Case NUR 275 Final Nutrition Remediation- Mercy College of Health Science Case 2: Infection and Liver Impairment Joylie Herd Age 3 Jouylie Herd is a 3-year-old born to a drug addicted mother. At birth, she contracted Hepatitis B from her mother who unknow

Case NUR 275 Final Nutrition Remediation- Mercy College of Health Science Case 2: Infection and Liver Impairment Joylie Herd Age 3 Jouylie Herd is a 3-year-old born to a drug addicted mother. At birth, she contracted Hepatitis B from her mother who unknow Case 2: Infection and Liver Impairment Joylie Herd Age 3 Jouylie Herd is a 3-year-old born to a drug addicted mother. At birth, she contracted Hepatitis B from her mother who unknowingly had the virus. Joylie has lacked preventative healthcare, including routine immunizations. She attends an unlicensed daycare while her mother, Jill, a single parent works at the local supermarket as a cashier. The daycare recently had an outbreak of Hepatitis A and is under investigation. Jill has been clean and sober for six months. Jill is proud if her sobriety and the fact that she and Joylie now live in an apartment rather than the shelter. Joylie is brought into the clinic by her mother for flu-like symptoms including poor appetitis and a ‘tummy ache.’ She’s been running a low-grade temperature. Jill says, “she hasn’t been her usual active self and is napping a lot.” Please answer the following questions- you may highlight or change the color of the font or bold the answer. 1. The nurse begins the assessment. What subjective information should the nurse ask Jill about Joylie? Select all that apply. Health history Length and severity of current symptoms Interactions with her father, Interactions with her father Normal dietary intake Immunization record 2. What priority safety information should the nurse collect? Blood pressure Focused abdominal assessment Mother-daughter interactions Cleanliness of the child 3. Upon physical assessment, the nurse palpates an enlarged liver. What hypothesis can the nurse make from this finding? This is a normal finding in a 3-year-old This is a normal finding in a 3- year-old Joylie will likely have a clotting disorder The finding is abnormal and requires additional testing 4. Because of the enlarged liver, the health care provider orders some additional tests. Which serum labs should the nurse anticipate? Select all that apply. AST, ALT, GGT. Complete blood cell counts Metabolic panel Arterial blood gasses Amylase and lipase 5. After evaluating the lab report, the nurse performs a more thorough assessment. What additional findings should be anticipated? A high temperature Dark pink mucous membranes Jaundice of the sclera. A lack of edema 6. NurseThink® Prioritization Power! Reflect on Joylie’s assessment findings and identify the Top 3 Priority concerns. a. Infection related to temperature b. Abdominal discomfort related to liver enlargement c. Poor health maintenance related to hepatitis B 7. Joylie is admitted to the pediatric unit for additional tests. The nurse working that day is precepting a newly graduated licensed practical nurse (LPN) and an experienced unlicensed assistive personnel (UAP). For each of the admission tasks on the left, determine the most appropriate delegation for each skill. RN LPN UAP or None a. Gather thermometer and blood pressure equipment- UAP b. Start an IV- RN c. Request toddler pull-up diapers from central supply- UAP d. Obtain health history from the parent-RN e. Perform a head-to-toe assessment- RN f. Obtain a pull-out bed for the parent- U