The community health RN is caring for a family with a child who has significant

Question

The community health RN is caring for a family with a child who has significant developmental delays. The child is 9-years-old and exhibits the development of a 6-month old infant. She can move her extremities spontaneously, hold her head up and cry out occasionally. She has a gastrostomy tube for her medications and she receives continuous tube feeding via pump. She was discharged 2 days ago after a 5-day hospitalization for failure to thrive. During the hospital stay, the child’s tube feeding formula was adjusted to meet her growing needs. The community health RN is monitoring the child after discharge, following up on the child’s weight and the parent’s knowledge of the new feeding formula type, amount, and schedule. Today the child weighs 50 pounds. The child’s current weight represents a 2-pound weight gain since hospital admission.

The RN has chosen the NANDA-I nursing diagnosis of Ineffective health management r/t insufficient knowledge of expected growth and calorie requirements AEB parent states, “I thought the same tube feeding would be enough calories for a long time, I don’t know how to tell if the feeding should be adjusted.”

Initial Discussion Post:

Create a documentation entry to record this patient’s current health status. You may choose any of the following formats: narrative notes, PIE, SOAP, SOAPIE, SOAPIER, Focus Charting, or FACT system

Describe how an electronic health record (EHR) would be of benefit for the specific health care needs of this patient

Base your initial post on your readings and research of this topic. Your initial post must contain a minimum of 250 words. References, citations, and repeating the question do not count towards the 250 word minimum.

Explanation / Answer

Situation: AEB parent and her view on feeding tube and also concerned that the child may fall out of the bed, while parent is asleep or when parent has to step away from the bed.

A – The patient’s mother not aware about the feeding tube adjustment as per the age and did not regard to change it as it would not make difference as per age. Patient’s age a concern. Child cries when mom has to leave for any period of time.

P – Review with mother about the regulations and changes / adjustments required for feeding tube age wise, appropriate for the child and also the nutrition that changes as per age. The nutritional requirements discussed and emphasized about weight changes post admission. Review with mom safe sleep guidelines, rationale and recommendations. A safety check has been performed, the documentation of the monitor control number and valuation of appropriate alarm bounds. The accuracy of all assessment/entries comprised on the flow sheet at that time and Vital signs should be plotted on the graph if they are assessed and charted every 4 hours or more often. Graph the vital signs using the graph legend symbols and assessment legend.

I - Discussed safe sleep rules for in hospital care. Articulated concerns to parents related to kid’s safety, for example if mother wants to leave bed during the night. Mother states she will continue to sleep with the child. Safety report completed. Responsible physician notified. Team will speak to parents in the morning and discuss acceptable strategies to keep child safe.

E – Patient now feeling much better after feeding tube change and happy with parent’s cooperation for understanding in nutritional needs also patient remained safe overnight.

Benefits of EHR:

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