NCS 3101 Child And Adolescent Health


Sarah is a 12-year-old girl who has been transferred via Royal Flying Doctor Service [RFDS] to the hospital from a remote community, as a newly diagnosed type one diabetic [T1DM]. This follows a history of ill health, including abdominal pain, hyperglycaemia and a current presentation of mild ketoacidosis. Sarah and her mother have just arrived on the ward and the nursing team you are working with has been allocated Sarah to their patient load. You are responsible for completing admission details commencing initial nursing assessments when admitting Sarah to the ward. Sarah’s initial admission observations are T- 37.8 oC, HR – 104, RR – 30,  BP 90/55, weight 33.5 Kgs, height 135cms. Her current BSL = 16.1 mmols. Sarah has an intravenous cannula insitu with NaCl currently at maintenance rate, which is causing her distress. Sarah’s mother is understandably anxious and confides that Sarah is very scared of needles. Identify your initial nursing actions and considerations as Sarah arrives on the ward and for the next 24hrs. The medical team quickly stabilises Sarah’s blood glucose levels in response to a prescribed insulin regime, in the following days your nursing focus is to facilitate and educate Sarah and her mother on regular blood glucose testing, administering insulin, nutritional information and developing a C&FCC detailed and personalised maintenance plan for continued health in line with Sarah’s anticipated remote lifestyle following discharge.

  • Students are required to research and write a nursing case study essay with headings, directly relating to the above scenario parts A and B. Examine and discuss your initial relevant nursing assessments and management, subsequent health education planning and implementation, and, discuss all relevant general nursing care incorporating a C&FCC approach. Identify what nursing interventions you will consider and any referrals you will put into place during Sarah’s stay on the ward.
  • Discuss specialised members of the multidisciplinary team, and which particular members that would be involved in Sarah’s management of care, including what services that they will provide in the given scenario.
  • Referring to the C&FCC framework, develop a care plan incorporating a diabetes education plan for Sarah and her family that includes short and long term goals including discharge planning and followup services. Supportive rationale for your management is required. The care plan is not to be submitted but your planning, rationale for the plan and anticipated outcomes are to be discussed.
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