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Read the images below, then select a priority health issue, and include: One (1) short term goal and one (1) long term goal Goals should follow SMART criteria (specific, measurable, attainable, realistic, and timely) Three (3) nursing actions/interventions for one of the identified goals An explanation of the rationale for the actions/interventions selected (supported with relevant and current literature) Rreference list for supporting evidence

Read the images below, then select a priority health issue, and include: One (1) short term goal and one (1) long term goal Goals should follow SMART criteria (specific, measurable, attainable, realistic, and timely) Three (3) nursing actions/interventions for one of the identified goals An explanation of the rationale for the actions/interventions selected (supported with relevant and current literature) Rreference list for supporting evidence

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
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Read the images below, then select a priority health issue, and include:

  • One (1) short term goal and one (1) long term goal
  • Goals should follow SMART criteria (specific, measurable, attainable, realistic, and timely)
  • Three (3) nursing actions/interventions for one of the identified goals
  • An explanation of the rationale for the actions/interventions selected (supported with relevant and current literature)
  • Rreference list for supporting evidence

 

Care Scenario: Lily is a 16-year-old girl on the pediatric neuroscience unit who was admitted for observation and seizure medication adjustment following a tonic-clonic seizure at tennis practice 2 days ago. On admission her antiepileptic drug levels were subtherapeutic and she stated: "I have been so stressed lately. I forgot to take meds one day and then just stopped taking them. I am tired of taking the medications. They make me feel different, and I don't like that. I thought maybe my grandparents were right. They told me I am just unbalanced and that is why I was so stressed. I thought if I stopped the seizure medications and tried to find harmony and balance, I would be okay and back to myself." In hospital, Lily has been taking her medications as prescribed and her levels are back within therapeutic range. Lily is now ready for discharge. History of Present Illness: Lily was 4-years old when she had her first seizure. She had a respiratory infection and fever so was initially treated for a febrile seizure in ED and then discharged home. Several months later she had another seizure and by age 5 had had six seizures. During this time Lily was referred to a pediatric neurology team for epilepsy. She has been on anti-epileptic medication since her third seizure. Lily has had about one or two seizures a year since the age of 7. Most of these have been associated with missed doses of medication or additional stressors. Health History: ● ● Lily was born at 39 weeks' gestation; normal pregnancy and uneventful labour and delivery Her immunizations are up to date Current weight is 55.4 kg, and she is 64 inches Developmental Variables: ● Erickson's Stage (Identity vs. Confusion) Age of menarche - 13 years Family History: Lily is an only child. She lives with her parents and paternal grandparents. Her parents immigrated to Canada from Beijing as university students and her grandparents came to live with the family when Lily was born. In the home, Lily and her family speak both Mandarin and English. Lily's grandparents do not speak much English and feel responsible for raising Lily with the knowledge and awareness of their ancestors. Lily's grandparents believe in and practice traditional Chinese medicine (TCM). Lily and her parents follow some TCM concepts but are also willing to use Western medicine, particularly when treating her seizures. There is sometimes conflict between the values & beliefs of Lily's grandparents and her parents. Current Medications: Adapted from: Tagher, G., & Knapp, L. (2019). Pediatric Nursing. Wolters Kluwer Health. https://wolterskluwer.vitalsource.com/books/9781975151782 1
Transcribed Image Text:Care Scenario: Lily is a 16-year-old girl on the pediatric neuroscience unit who was admitted for observation and seizure medication adjustment following a tonic-clonic seizure at tennis practice 2 days ago. On admission her antiepileptic drug levels were subtherapeutic and she stated: "I have been so stressed lately. I forgot to take meds one day and then just stopped taking them. I am tired of taking the medications. They make me feel different, and I don't like that. I thought maybe my grandparents were right. They told me I am just unbalanced and that is why I was so stressed. I thought if I stopped the seizure medications and tried to find harmony and balance, I would be okay and back to myself." In hospital, Lily has been taking her medications as prescribed and her levels are back within therapeutic range. Lily is now ready for discharge. History of Present Illness: Lily was 4-years old when she had her first seizure. She had a respiratory infection and fever so was initially treated for a febrile seizure in ED and then discharged home. Several months later she had another seizure and by age 5 had had six seizures. During this time Lily was referred to a pediatric neurology team for epilepsy. She has been on anti-epileptic medication since her third seizure. Lily has had about one or two seizures a year since the age of 7. Most of these have been associated with missed doses of medication or additional stressors. Health History: ● ● Lily was born at 39 weeks' gestation; normal pregnancy and uneventful labour and delivery Her immunizations are up to date Current weight is 55.4 kg, and she is 64 inches Developmental Variables: ● Erickson's Stage (Identity vs. Confusion) Age of menarche - 13 years Family History: Lily is an only child. She lives with her parents and paternal grandparents. Her parents immigrated to Canada from Beijing as university students and her grandparents came to live with the family when Lily was born. In the home, Lily and her family speak both Mandarin and English. Lily's grandparents do not speak much English and feel responsible for raising Lily with the knowledge and awareness of their ancestors. Lily's grandparents believe in and practice traditional Chinese medicine (TCM). Lily and her parents follow some TCM concepts but are also willing to use Western medicine, particularly when treating her seizures. There is sometimes conflict between the values & beliefs of Lily's grandparents and her parents. Current Medications: Adapted from: Tagher, G., & Knapp, L. (2019). Pediatric Nursing. Wolters Kluwer Health. https://wolterskluwer.vitalsource.com/books/9781975151782 1
Education: ● ● Levetiracetam (Keppra) 1000mg PO BID Divalproex (Depakote) 300 mg PO BID Lily is in grade 11 and is doing well academically Lily is excited to start touring universities soon in preparation for applications Roles & Relationships: Lily is a member of several clubs and groups, including the school newspaper and drama club. Recently, although a quiet and reserved teen, Lily has been hanging out more with friends and has even been invited to some weekend parties. Lily gets along well with her parents and grandparents but sometimes hears them arguing about what is best for Lily. Self-Concept: Diet: Lily's biggest fear is having a seizure at school; "that would be so humiliating". She also wants to obtain her driver's licence as many of her friends are starting to drive but worries she will be left out because of her epilepsy. Lily eats a varied diet with traditional Chinese cooking at home as well as North American influences. She has been invited to a couple of parties where peers were drinking alcohol but Lily denies alcohol use. Activity: Lily plays tennis competitively and walks to school each day. Lily estimates 3-4 hours of screen time/day/ Sleep: Lily typically sleeps 6-8 hours/night. Review of Body Systems: Lily's physical exam is all within normal limits. Lily has been taking her medications faithfully and her levels are back within therapeutic range. Adapted from: Tagher, G., & Knapp, L. (2019). Pediatric Nursing. Wolters Kluwer Health. https://wolterskluwer.vitalsource.com/books/9781975151782 2
Transcribed Image Text:Education: ● ● Levetiracetam (Keppra) 1000mg PO BID Divalproex (Depakote) 300 mg PO BID Lily is in grade 11 and is doing well academically Lily is excited to start touring universities soon in preparation for applications Roles & Relationships: Lily is a member of several clubs and groups, including the school newspaper and drama club. Recently, although a quiet and reserved teen, Lily has been hanging out more with friends and has even been invited to some weekend parties. Lily gets along well with her parents and grandparents but sometimes hears them arguing about what is best for Lily. Self-Concept: Diet: Lily's biggest fear is having a seizure at school; "that would be so humiliating". She also wants to obtain her driver's licence as many of her friends are starting to drive but worries she will be left out because of her epilepsy. Lily eats a varied diet with traditional Chinese cooking at home as well as North American influences. She has been invited to a couple of parties where peers were drinking alcohol but Lily denies alcohol use. Activity: Lily plays tennis competitively and walks to school each day. Lily estimates 3-4 hours of screen time/day/ Sleep: Lily typically sleeps 6-8 hours/night. Review of Body Systems: Lily's physical exam is all within normal limits. Lily has been taking her medications faithfully and her levels are back within therapeutic range. Adapted from: Tagher, G., & Knapp, L. (2019). Pediatric Nursing. Wolters Kluwer Health. https://wolterskluwer.vitalsource.com/books/9781975151782 2
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