The Nursing Process: Care of a 3 year old Patient with Bilateral Pneumonia

The Nursing Process: Care of a 3 year old Patient with Bilateral Pneumonia
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The Nursing Process: Care of a 3 year old Patient with Bilateral Pneumonia
Assessment
Data collection
Description of the child and family
The patient, MR, is a three year old female born on January 11, 2009. She was admitted to Akron Children`s Hospital on February 2, 2012 complaining of a running nose, cough, decreased appetite and fever for a week accompanied by three episodes of vomiting. A diagnosis of bilateral Pneumonia was made. MR has a seven year old sister and a five year old sister. She resides in Akron, Ohio, at her parent`s home. She lives with her parents who have been married for the last nine years. The patient`s family smokes, though not in the house. She is insured by Medical Mutual of Ohio through her parents. She has had one previous admission at the age of three weeks when she was treated for meningitis.
Developmental assessment
The patient is 95 cm (37.4 inches) tall. This puts her at the 58th percentile for height. The child weighed 14kgs (30.865) pounds, which puts her at the 52th percentile for weight. Body mass index (BMI), though not a useful measure in children is calculated using the formulae: weight in kilograms divided by height in meters squared (Ball, Bindler, & Cowen, 2010). She has a BMI of 15.5, which is the 45th BMI percentile. This means that if we took a hundred children of MR`s age and sex and ranked them her BMI would be 45th. According to Ball et al. (2010), MR is healthy. She is neither overweight nor underweight. Her weight and height are appropriate for her age and sex. The age of 3 to 6 years coincides to the Phallic stage of psychosexual development, as proposed by Sigmoid Freud and at this stage reproductive organs become very important to the child. Despite her illness, she was noted to be fascinated with her genitals, just as is expected at her age. Her language is totally normal, nothing out of what is expected of a three year old. She could speak in three to five word sentences. She was up and about, quite active sometimes. The mother reports that prior to her illness she was always exploring her environment, sometimes climbing on things. She was able to draw simple shapes and was quite good at following commands. Her mother reports that she was sleeping for 10 to 12 hours at night. I find her social, emotional, gross motor, fine motor and cognitive development in order.
Nutritional assessment
For a child to grow well, his or her nutritional needs must be well taken care of. Prior to her malady MR was a healthy child with a good nutritional status. However, upon getting sick things took a negative turn with her reduced appetite being compounded upon by episodes of vomiting (McIntosh, 2002). She was however still in fair nutritional status, as none of her metric values are outside the normal range.
Pathophysiology
Pneumonia is an infectious/inflammatory...