Purpose of Assignment
   To provide the student an opportunity to integrate knowledge from the sciences, developmental theory and physical assessment data to the care of a pediatric patient and family in the acute care setting.  The student will utilize critical thinking and independent judgments in presenting a holistic plan of care in a formal oral presentation.

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Student Approach to Assignment
    In order to provide quality, holistic care to patients, it is integral to understand each factor affecting the patient. This not only includes the patient’s admitting diagnosis that brought them to the hospital, but also other secondary diagnoses and physical, cognitive, emotional, spiritual needs of the patient. Through an extensive analysis of the patient’s condition including their health history, assessment findings, identifying nursing problems, establishing a plan of care, and addressing teaching needs as well as correlating relevant research with the patient, it provided opportunity to increase my understanding of how well a nurse must know their patients. In looking at the assignment, it also required an oral component which stressed utilization of adequate educational techniques to engage my peers and ready myself as a nursing professional.

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Reason for Inclusion of Assignment in this Portfolio
Nursing Practice​

• Demonstrates an awareness of complementary modalities and their usefulness in promoting health

• Example: In the nursing practice section of the paper, I described other methods of alleviating pain other than the prescribed PRN analgesics and use of a PCA pump. Use of heat packs and patient repositioning allowed the patient a sense of relief. In addition, I explored nursing research that looked at virtual reality as a means to distract from and alleviate pain.

• Implements traditional nursing care practices as appropriate holistic health care to diverse populations across the lifespan

• Example: In describing the interventions associated with the 2 most prioritized interventions for this patient, I detailed the use of a different pain scoring system based on age, use of a PCA pump, administration of pain medication, and non-pharmaceutical methods of reducing pain. An alternative FLACC pain scale was used as opposed to a numeric scale as the child was having difficulty accurately reporting his pain. Various methods of reducing his pain was justified by the immense chronic and acute pain associated with sickle cell anemia. In addition, due to an exacerbation of his disease evidenced by acute chest syndrome, his pulmonary health was also prioritized. Continuous monitoring of his oxygenation and ongoing respiratory assessments as well as administration of supplemental oxygen and nebulizers were key interventions in reducing impairment of gas exchange. Going further into discharge teaching, it describes the importance of teaching not only the child, but other members of his immediate family in how to manage the child's disease.

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Communication

• Expressed oneself and communicates effectively with diverse groups and disciplines using a variety of media

• Example: For my presentation, I utilized a compilation of images, video, and text to effectively communicate the content I was presenting. In order to better explain what sickle cell anemia and its effect on the body, I made use of a video to show how the misshapen red blood cells create blockages in the patient's vasculature. Going further, I included an x-ray image of a patient with acute chest syndrome. With this visual, I was able to show where, how and why these blockages occur. Though I was presenting this information to the other peers in my nursing class, the visual images and text create a strong foundation for understanding to other groups. The presentation itself was created for not only nursing professionals to utilize, but also other members of the healthcare team, the patients, and their families.

• Demonstrates skills in using technology, informatics, and communication devices that support safe nursing practice

• Example: Some of the interventions listed included oxygen saturation monitoring and PCA pump use and teaching. The patient was placed on continuous oxygen saturation monitoring his current saturations were dangerously decreasing and needed constant intervention via supplemental oxygen and pharmaceutical aid. The patient also required use of a PCA pump due to the immense amount of pain he was feeling. Due to observed inadequate pain control, the patient was repeatedly instructed on proper use of the device. Other interventions which required non-nursing staff became the responsibilities of respiratory therapists and the child life department. Utilizing the paging system on the hospital phones allowed timely communication between nurse and other professionals thus decreasing wait time for necessary treatment.

• Adapts communication methods to patients with special needs

• Example: My chosen patient had a diagnosis of ADHD and during care, the nurse and I continuously reoriented him and kept teaching consistent and repetitive. Upon delivering medications to the patient, he continuously alternated between requesting food and asking to use the bathroom despite it being unsafe for him to stand up and do so. With each request, we explained our reasonings to postpone both activities for the time being. Consistent reorientation to the task at hand and planning time to do the requested activities allowed for a successful compromise between nurse and patient. When it came to PCA pump teaching, however, we had to continue prompting the child when to use the pump. Due to focus on other things, he failed to remember use of the pump. Teaching was done by ensuring minimal distraction in the room and a teach-back of the desired task.