D119 NURS 6830 Pediatric Primary Care for the Advanced Practice Nurse Paper Example
D119 NURS 6830 Pediatric Primary Care for the Advanced Practice Nurse Assignment
D119 NURS 6830 Pediatric Primary Care for the Advanced Practice Nurse Assignment Brief
Assignment Instructions Overview
This assignment requires students to develop a comprehensive Growth and Development Care Plan for a pediatric patient. The care plan should address the patient’s medical history, growth and development stages, nursing diagnoses, interventions, and expected outcomes. The goal is to integrate theoretical knowledge with practical nursing care principles to assess and promote optimal development in pediatric patients.
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Understanding Assignment Objectives
The objective of this assignment is to apply nursing principles in pediatric primary care, ensuring holistic assessment and intervention planning. Students will:
- Evaluate the patient’s physical, cognitive, and psychosocial development against expected milestones.
- Identify deviations from normal growth patterns.
- Develop individualized nursing care plans based on the patient’s needs.
- Implement and justify nursing interventions that support growth, safety, and overall well-being.
- Utilize evidence-based practice to guide decision-making.
The Student’s Role
Students will assume the role of an Advanced Practice Nurse (APN) in pediatric primary care, demonstrating expertise in:
- Conducting a thorough health assessment, including patient demographics, birth history, immunization status, and developmental screenings.
- Identifying key nursing diagnoses related to the patient’s condition and growth.
- Planning and prioritizing interventions that are developmentally appropriate.
- Assessing patient outcomes and making adjustments to the care plan based on progress.
- Addressing patient education needs, including discharge planning and caregiver instructions.
Competencies Measured
This assignment evaluates critical nursing competencies, including:
- Patient Assessment & Data Collection – Gathering and analyzing subjective and objective data to inform clinical decision-making.
- Growth and Development Analysis – Comparing the patient’s development against expected age-related norms.
- Nursing Diagnosis Formulation – Utilizing NANDA-approved nursing diagnoses to establish a structured care plan.
- Intervention Planning & Implementation – Developing targeted, evidence-based interventions to address identified patient needs.
- Outcome Evaluation – Measuring patient progress against established SMART goals.
- Safety and Discharge Planning – Ensuring appropriate education and preparation for home care following hospitalization.
- Professional Documentation – Presenting a well-organized, evidence-based care plan that meets nursing standards.
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D119 NURS 6830 Pediatric Primary Care for the Advanced Practice Nurse Paper Example
Patient Demographics and Medical Diagnosis
Patient Name: [Patient Name]
Sex: Female
Age: 3 years, 2 months
Date of Birth: [DOB]
Room: [Room Number]
Medical Diagnosis: Developmental Delay with Chronic Respiratory Failure
Birth History:
- Premature birth (28 weeks gestation)
Prior Hospitalizations:
- No significant hospitalizations on record
Prior Surgeries:
- G-tube placement
- Tracheostomy placement
- Ventriculoperitoneal (VP) shunt placement
Immunization Status:
- Up-to-date as per CDC guidelines
- DTaP: Last dose on 01/15/23
- Hib: Last dose on 12/10/22
- MMR: Last dose on 02/20/23
Allergies:
- Dairy, soy, latex
Code Status:
- Full Code
BMI & Growth Percentiles:
- BMI: 18.5 kg/m²
- Height: 85 cm (10th percentile)
- Weight: 12.8 kg (15th percentile)
- Head Circumference: 48 cm (25th percentile)
Language Barriers:
- Primary language: English
- No significant barriers
Ethnic Origin and Race:
- African American
Spiritual/Religious Influences:
- Christian
Tests, Treatments, and Interventions Impacting Clinical Care:
- Chronic respiratory support (tracheostomy)
- Developmental therapy
- Speech and physical therapy
Health Beliefs/Practices:
- Family prefers natural remedies before seeking medical care
- Uses herbal teas and warm compresses for minor ailments
- Avoids over-the-counter medications unless prescribed
Growth and Development
Expected Developmental Stages:
- Physical: Expected to walk independently, climb stairs, and feed self.
- Cognitive: Recognizing basic colors, simple problem-solving, and short sentence formation.
- Psychosocial: Exhibiting independence, parallel play, and simple social interactions.
Developmental Deviations:
- Physical: Limited mobility, cannot walk independently.
- Cognitive: Limited verbal communication and problem-solving skills.
- Psychosocial: Delayed social engagement and emotional expression.
Erikson’s Stage of Development:
- Autonomy vs. Shame and Doubt
- The child is expected to explore independence but struggles due to developmental delays.
Piaget’s Stage of Development:
- Preoperational Stage
- Expected to use symbolic thinking but has limited verbal expression.
Body Image Changes:
- Increasing self-awareness of body parts.
- Beginning to recognize differences in gender and physical appearance.
Modifications to Care Approach:
- Use simple words and visual cues.
- Encourage independence with age-appropriate tasks.
- Provide sensory-based activities to enhance learning.
Evaluation of Developmental Milestones:
- Limited mobility and speech development compared to peers.
- Requires intensive therapy for motor and cognitive skill enhancement.
Socialization
- Encourage structured play with family and peers.
- Use interactive toys to enhance cognitive development.
- Promote positive reinforcement to build confidence.
Safety Assessment and Interventions
- Respiratory Safety: Ensure suctioning is available for tracheostomy care.
- Mobility Support: Provide fall-prevention strategies and mobility aids.
- Nutritional Monitoring: Ensure G-tube feedings meet nutritional requirements.
Discharge Planning & Teaching Needs
Family Education:
- Respiratory Management – Proper suctioning and tracheostomy care.
- Medication Administration – Correct dosage and schedule adherence.
- Developmental Support – Engage in home-based therapy exercises.
- Safety Measures – Prevent falls and aspiration.
Nursing Diagnoses (NANDA Format)
| Priority | Nursing Diagnosis | Related To | As Evidenced By | Rationale |
| 1 | Ineffective Airway Clearance | Retained secretions | Presence of tracheostomy, increased secretions, abnormal lung sounds | Essential for maintaining oxygenation and preventing respiratory distress |
| 2 | Delayed Growth and Development | Developmental delay | Limited mobility, lack of verbal communication | Early intervention is key to cognitive and physical improvements |
| 3 | Risk for Falls | Impaired mobility | Muscle weakness, inability to walk | Prevention of injuries and promotion of safe mobility |
Nursing Management and Interventions
Nursing Diagnosis: Ineffective Airway Clearance
| Assessment | Expected Outcome | Interventions | Evaluation |
| Monitor respiratory rate and oxygen saturation | Maintain oxygen saturation >95% within 8 hours | – Suction as needed |
- Administer bronchodilators per order
- Encourage upright positioning | Improvement in breathing effort, stable oxygen saturation |
Nursing Diagnosis: Delayed Growth and Development
| Assessment | Expected Outcome | Interventions | Evaluation |
| Assess developmental milestones and cognition | Child will demonstrate improvement in recognizing objects within 24 hours | – Use picture cards to enhance recognition |
- Engage in interactive play
- Encourage parental involvement | Increased engagement and recognition of at least 2 new objects |
Plan of Care Evaluation:
- Ongoing assessment of developmental milestones.
- Continuous monitoring of respiratory function.
- Family education and involvement in daily care.
References
Hockenberry, M. J., & Wilson, D. (2019). Wong’s Nursing Care of Infants and Children. Elsevier.
American Academy of Pediatrics (2023). Developmental Milestones. Retrieved from www.aap.org
NANDA International (2021). Nursing Diagnoses: Definitions and Classification 2021-2023.
Detailed Assessment Instructions for the D119 NURS 6830 Pediatric Primary Care for the Advanced Practice Nurse Paper Assignment
NUR 4055- Nursing Care of Children and Families
GROWTH AND DEVELOPMENT CARE PLAN
| Student Name: | Week: | Dates of Care: |
Patient Demographics and Medical Diagnosis
| Patient
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Sex | Age | Date of Birth | Room | Medical Diagnosis:
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| Birth History:
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Prior Hospitalizations: | |||||||
| Prior Surgeries:
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Immunization Status:
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| Allergies:
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Code Status: | BMI:
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| Height with Percentile:
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Weight with Percentile:
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Head Circumference (if age appropriate) with Percentile:
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| Language Barriers:
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| Ethnic Origin and Race:
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| Spiritual/Religious influences:
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| Tests, treatments and interventions impacting clinical day’s care:
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| Health Beliefs/Practices (include how they use the health care delivery system, any “folk practices” or at home remedies they try before consulting with RN or MD, use of OTC meds, etc.):
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Growth and Development:
| Identify expected physical, cognitive and psychosocial stages of development:
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Compare patient development to expected age/developmental stage and report any deviations:
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| Erickson’s Stage of Development:
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Supporting Assessments:
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| Piaget’s Stage of Development:
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Supporting Assessments:
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| Identify Expected Body Image Changes Associated with the Patient’s Developmental Age:
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Modifying Approaches to Care in Accordance with the Patient’s Developmental Stage:
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| Evaluating the Patient’s Achievement of Expected Developmental Level and Milestones:
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Socialization (family & peer relationships, discipline, play):
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| Saftey Assessment and Interventions:
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Discharge planning (what will the pt/family need to be successful caring for the pt at home) and Teaching Needs (Disease process, medications, safety, style, barriers):
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| Discharge Plan:
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| Teaching Needs:
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Nursing Diagnoses
List the top 3 nursing diagnoses for this patient. Use NANDA format (diagnosis, related to, as evidenced by) and place the diagnoses in their priority order. Briefly discuss the rationale for this priority order. Use nursing diagnosis that relate to the patient’s growth and development.
| Priority | Nursing Diagnosis | Related to | As Evidence By | Rationale |
| 1 |
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| 2 |
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| 3 |
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Nursing Management and Intervention
Select the two highest priority nursing diagnoses (related to growth and development) and complete the following table.
Nursing Diagnosis:
| Assessment or data collection relative to the nursing diagnosis | Patient Outcome (objective, expected or desired outcomes, or evaluation parameters) | Interventions/
Implementations |
Evaluation |
Nursing Diagnosis:
| Assessment or data collection relative to the nursing diagnosis | Patient Outcome (objective, expected or desired outcomes, or evaluation parameters) | Interventions/
Implementations |
Evaluation |
Care Plan Grading Rubric–Pediatrics
Care Plan Grading Rubric—Pediatrics Student Name__________________________
| Description | Points Received/
Total Points Possible |
Comments | ||
| Diagnosis #1 | Diagnosis #2 | Totals | ||
| Patient Information and Health Assessments
– Complete patient demographics, health assessments, and interventions |
____/ 2 | |||
| Growth and Development:
– Identify expected physical, cognitive and psychosocial stages of development and compare to patient’s actual stages of development |
____/ 9 | |||
| Safety Assessment, Discharge Plan, Teaching Needs:
– Include expected and actual needs |
____/3 | |||
| Nursing Diagnosis (Include ALL 3 Dx):
– Reflects the primary diagnosis – Appropriate for patient scenario as well as priority level – In acceptable NANDA format – Includes all parts stem, R/T, AEB |
__ __/ 6 | |||
| Assessment:
– Appropriate for chosen diagnosis Includes objective & subjective historical support diagnosing data |
____/2 | + ____/2 | = ____/ 4 | |
| Patient Outcomes:
– Specific to the patient diagnosis – Contains the following 4 criteria: measurable, attainable, realistic, and timed – All criteria present for patient’s expected outcome |
____/3 | + ____/3 | = ____/ 6 | |
| Intervention/Implementation:
– Includes interventions/ nursing actions directly relating to pt. outcomes – Specific in action, frequency and contain rationale – # of interventions is appropriate to help pt./ family meet their outcomes |
____/4 | + ____/4 | = ____/ 8 | |
| Evaluation:
– Includes all data that is listed as criteria in outcomes – Outcomes are determined to be met, partially met, or not met – If outcome was not met/ partially met, plan of care is revised/ continued & new evaluation date/time is set |
____/1 | + ____/1 | = ____/ 2 | |
| – | ||||
Total Points: ____/ 40
Deductions for late work are at the discretion of the instructor. There may be no more than 10% for every day past the indicated due date
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