NR452 Nursing Care of Children Post Assessment Questions

22 August 2024

Nursing Care of Children: Strategies for Managing Respiratory Syncytial Virus (RSV) and Respiratory Distress in Newborns

What Information Regarding Strategies to Decrease the Spread of Infection Should the Nurse Provide to the Parents of a Child with Respiratory Syncytial Virus (RSV)?

Respiratory Syncytial Virus (RSV) is a highly contagious virus that can cause severe respiratory illness, particularly in infants and young children. The role of the nurse in educating parents on strategies to prevent the spread of RSV is crucial for protecting both the affected child and the broader community.

One of the primary strategies to prevent the spread of RSV is rigorous hand hygiene. Nurses should emphasize the importance of frequent handwashing with soap and water for at least 20 seconds. Hand hygiene is essential for everyone in the household, as the virus can survive on hands and surfaces for several hours (Centers for Disease Control and Prevention [CDC], 2021). Handwashing should be practiced especially after touching the child, handling tissues, or coming into close contact with the child.

Minimizing close contact between the infected child and other individuals, particularly those at high risk for severe RSV, is another critical strategy. Research indicates that isolating infected individuals and reducing their exposure to others can significantly decrease the spread of the virus (Hall, Weinberg, & Iwane, 2009). Nurses should advise parents to avoid taking the child to crowded places or daycare during the illness.

Disinfection of frequently touched surfaces is also vital in preventing RSV transmission. The CDC (2021) recommends regular cleaning and disinfection of toys, doorknobs, and countertops to eliminate the virus from surfaces where it can linger. Proper disposal of tissues used by the infected child is another important step. Parents should be instructed to discard tissues in a lined trash can and wash hands immediately afterward to prevent further spread.

Cough etiquette is another key component in controlling the spread of RSV. Nurses should teach parents and, if possible, the child to cover their mouth and nose with a tissue or elbow when coughing or sneezing. This practice helps prevent respiratory droplets from becoming airborne and potentially infecting others (CDC, 2021).

Additionally, nurses should advise parents to monitor and limit visitors to the home while the child is ill with RSV. If visitors are necessary, they should follow strict hand hygiene and cough etiquette protocols. In cases where the child is hospitalized, the appropriate use of personal protective equipment (PPE) such as masks and gloves is essential to protect both healthcare workers and family members (World Health Organization, 2020).

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What Are Some Community Resources That the Nurse Should Initiate Referrals for This Client?

When an elderly client is discharged home following a long hospitalization, it is essential for the nurse to initiate referrals to community resources that can support the client’s ongoing care and promote their well-being. The following resources are particularly important:

  1. Home Health Care Services: Referral to a home health care agency can provide nursing care, physical therapy, occupational therapy, and other services in the comfort of the client’s home. Home health services help manage chronic conditions, monitor recovery, and prevent readmission to the hospital (Harris-Kojetin et al., 2019).
  2. Meals on Wheels: This program delivers nutritious meals to elderly individuals who may have difficulty preparing their own food. Proper nutrition is vital for recovery and maintaining health, especially after a prolonged hospitalization (Thomas & Mor, 2013).
  3. Transportation Services: Many elderly clients may require assistance with transportation to attend follow-up appointments, pick up medications, or run errands. Referral to a community transportation service helps the client maintain their independence and adhere to their healthcare regimen (Lynott & Figueiredo, 2011).
  4. Adult Day Care Programs: These programs offer social interaction, activities, and supervision during the day, which can be particularly beneficial for elderly clients who live alone or have limited social support (Fields et al., 2018).
  5. Medication Management Programs: Community-based programs can assist the client in managing their medications, including setting up pill organizers, providing reminders, and monitoring for potential side effects or interactions (Gillespie, Mörlin, Hammarlund-Udenaes, & Hedström, 2012).
  6. Social Services: A referral to a social worker can connect the client with various benefits and services, such as financial assistance, housing support, and caregiver respite (Benjamin & Matthias, 2011).

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What Factors Should the Nurse Look for That Would Increase a Client’s Risk for Injury?

During the initial assessment upon admission, the nurse must identify factors that may increase the client’s risk for injury. These factors include:

  1. History of Falls: A history of recent falls or difficulty with mobility significantly increases the risk of future falls and related injuries, such as fractures. Fall risk assessments are a standard part of admission procedures and help guide care planning (Ambrose, Paul, & Hausdorff, 2013).
  2. Impaired Mobility: Conditions such as arthritis, stroke, or muscle weakness can impair mobility, making the client more susceptible to falls and other injuries. The nurse should assess the client’s mobility and implement safety measures accordingly (de Vries et al., 2010).
  3. Cognitive Impairment: Clients with dementia, delirium, or other cognitive impairments are at higher risk for injury due to confusion, poor judgment, or an inability to follow safety instructions. Cognitive assessments help identify these clients so that appropriate interventions can be put in place (Inouye et al., 2014).
  4. Medications: Certain medications, particularly sedatives, antihypertensives, or anticoagulants, can increase the risk of falls, dizziness, or bleeding, leading to injury. The nurse should review the client’s medication list to identify potential risks and collaborate with the healthcare team to adjust treatment as needed (Huang et al., 2012).
  5. Sensory Deficits: Impaired vision or hearing can make it difficult for clients to detect hazards in their environment, increasing the risk of injury. The nurse should assess for sensory deficits and ensure that the environment is safe and accessible (Crews & Campbell, 2004).
  6. Environmental Hazards: The hospital environment itself can pose risks, such as slippery floors, poorly lit areas, or cluttered spaces, which may lead to accidents. Nurses should conduct regular environmental assessments and advocate for necessary changes to enhance safety (Oliver, Healey, & Haines, 2010).

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What Problem-Solving Strategies Should the Charge Nurse Use When a Client’s Wife is Angry About Her Husband’s Care?

When a client’s wife expresses anger about her husband’s care, the charge nurse should use the following problem-solving strategies:

  1. Active Listening: The charge nurse should listen attentively to the wife’s concerns without interrupting. Active listening is crucial in validating her feelings and showing that her concerns are being taken seriously (Rogers & Farson, 2015).
  2. Empathy and Acknowledgment: Acknowledge the wife’s emotions and express empathy for her situation. Empathy can help de-escalate the situation and build rapport, making it easier to address the underlying issues (Goleman, 1998).
  3. Gathering Information: The charge nurse should gather more details about the specific issues the wife is concerned about. Asking open-ended questions can help understand the underlying problems and the context of her concerns (Davis & Shriberg, 1988).
  4. Assessing the Situation: After gathering information, the charge nurse should assess the situation to determine if the concerns are valid and if any lapses in care have occurred. This assessment may involve reviewing the client’s chart, speaking with the care team, and observing the care being provided (Croskerry, 2002).
  5. Problem-Solving: Work collaboratively with the wife and the healthcare team to develop a plan to address her concerns. This may involve adjusting the care plan, improving communication, or involving additional resources, such as a patient advocate or social worker (Hammond et al., 2007).
  6. Follow-Up: Ensure that the wife is kept informed about the steps being taken to address her concerns and schedule a follow-up discussion to ensure she is satisfied with the resolution. Continuous communication is key to maintaining trust and preventing future issues (Harrison, 2015).

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References

Ambrose, A. F., Paul, G., & Hausdorff, J. M. (2013). Risk factors for falls among older adults: A review of the literature. Maturitas, 75(1), 51-61. https://doi.org/10.1016/j.maturitas.2013.02.009

Centers for Disease Control and Prevention. (2021). Respiratory Syncytial Virus Infection (RSV). Retrieved from https://www.cdc.gov/rsv/index.html

Crews, J. E., & Campbell, V. A. (2004). Vision impairment and hearing loss among community-dwelling older Americans: Implications for health and functioning. American Journal of Public Health, 94(5), 823-829. https://doi.org/10.2105/AJPH.94.5.823

Croskerry, P. (2002). Achieving quality in clinical decision making: Cognitive strategies and detection of bias. Academic Emergency Medicine, 9(11), 1184-1204. https://doi.org/10.1197/aemj.9.11.1184

Davis, S. H., & Shriberg, D. (1988). Conflict resolution: A foundation for student learning. NASSP Bulletin, 72(509), 86-91. https://doi.org/10.1177/019263658807250915

de Vries, N. M., Staal, J. B., van Ravensberg, C. D., Hobbelen, J. S., Olde Rikkert, M. G., & Nijhuis-van der Sanden, M. W. (2010). Outcome instruments to measure frailty: A systematic review. Ageing Research Reviews, 10(1), 104-114. https://doi.org/10.1016/j.arr.2010.09.001

Fields, N. L., Anderson, K. A., & Dabelko-Schoeny, H. (2018). The effectiveness of adult day services for older adults: A review of the literature from 2000 to 2011. Journal of Applied Gerontology, 33(2), 130-163. https://doi.org/10.1177/0733464812443308

Gillespie, U., Mörlin, C., Hammarlund-Udenaes, M., & Hedström, M. (2012). Medication reviews to prevent adverse drug reactions in hospitalized older adults: A randomized controlled trial. International Journal of Clinical Pharmacy, 34(6), 823-832. https://doi.org/10.1007/s11096-012-9699-8

Goleman, D. (1998). Working with emotional intelligence. Bantam Books.

Hall, C. B., Weinberg, G. A., & Iwane, M. K. (2009). The burden of respiratory syncytial virus infection in young children. The New England Journal of Medicine, 360(6), 588-598. https://doi.org/10.1056/NEJMoa0804877

Hammond, K. R., Hamm, R. M., Grassia, J., & Pearson, T. (2007). Direct comparison of the efficacy of intuitive and analytical cognition in expert judgment. Center for Research on Judgment and Policy, University of Colorado. https://www.jstor.org/stable/42862883

Harris-Kojetin, L., Sengupta, M., Park-Lee, E., & Valverde, R. (2019). Long-term care services in the United States: 2013 overview. Vital and Health Statistics, 3(37), 1-130. National Center for Health Statistics. https://www.cdc.gov/nchs/data/series/sr_03/sr03_037.pdf

Harrison, R. (2015). The patient feedback imperative: Helping healthcare providers improve. Patient Experience Journal, 2(2), 96-103. https://pxjournal.org/journal/vol2/iss2/15/

Huang, A. R., Mallet, L., Rochefort, C. M., Eguale, T., Buckeridge, D. L., & Tamblyn, R. (2012). Medication-related falls in the elderly: Causative factors and preventive strategies. Drugs & Aging, 29(5), 359-376. https://doi.org/10.2165/11599460-000000000-00000

Inouye, S. K., Westendorp, R. G., & Saczynski, J. S. (2014). Delirium in elderly people. The Lancet, 383(9920), 911-922. https://doi.org/10.1016/S0140-6736(13)60688-1

Lynott, J., & Figueiredo, C. (2011). How the travel patterns of older adults are changing: Highlights from the 2009 National Household Travel Survey. AARP Public Policy Institute. https://www.aarp.org/research/topics/community/info-2011/us-travel-patterns-older-adults.html

Oliver, D., Healey, F., & Haines, T. P. (2010). Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine, 26(4), 645-692. https://doi.org/10.1016/j.cger.2010.06.005

Rogers, C., & Farson, R. (2015). Active listening. In Littlejohn, S. W., & Foss, K. A. (Eds.), Encyclopedia of communication theory. SAGE Publications, Inc. https://doi.org/10.4135/9781412959384.n6

Thomas, K. S., & Mor, V. (2013). The relationship between older Americans Act Title III state expenditures and prevalence of low-care nursing home residents. Health Services Research, 48(3), 1215-1226. https://doi.org/10.1111/1475-6773.12015

World Health Organization. (2020). Infection prevention and control during health care when coronavirus disease (COVID-19) is suspected or confirmed. Interim guidance. Retrieved from https://www.who.int/publications-detail/ipc-during-health-care-when-covid-19-is-suspected-or-confirmed