at home with the procedures at the hospital.

The findings support the positive effect of hospital play on the wellbeing of children and their responsiveness to therapy and medical procedures in the hospitalization period. Play is a crucial aspect of children's development and should be facilitated even in hospital settings. The most important among the gains that accrue from hospital play is that it helps the hospitalized children to cope with their condition and relieves them stress (Li et al., 2016).

Conclusion

Play is an important part of the development of a child. It is also a way through which a child communicates. Although disease, physical and psychological setbacks may affect the ability of a child to play, hospital play can greatly mitigate the effects of sickness and hospitalization. The play also helps health professionals to investigate what the children feel and think of their hospitalization and health condition. The knowledge of such mental status of children helps in developing strategies to help children to cope and respond better to hospitalization and therapeutic procedures. The play exhibits multiple characteristics that can be used not only in the treatment context to improve healthcare outcomes but also aid the improvement of the child's general function and development across domains. Play can be used by healthcare professionals as a treatment strategy for hospitalized children. The importance of play increases as the child's condition moves to critical status, disability, and even life-threatening health conditions. Play restores continuity in a child's psychosocial life. Healthcare professionals can gain useful insights regarding the child's health and mental condition through the use of play and observing the responses of the children engaged in the course of hospitalization. Children also have a chance to gain control of their bodies and situation. Consequently, hospitalization can, for once, be viewed by the children as a good development to help their condition. However, play is not just playing; there are standardized games that target specific responses and…


Sample Source(s) Used

References

Campos, M. C., Rodrigues, K. C. S., & Pinto, M. C. M. (2010). Evaluation of the behavior of the pre-school one just admitted in the unit of pediatrics and the use of the therapeutic toy. Einstein (São Paulo), 8(1), 10-17.

Caplin, D., & Cooper, M. (2007). Child development for inpatient medicine. In Comprehensive pediatric hospital medicine (pp. 1285-1292). Mosby.

Emde, R. N., & Harmon, R. J. (Eds.). (2012). Continuities and discontinuities in development. Springer Science & Business Media.

Hockenberry, M. J., & Wilson, D. (2019). Wong's nursing care of infants and children E-book. Elsevier Health Sciences.

Koukourikos, K., Tzeha, L., Pantelidou, P., & Tsaloglidou, A. (2015). The Importance of Play during Hospitalization of Children. Materia socio-medica, 27(6), 438–441. https://doi.org/10.5455/msm.2015.27.438-441

Li, W. H., Chung, J. O. K., Ho, K. Y., & Kwok, B. M. C. (2016). Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC pediatrics, 16(1), 36.

National Collaborating Centre for Women's and Children's Health; UK. (2009). Diarrhea and vomiting caused by gastroenteritis: diagnosis, assessment, and management in children younger than 5 years.

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