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SIMULATION: Case Presentation- Molly Huggins

Situation: Molly Huggins is a six-year-old female who was brought to the ED by her mother because she is wheezing. The mother reports the child has asthma and has been experiencing increasing shortness of breath for the past two days. The Peak Expiratory Flow value was between 50%-80%. The mother has been giving her nebulizer treatments more frequently, but reports she is still wheezing. Several extended family members are also ill with upper respiratory infections.

Background: The child was born prematurely at 32 weeks. She was on a ventilator in the NICU for three weeks. She has a history of reactive airway disease as an infant but has no known drug allergies. She has been treated at home with albuterol aerosol for relief of acute symptoms, Advair inhaler & Singulair for control therapy. This is her third admission to the ED, but she has never been admitted to the hospital unit overnight.

Social/Family History: Lives with her mother who works full time. Attends first grade at a school which is close to home. She is a good student.

Weight: 20 kg             Height: Unknown

Vital signs: HR 112, BP 119/71, RR 30, SpO2 has been 92% on room air, Temp 370 C

General Appearance: Well-nourished child of stated age, appears anxious.

Cardiovascular: Sinus tachycardia

Respiratory: Wheezes in lower lobes bilat

GI: Active bowel sounds x4 quad

GU: Has not voided in ED

Extremities: Pink, warm with adequate turgor; movement equal bilaterally, peripheral pulses strong

Skin: Warm, pale, and dry mucous membranes

Neurological: Alert and oriented to person, place and time. Pupils equal, round, reactive to light (PERRL). No neurological deficits, slightly agitated 

Pain: Denies pain

After reading the case presentation above, answer the following questions and bring with you to Sim. This is your ticket in the door.

How will you modify your typical approach based on the child’s age & developmental level with regards to…
 Communication?
Assessment?
Interventions?

 

        2. What additional background/history information do you want to collect?

 

 

 

         3. List 5 orders do you expect the provider to give for this patient.

 

 

 

         4. What potential complications are you on alert for?

 

         

         5. What are your top 3 priority interventions will you expect to perform for this child?

 

 

 

         6. Look up the medication reported in Molly’s history and be prepared to administer them safely. Are these medications appropriate? What else could be prescribed to treat and manage her Asthma?

SCIENCE
HEALTH SCIENCE
NURSING
NURSING 12504