1
Elizabeth Chance ED.D, MSN, RN
Michelle Malloy BSN, RN
Gail McIlvain-Simpson, MSN, PNP-BC
A.I. DUPONT HOSPITAL FOR
CHILDREN CLINICAL
ORIENTATION
2
Instructors for Childbearing
3E and 3F
A.I.duPont Hospital for Children
 Elizabeth Chance, W: (302) 292-3882, C: (302) 690-
5374,
E-mail: echance1@dtcc.edu
 Michelle Maloy, H: (302) 395-2922, C: (302) 379-3478.
E-mail:mmaloy1@dtcc.edu
 Gail McIlvain-Simpson, W: (302) 453-3040; C: (302)
690- 2744 E-mail: gsimpso7@dtcc.edu Pager #: 2476357
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What type of reaction do you have when you
think of your pediatric rotation here?
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General Information (pg.1)
Clinical Hours: You need to be on time to receive clinical assignment
Monday, 0630-1300 or Monday, 1400-2030
Tuesday, 0630-1400 or Tuesday, 1400-2130
Uniform:
Student Uniform with Delaware Tech Picture ID and patch.
Bring stethoscope, black ink pen, pen light, highlighter, scissors and clinical notebook.
Lunch:
Meals are available in the employee cafeteria. You must have a student ID to get a
discount.
You may bring a snack or lunch with you.
Storage:
Limited space. Leave valuables at home.
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Clinical Absence
Call clinical instructor at home by 0530 (AM
clinical) or 1230 pm (PM clinical) if you are
going to be late or absent.
If you are in the community the day you are absent
or late, call the community instructor by 0700.
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HIPAA
Written
Verbal
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Safety Guidelines for Hospitalized Children
( pg. 17)
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Make sure the child has an ID band and security alarm on wrist or ankle ( at beginning of shift).
Keep the environment safe by keeping:
 Keep side rails up at all times
 Beds of ambulatory children locked in place and at the lowest possible height.
 The room neat, clean and organized.
 Keep bedside table away from crib/bed.
 Floor clear of fluids or objects that could contribute to a fall.
Directly supervise infant and preschool children when OOB. & older children if needed
Check all children at least every hour.
Check bath water carefully before placing a child in a bath.
Strap infants and small children into infant seats, feeding chairs and stroller securely.
Do not leave infants or children unattended in treatment rooms or on scales.
Assess toys brought to the hospital by parents or visitors for:
 Appropriateness for age and condition.
 Washable and unbreakable.
 Absence of small, removable parts that can be aspirated or swallowed.
Set limits for the child’s safety:
 Make sure the child understands where he/she is permitted to go and what he/she is
permitted to do in the hospital.
Enforce limitations consistently
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Cribs come in all shapes and sizes
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Identification Bands
(pg.4)
 It is your responsibility to check that the child
has an ID band.
 Each child will have both an ID band and an
electronic alarm.
 If “Tag Alert” is announced make sure you
check on your patient.
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What is your scope of practice
for Pediatric Clinical?
What you can do
What you cannot do
 Bath
 Intravenous therapy
 Linen changes
 TPN (Total parenteral nutrition)
 Assessments
 Document in EPIC
 Vital signs
 Weights, heights, head
circumference
 Intake and output
measurements
 Developmental stimulation
 Required nursing skills with
instructor (i.e. medications)
 Point of care testing: blood
sugars, N-G ph testing, guiac
 Respiratory medications
 Intravenous medications
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Required Nursing Skills
Instructor needed (pg.5)
1. Procedures related to alternative feeding techniques: (Wong’s Textbook: p. 745-750).
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Gavage feeding: NG, NJ, ND
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Gastrostomy feeding
Students should be ready to perform tube feedings and should be prepared on how to use the “flexiflow feeding pump” equipment.
(Pump available in the lab).
2. Pediatric Administration of Medications: (Wong’s Textbook: p. 717-732). All medications, even topical
a. Generic and trade name.
b. Classification
c. Mechanism of Action
d. Dosage: compare to calculation of min/max per dose
e. Side effects and possible adverse reactions
f. Nursing Considerations
3. Dressing Changes: (Wong’s Textbook: p. 1065-1069; 750-751).
Dry dressings
Wet compresses or dressings
Soaks
Baths
Ostomies
Catheterization, suctioning, and enemas: (Wong’s Textbook: p. 713-714; 741-745; 750).
*Reminder: Any omission of the required nursing skills or procedures may be reflected on a Clinical Advisement Form.
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Are you ready for the day?
 Clinical notebook (reference items)
 Stethoscope, penlight, scissors black ink pen,
highlighter ( Watch with second hand)
 DTCC ID
 Know area where you are to park
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A. I. DuPont Parking (pg. 2)
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Active Orders and MAR (pg.4)
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Your instructor will print a copy of the active orders and MAR for your
child; you should use the information to organize your care.
 When you arrive on the unit, obtain your assignment from the instructor.
 Review any information needed to provide morning/evening patient
nursing care. What questions do you have for the nurse giving you
report?
 Introduce yourself to nurse. Get report from staff nurse.
 Most importantly, communicate how long you will be on the unit
and the care you will be providing for patient and family
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After receiving your assignment, you may start your nursing care.
Provide verbal report to staff nurse before leaving the unit.
All active orders and MAR regarding your child must be returned to the
instructor before you leave the unit for the day (HIPPA).
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We are guests
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Vital signs
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(pg.3)
You are responsible for the vital signs including the pain scale ordered
between and including 0800 to 1200 and 1600 to 2000 (Pain scale hourly).
Obtain the pulse by the apical route if the child is 3 years of age or younger.
Obtain a BP on each child using the space lab.
Vital sign frequency is found on the active orders.
Check previous vital signs to obtain a baseline before doing your
assessment.
Report vital signs to instructor and staff nurse.
Report the route used for obtaining the temperature (temporal, axillary,
oral).
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Weights and Heights (pg.3)
 Weights are obtained weekly for the child less
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than 12 months unless otherwise specified in
active orders.
Check the active orders to review the prior weight
for comparison.
Weigh the child in the morning before breakfast.
Child must be weighed without clothing and
diaper.
Make sure to use scale assign to the child’s room.
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Feedings
(pg.3)
•Verify the type and amount
of feeding on active orders.
•Have all feeding equipment
ready (bottles, nipple,
formula, tube feedings).
•You may have to order
breakfast, lunch, or dinner
for your child (meals do not
automatically come up).
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Flexiflow Quantum
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Intake and Output (pg.3)
•Every child is on intake and output.
•Document the intake and output on the
Childbearing Database, report to clinical instructor &
staff nurse.
•Intake – be specific when charting the amount in
metric system.
•Output – If the child is not potty trained, weigh the
diapers to obtain the correct amount of urine and/or
stool.
•To measure outputs in older children utilize
commode, hat, or urinal (if child is older or
ambulatory explain to child & parents that you are
keeping I&O)
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Medications
(pg.4)
 You will administer medications at the Nemours Hospital with your
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instructor’s supervision and guidance.
You will be responsible for the theory related to the medications on
both weeks that you are at Nemours Hospital.
You will be responsible for administration of any medication (po, IM,
sq, rectal, ophthalmic, otic or topical ) ordered between and including
the hours of 0800 to 1200 (inclusive of medication at this time).
Section 593 students are responsible for medication administration
between the hours of 1600-2000 (inclusive of medication at this time).
You are responsible for knowledge related to IV, inhaler and
nebulizer medications but will not be administering the
medications.
Refer to the Pediatric Medication Administration Guidelines for
further information.
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General Guidelines (pg.6)
Prior to preparation of medication, verify the medication in the patient’s orders.
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Assess for client allergies.
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All administration of medications will include the 3 checks for correct medication
including the expiration date. Know child’s weight and any allergies.
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Follow the 7 rights – medication, dose, route, patient, time, and right to know and
right to refuse.
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Be prepared to discuss medication knowledge (will discuss next).
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Do not leave any medication unattended.
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When you are ready to give a medication, let the instructor know.
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The instructor will be present for preparation and administration of any
medication.
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Scan the patient’s ID band prior to administration of any medication. Scan every
medication before given. You must do this each and every time you give the
medication.
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The instructor will document the medication administration on the computer.
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Pediatric Medication Knowledge (pg.6)
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Generic and trade name.
Classification
Mechanism of Action
Dosage – compare to calculation of min/max per dose
Side effects and possible adverse reactions
Nursing considerations including necessary assessment before/after giving the
medication.
Patient education/preparation
Have pertinent Lab data and assessment available (electrolytes, PTT, BP, HR, etc.)
The information must be readily available prior to the instructor’s presence (written in
your care plan, on individual cards, or on notepaper.
Note: An omission at any step in the procedure may be reflected on a Clinical
Advisement Form.
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Nurses Notes (pg.3)
 Should include an assessment pertaining to
your child’s condition – If child admitted for
fever state whether there is a fever and give
details (Tylenol administration & response)
 Do not include statements such as : AM care
performed or bath given, vital signs given
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Parent Visitation
 Any responsible adult may stay with the child
24 hours a day.
 Family Contact by phone or visit should be
reported to nursing staff.
 Family Resource Center
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Break/Lunch (pg.4)
 A lunch/dinner break will be provided.
 You may take a mid-morning or mid-afternoon
break if needed. The timing of the break
should be based upon your child’s needs and
the nursing care needed.
 Let the staff nurse and the instructor know
when you are going to leave the unit.
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Downtime
 Make sure you have collected essential information
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needed for Databases and Concept Maps
Are there other services you can provide to your
child and their family?
Can you assist fellow students with their
assignments? Every student needs to complete
work before we can leave
Is there anything you can do to help the unit?
Explore resources
Are there other learning opportunities?
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How to Get and Give Report
 Getting report – Ask specific questions in regards to your
individual patient (what do you need to know to
effectively care for that patient during your clinical time
on the unit.)
 Giving report – Be succinct & organized
Demographics, assessments (VS, I&O, pain scales,
weight, ht, head circumference), tests, alerts, status.
Consultations, visitors.
You must give report before leaving unit!!
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Postconference Topics
 Concept Maps (Nursing Diagnoses)
 Community experiences
 Growth & Development
 Articles & Rubric
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Resources (Personnel)
 Advanced Practice Nurses
 Specialty nurses
 Social Work
 Child Life
 Library
 Pharmacist
 Ward/unit clerk
 ETC…………
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Resources
Non-personnel
 Lexi Comp – pharmacy issues
 Info Link – evidence based medicine
 KIDSHEALTH.org – child/family information
 Library
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Policies and Procedures
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Procedure Room
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Development, Dissemination and
Enculturation
The Magnet Model
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Exemplary Professional
Practice
Successes:
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Shared Governance Congress and
Councils
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Nursing Advancement Program
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AtStaff scheduling system, unit based
scheduling committees, unit based
staffing guidelines
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SWAT nurses, Clinical Informatics Nurses
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EMR documentation
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Reward programs: Nurses Week,
Magnet Awards, DAISY Awards, Service
Awards, Nursing Spectrum and
Delaware State Nursing Practice awards
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Comprehensive quality data
disseminated to Quality Council unit
representatives and Nursing Leadership
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Announcements
 Code Blue
 Code Red
 Tag alert
 Delta alert
 Trauma alert
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Assignments
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Assignment for Clinical Weeks
at Nemours Hospital
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You are required to complete and submit the Childrearing Database and Concept
Map every week while in the hospital setting.
On a full clinical week (Mon & Tues) completed database and concept maps
are due on TUESDAY at post conference. Be prepared to discuss the
information at post-conference.
On a split clinical week (orientation and/or community day) completed
database and concept maps are due on WEDNESDAY by 1600.
On a split clinical week, section 593 students submit database and concept
maps also on WEDNESDAY by 1600 to full time faculty Gail McIlvain-Simpson’s
mailbox.
Section 501 and 592 students complete the weekly self-evaluation found under
the “Assignment Tab” on blackboard by 1000 Wednesday and 593 students by
1400 on Wednesday.
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Directions: The student is responsible to complete the clinical self-evaluation assignment on
Blackboard each week by 10AM, Wednesday.
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Student
Clinical Week
Date
Client
Diagnosis
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I was able to address the following client problems: HOW?
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I provided the following basic care, skills and procedures: Did you have any difficulty?
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I administered medications by the following routes: What medications & what route – any
difficulties?
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My clinical performance was strongest in the following areas:
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If I could repeat this clinical week, I would do the following things differently:
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I feel that I could improve in the following areas:
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My plans for improvement in these areas include the following actions:
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Please be as detailed as possible – this information is to be utilized on your
evaluation.
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Assignment for Community Week
(pg.7)
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Obtain a pediatric nursing evidence-based research article from a valid and
reliable source within the last five years. Article must be on anything related to
the pediatric population (i.e. any disease entity or lecture material covered in
class). Use library Database – see instructions on Blackboard
The article should not be a letter to the editor, news letter, medical
newsletter, case study, or Kidshealth.org.
Highlight the important information and submit to your instructor at postconference.
Evaluate the article using the criteria from the Journal Evaluation rubric included
in clinical notebook.
Write supporting comments and score on the rubric sheet.
Complete the self-evaluation for the community experience found under the
“Assignment Tab” under the “Childrearing Community Assignment” folder on
blackboard.
Section 501 & 592 students complete by 1000 on Wednesday and 593 students
by 1400 on Wednesday.
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Department of Associate Degree of Nursing
NUR 144 (pg.8)
Student Name: _________________________________________
Research Article Rubric
Date: _________________
12/12/07-EC
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Factor
Code/
Description
W1
Content
Relevance
W2
Quality of
Expression
Total
Pts
30
30
W3
References
20
W4
Mechanics
10
W5
Formatting
10
Unacceptable
Article misses
some of the
content specified
by the instructor
and/or the
coverage of the
content is
superficial
(1-23)
Article is unclear
and/or
disorganized;
use of vocabulary
and/or syntax
would be
unacceptable for
professional
publication
(1-23)
References are
not cited and/or
the primary
sources are from
non-peer
reviewed sources
(1-15)
Article has
numerous
typographical,
spelling and/or
punctuation
errors
(1-7)
Article is not
research-base
generated and/or
is in substantial
non-compliance
with APA
guidelines
(1-7)
Acceptable
Target
Article addresses the
content specified by
the researcher
(24-26)
Article fully and
thoroughly addresses
the content specified by
the researcher
(27-30)
Article is clear;
vocabulary and syntax
are sometimes less
formal than expected
for professional
publication
(24-26)
Article has a scholarly
quality, express points
in a clear, logical and
organized manner;
contain vocabulary and
syntax that reflect
standards suitable for
professional
publications
(27-30)
Article has cited
references from
primarily peer reviewed
journals
(18-20)
Article has references
many of which are not
from peer reviewed
journals
(16-17)
Article has few
typographical,
grammatical, spelling
and/or punctuation
errors
(8)
Article is free of
typographical,
grammatical, spelling
and punctuation errors
(9-10)
Article is researchbase generated and is
in substantial
conformance to APA
guidelines; minor
deviations are noted
(8)
Article is research-base
generated and in
conformance to APA
guidelines
(9-10)
Scor
e
Comments
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Childbearing Community
Protocol
You will be in the community for your pediatric clinical experience on
 Monday ______________
 Those of you doing Think First for Kids and Tar Wars will meet at Delaware Tech in room
C214 at 0730 for a pre-conference with your clinical instructor and clinical group (only
those students participating in Think First for Kids& Tar Wars).

In blackboard under the “Course Protocols” tab you will find pertinent information
regarding your assigned community site.
 On the course protocol tab in blackboard, select the “Childrearing Community Protocol”
then click on the “Community Protocol Information” and then on the “Agency Protocols”
where you will find additional objectives that are site specific, agency protocols, and any
specific materials related to your community experience. You are responsible for
reading/viewing this material prior to pre-conference on Monday morning.
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Your clinical instructor will be rotating to all of the community clinical sites.
 However, if you need to communicate with your instructor when she is not on site, you
may call/page her. She will return your call as soon as possible. If you do not hear back
from the instructor within 15 minutes, please call/page her again.
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If you are sick and will be absent on a day of your community health experience,
 Call your clinical instructor to notify her of any absence or lateness by 0700.
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Section 501 and 592 students submit community evaluation found on blackboard by 1000
Wednesday and 593 students by 1400 on Wednesday.
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Clinical Evaluation Form
Student’s Name __
Advisor __ ______
Evaluation - Interim / Final
___
Weeks ______
Total: Absence___ _____ Late_________
To pass this course clinically, the student must meet all clinical objectives.
Specific Clinical Performance Criteria for each clinical objective are listed in the course syllabus.
Clinical Objective
Interim/Final
1. Implement safe nursing care incorporating theoretical knowledge, the nursing process and concepts of
critical thinking for the individual client.
2. Implement therapeutic communication techniques when interacting with the client and members of the
health care team.
3. Implement caring behaviors respecting the diversity of the individual, family and community.
4. Implement the management concepts of organization and collaboration while caring for the individual client.
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Implement safe nursing care incorporating
theoretical knowledge, the nursing process
and concepts of critical thinking for the
individual client.
NANDA
Database
Concept
Map
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Implement communication techniques when
interacting with the client and members of the
health care team.
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Implement caring behaviors acknowledging the
diversity of the individual client.
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Identify available resources
Demonstrate nonjudgmental approach
Tactful & respectful approach
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Implement the management concepts of organization and
collaboration while caring for the individual
client.
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Incorporate knowledge of ethical and legal standards of
nursing practice when caring for the individual client.
d. Follow course protocol for reporting absences and
lateness.
f. Submit written materials on time.
 Professionalism
 Being prepared for clinical
 Submitting assignments on time
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Incorporate knowledge of ethical and legal standards of
nursing practice when caring for the individual client.
d. Follow course protocol for reporting absences and
lateness.
f. Submit written materials on time.
 Professionalism
 Being prepared for clinical
 Submitting assignments on time
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Advisements
 Issues regarding clinical objectives will be
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sited via advisements
For example : Not calling instructor as per
protocol for lateness or absence.
Not submitting required work on time
Inability to perform vital signs
Unprofessional behavior
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
0630-0645– Receive client assignment (pg.12)
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Review active orders, MAR, H&P.
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Note any scheduled procedures for client.
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0645- 0715
Listen to report with staff.
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Introduce self to staff and inform staff nurse of your duties for the day.
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Obtain report from staff.
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Plan and organize your time for the day.
0715-0830-
Obtain vital signs, weight, pulse ox, pain assessment
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Report vital signs to the staff nurse and instructor
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Notify instructor of your child’s medication times by 0745
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Obtain physical assessment
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Assist child with breakfast
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0830-113
Report abnormal findings immediately to instructor and staff.
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Responsible for all patient care including 0800/1200 including VS and assessments.
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Bathe child and change linen. Continue Data collection (assessments) and therapeutic communication.
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Perform ordered procedures and skills under instructor supervision.
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Monitor and report intake and output to instructor/staff
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Responsible for administration of all medications except IV and respiratory medications ordered between 0800 and
1200.
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Assist classmates and/or staff when able.
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Make sure child’s room is clean and orderly
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Obtain noon vital signs
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Prepare child for lunch and assist with lunch as necessary.
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1000-1230-
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Finish care with child and family
Complete assessment
Complete nursing care with instructor’s guidance as necessary
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1400-1445
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-
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-Receive client assignment
Review active orders, MAR, H&P.
-Note any scheduled procedures for client.
1445-1515 -Listen to report with staff
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-Introduce self to staff and inform staff nurse of your duties for the day
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1515-1630,- Obtain vital signs, weight, pulse ox, pain assessment
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-Report vital signs to the staff nurse and instructor.
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-Notify instructor of your child's medication times by 1545
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-Obtain physical assessment
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-Assist child with dinner (1700)
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1630-1730 Report abnormal findings immediately to instructor and staff.
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-Responsible for all patient care including 1600/2000 including VS and assessments.
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-Bathe child and change linen, if not already done for the day
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-Continue data collection (assessments) and therapeutic communication
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-Perform ordered procedures and skills
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-Monitor and report intake and output to instructor/staff
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-Responsible for administration of all medications except IV and
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-Respiratory medications ordered between 1600 and 2000
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-Assist classmates and/or staff when able
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-Make sure child's room is clean and orderly
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1730-1800
Dinner Break
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1800-2000
-Obtain and report 2000 vital signs
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-Finish care with child and family
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-Verbally report off to staff nurse
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-Turn in active orders and MAR to instructor
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Case study for Nurses Note
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Case Study for Nurses Note –
You are assigned to a 4 month old with admitted with pneumonia.
Child has history of Down’s syndrome & bronchopulmonary dysplasia.
On 2 L of oxygen (nasal cannula). Respiratory rate 40-60.
Breath sounds decreased in both lower lobes with scattered rhonchi.
Has a gastrostomy tube. NG feeds received at 11 AM & at 1115 had emesis
Nasal flaring and substernal retractions around 9 AM.
Respiratory rate 60.
PO2 90 at 09, 98 10, 92 @11 . Mid morning a respiratory treatment (nebulizer) performed at
0950.
What might your nurses note look like?
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__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
______________________________________________________________
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Case Study #1 Pain Assessment 5th vital sign
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Patient: 2 year old, white, female
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Admitting Diagnosis: Left Lateral Neck Cellulitis
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Objective Data: VS- 38.2C, 145, 26, 127/72; left lateral neck swelling, erythematous
ulceration
Chief Complaint: “Fever, neck red and swollen”
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(4cm in diameter), warm to touch, small amount of serosanguinous drainage
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noted, pt. holding head towards the right and guarding neck, pt’s mother reports,
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“she’s not herself, usually very playful and talkative”, pt. now fussy, with
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occasional moans, more difficult to console, increased tone in b/l legs, and a
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worried facial expression.
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Subjective Data: Pt. reports, “boo boo” as she points to her left lateral neck.
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Orders: Q4 VS, I & O, IVF’s, IV antibiotics, Regular diet as tolerated, Bid dressing
changes,
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I&D of wound, blood cultures, and patient isolation
Medications: IV Clindamycin, PO Tylenol
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 As a group please answer the following questions:
 What type of pain is the patient experiencing? Chronic or Acute
 List at least 4 questions that should be included in your pain
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
assessment
What tools are available to assist you with your pain assessment?
Which tool would you choose in this scenario? Why?
What pain scale rating would you give the patient?
List 2 possible nursing diagnosis for this patient?
What interventions would be appropriate for this scenario?
What type of precautions should this patient be on? What does that
mean?
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Case Study #2
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Growth Assessment/ Immunizations
Patient: 18 month old, white, male
Chief Complaint: “Refuses to eat anything, only wants his bottles of milk”
Assessment: VS- 36.5C, 125, 28, 90/60; HC-44.8cm, Wt-9.1kg, Ht-74.1cm
skin pale, dry, and scaly; hair dull, dry, and sparse; pale
conjunctivae,
red cracks at sides of mouth, and a pale tongue, delayed in
reaching
milestones, sits without support and crawls some, however, does not walk;
mother reports pt’s intake of milk is 40 or more ounces per day
H/H-7.6/23, albumin-2.9g/dl
Orders: Q4 VS, I & O, daily weights, IVF’s, CBC, glucose, cholesterol, triglycerides,
and serum albumin; Regular diet as tolerated, limit milk intake to 16 ounces per day.
Medications: PO Zantac
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 As a group please answer the following questions:
 What is the patient’s likely diagnosis?
 Please plot patients head circumference on the appropriate
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graph, what percentile is the patient?
Please plot the patient’s height on the appropriate graph,
what percentile is the patient?
Please plot the patient’s weight on the appropriate graph,
what percentile is the patient?
Using the provided immunization chart and blank
immunization record from the childrearing database, please
indicate what immunizations the child should have received
until now, and when the child should have received them
(ages).
List 2 possible nursing diagnosis for this patient?
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Case Study #3
Patient: 8 year old, African American, male
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144- Childrearing
Chief Complaint: “I feel likeNUR
a fish
out ofOrientation
water, I can’t hardly breathe”
Case Study #3
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Nurses Note: Assumed care of pt. at 0700. Pt. receiving continuous Albuterol neb
treatment, tolerating well. Temp. 38.1 PO, Resp. 26-28; O2sats 91%-94% on 7L O2 via
face mask; Moderate substernal retractions noted; no nasal flaring or grunting; b/l
lungs coarse with scattered wheezes on expiration; neuro intact, PERRLA, pt.
appropriate for age; pt. NPO per order, abdomen soft, non distended BS+; IVF via
Left hand, infusing without difficulties, site benign; pt. voiding via bedside commode
without difficulties; pt. mother at bedside active in pt care.
Concept Mapping
Patient: 8 year old, African American, male
Chief Complaint: “I feel like a fish out of water, I can’t hardly breathe”
Nurses Note: Assumed care of pt. at 0700. Pt. receiving continuous Albuterol neb treatment,
tolerating well. Temp. 38.1 PO, Resp. 26-28; O2sats 91%-94% on 7L O2 via face mask;
Moderate substernal retractions noted; no nasal flaring or grunting; b/l lungs coarse with
scattered wheezes on expiration; neuro intact, PERRLA, pt. appropriate for age; pt. NPO per
order, abdomen soft, non distended BS+; IVF via Left hand, infusing without difficulties, site
benign; pt. voiding via bedside commode without difficulties; pt. mother at bedside active in pt
care.
Orders: Q1 hour VS, I &O’s, IVF’s(D5.45NACL @60ml/hr), NPO, Continuous pulse ox
Medications: Continuous Albuterol, Tylenol, IV zofran
As a group please answer the following questions:
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Orders: Q1 hour VS, I &O’s, IVF’s(D5.45NACL @60ml/hr), NPO, Continuous pulse ox
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Medications: Continuous Albuterol, Tylenol, IV zofran
1. What is the likely diagnose in this case study?
2. List 2 possible nursing diagnosis for this patient?
3. Using this case study, Please complete the provide concept map (Remember to
include important assessment data, potential lab values, orders, medications, nursing
interventions, and teaching points).
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 As a group please answer the following
questions:
 What is the likely diagnose in this case study?
 List 2 possible nursing diagnosis for this patient?
 Using this case study, Please complete the provide
concept map (Remember to include important
assessment data, potential lab values, orders,
medications, nursing interventions, and teaching
points).
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Case study #4
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Concept Mapping
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Patient: 8 year old, African American, male
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Chief Complaint: “I feel like a fish out of water, I can’t hardly breathe”
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Nurses Note: Assumed care of pt. at 0700. Pt. receiving continuous Albuterol neb
treatment, tolerating well. Temp. 38.1 PO, Resp. 26-28; O2sats 91%-94% on 7L O2 via
face mask; Moderate substernal retractions noted; no nasal flaring or grunting; b/l
lungs coarse with scattered wheezes on expiration; neuro intact, PERRLA, pt.
appropriate for age; pt. NPO per order, abdomen soft, non distended BS+; IVF via
Left hand, infusing without difficulties, site benign; pt. voiding via bedside commode
without difficulties; pt. mother at bedside active in pt care.
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Orders: Q1 hour VS, I &O’s, IVF’s(D5.45NACL @60ml/hr), NPO, Continuous pulse ox
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Medications: Continuous Albuterol, Tylenol, IV zofran
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 As a group please answer the following
questions:
 What is the likely diagnose in this case study?
 List 2 possible nursing diagnosis for this
patient?
 Using this case study, Please complete the
provide concept map (Remember to include
important assessment data, potential lab
values, orders, medications, nursing
interventions, and teaching points).
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Summary Questions
 What are 3 pieces of information you need from
the active orders and report?
 Which procedures require an instructor to be
present?
 Prior to giving an oral medication list 3 things
you need to be prepared?
 If you are going to be late or sick and cannot
attend clinical what should you do?
 Name 3 key items you are to review when giving
report
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Summary Questions
 Name 2 key items you need to obtain when
receiving report?
 The infant assigned to you is an 8 month old.
Parent is not present. Name 2 key nursing
interventions.
 What is a good source form parent and child
educational materials?
 What assignment is due on Wednesday each
week and how is it to be submitted?
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Any Questions?
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