NR 602 Week 4 Clinical Pearl Case Study

Running head: CASE STUDY ASSIGNMENT 1 Week 4 Clinical Pearl Case Study Chamberlain College of Nursing NR 602: Primary Care of the Childbearing and Childrearing Family Week 4 Clinical Peal Case Study Clinical Pearl Issue: Safety Category Safety Issue-Pertinent negative Mother stated: “Sometimes I forget where I put my cigarettes. One time he grabbed a cigarette and he started chewing on it.” -Child is observed playing with parents anxiety tablets and mother states child always throws out her pills. -Mother is observed leaving child unattended watching her phone while child is propped up on table. Pertinent Positive Mother has poison control number available. Mother doesn’t smoke in child’s bedroom. Mother observed child around bodies of water. Mother has safety gates in place prior to stairs or dangerous places. Mother keeps all household cleaning products, poisons away from child’s reach. Mother keeps heat sources away from child. Mother knows steps to take during an episode of choking. Mother is CPR trained. Guidelines or Recommendations When there are small children in the home, adults should take care to place items in cupboards that are locked or beyond the reach of their kids. When using items, parents should close them and put them where they belong immediately after use. Examples of poisonous things found in the home include, but are not limited to, cleaning products, medications, perfumes, laundry detergents, plants, alcohol, cigarettes, and craft supplies. Also, parents will need to keep the number for poison emergencies by their phones in the event of a potential incident. This number is and calling this number will transfer the caller to the nearest poison control center. Reference: American Academy of Pediatrics (2020). Pediatric Health and Safety Guidelines. Retrieved from: and-policy/aap-health-initiatives/healthy- child-care/Pages/Safety-and-Injury- P Professional/Ethical Communication by Nurse Practitioner to Parent I see that you are CPR trained, and also that you have several measures in place for the safety of your child. For his age, it is important to ensure that medications and harmful objects such as cigarettes are kept either on elevated surfaces or away from the child’s reach. This will prevent any risk of injury to the child. I also see that you have the Poison control hotline number readily available. This is a wonderful tool to have should your child get into any substance or medication which could be harmful. Lastly, it is a great idea to provide direct supervision when children are propped in high surfaces to avoid any falls. Avoiding distractions with calls or phones will also ensure that the child is well observed. Should you have an urgent call or activity to perform- placing the child on the floor would be a great way to avoid any falls. Clinical Pearl Issue: Sleep Routines Category Sleep Routines Issue-Pertinent negative Mother stated: “Sometimes he sleeps for 10 hours, and I have to get him up. I have to push and push and get him up and it’s rough. Sometimes I can’t get him to sleep so if he could get some Xanax or some Benadryl or something to put him to sleep that would be great. Mother stated: “Yeah, he watches TV every night- that’s how he goes to sleep.” Pertinent Positive Child is able to sleep in the evenings most evenings. Child also has a bedtime routine. Guidelines or Recommendations Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. In addition to these recommendations, the AAP suggests that all screens be turned off 30 minutes before bedtime and that TV, computers and other screens not be allowed in children's bedrooms. Reference: American Academy of Sleep Medicine (6/13/2016). “Recommended Amount of Sleep for Pediatric Populations. Retrieved from: Professional/Ethical Communication by Nurse Practitioner to Parent It is great to have a bedtime routine. I see that your child enjoys stories, therefore reading to your child instead of allowing him to watch television will create a stable routine in which he is able to sleep about 11.5 hours in the evenings. It is also recommended that children this age take about 2 naps during the day for a total of 14 hours of sleep out of a 24hr day. Children this age should limit screen time during the evening hours at least 1 hour prior to bedtime to reduce the brains blue light sensory input and would benefit from a structured bedtime routine. Reading will also increase the bond between you and your child. Clinical Pearl Issue: Car Seat Safety Category Car Seat Safety Issue-Pertinent negative Mother Stated: She was recently in a car accident. Mother stated: “No he faces forward, just like everybody else in the car. When I turn around, when I’m driving, I need to be able to see him.” Pertinent Positive Mother uses a car seat at this time. Guidelines or Recommendations Infants and toddlers should ride in a rear- facing car seat (infant-only rear-facing car seat or rear-facing convertible car seat) until they are 2 years old or until they have reached the weight and height limits of their car seat. Once they are 2 years old (or, regardless of age, have outgrown their rear-facing car seat) toddlers should sit in a forward- facing car seat with harness straps as long as possible and until they reach the weight and height limits of their car seat. Reference: American Academy of Pediatrics (2020). Car Seat Guidelines. Retrieved from: Professional/Ethical Communication by Nurse Practitioner to Parent It is great that you are able to provide a car seat for your child. It would be best to change the direction of the car seat to back facing at this time or until he is either at the weight or height restriction to be forward facing. Doing this will decrease any chances of severe injury from a car accident. Good options for observation would be to place a mirror or small camera to view the child directly. There are some with very fun features the child may find interesting to view as well. Clinical Pearl Issue: Healthy Teeth Category Healthy Teeth Issue-Pertinent negative Mother Stated: “I brush it in the morning and at night with tap water” -Child is observed to have a bottle with sugary drink. Pertinent Positive Mother has a routine for brushing. Guidelines or Recommendations Clean or brush a young child’s teeth twice daily. Establish care with a pediatric dentist to ensure fluoride and routine cleaning is provided. Ensure to avoid sugary drinks during bedtime or naptime. Reference: American Academy of Pediatrics (2020). A Pediatric Guide to Children’s Oral Health. Retrieved from: Professional/Ethical Communication by Nurse Practitioner to Parent Having a routine for brushing is essential- great job on establishing a morning and evening routine. I would recommend including a fluoride toothpaste to brush gently all around your child’s teeth. In addition, establishing care with a Pediatric dentist is a great tool to keep your little ones teeth healthy and cavity free. Lastly, reducing sugary drinks and providing more water will help decrease tooth decay in the long run. Clinical Pearl Issue: Temper Tantrums and Discipline Category Temper Tantrums and Discipline Issue-Pertinent negative Mother stated: I tell him no all the time. Like no, no, don’t touch that, but he still touches things. -Mother is observed screaming at child to discipline. Pertinent Positive Mother does not use physical force with the child. Guidelines or Recommendations Guidelines from the AAP recommend: positive discipline strategies that effectively teach children to manage their behavior and keep them from harm while promoting healthy development. Reference: American Academy of Pediatrics (2018). Effective Discipline to Raise Healthy Children. Retrieved from: Professional/Ethical Communication by Nurse Practitioner to Parent Discipline can be difficult with a young child, however- great job avoiding the use of force, or physical punishments. Although children this age may require repetitive discipline, using routines that are predictable and easy to understand for the child will ensure compliance. Lastly, at times, a good technique is to remove the child from a high sensory event to decrease their tantrums or disciplinary issues. References American Academy of Pediatrics (2020). A Pediatric Guide to Children’s Oral Health. Retrieved from: American Academy of Pediatrics (2018). Effective Discipline to Raise Healthy Children. Retrieved from: American Academy of Pediatrics (2020). Car Seat Guidelines. Retrieved from: American Academy of Pediatrics (2020). Pediatric Health and Safety Guidelines. Retrieved from: American Academy of Sleep Medicine (6/13/2016). “Recommended Amount of Sleep for Pediatric Populations. Retrieved from: