Hannah Johnson Room 302

Hannah Johnson Room 302
Hannah Johnson, 10-year-old female presented to the ED 45 minutes ago
with dehydration, dysuria, and significant weight loss of 18 pounds over the
last 2 months. Both parents are with the child, the father is insisting that he
be notified of all interventions before they are initiated. Initial assessment
reveals: Skin dry and warm to touch, B/P 90/58, T 99.2, HR 110, RR 30. Child
appears thin. Breathing is fast and deep. Noted fruity odor to breath. Initial
labs: CBC WNL, K+ 2.89, BG 459, Urinalysis: Positive for ketones, glucose,
and bacteria. Orders: IV 0.9% normal Saline at 150 ml/hour, Add 20 mEq K+
after first liter, Ampicillin 250 mg PO q 6 hours, finger stick blood glucose
(FSBG) q 1 hour.




You responded correctly to 6 out of 6 evaluations:

Your
Category response Explanation
Educational Increased Status assessment reports abnormal and possible
Needs acuity newly diagnosis of type 1 diabetes.
Health Increased Status assessment reports abnormal labs and
acuity weight loss.
LOC Normal Status assessment reports no indication of
acuity increased LOC
Pain Increased Status assessment reports dysuria.
acuity
Psych Normal Status assessment reports no indication of
acuity Psychiatric deficits
Safety Increased Status assessment reports IV's and High Blood
acuity Glucose.
Physiological

Your
Respons
Description e Explanation
Breathing True Status assessment reports altered
pattern, breathing pattern
ineffective



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.
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, Your
Respons
Description e Explanation
Dehydration True Status assessment reports medical
dx of dehydration related to
abnormal labs and weight loss.
Tissue False Status assessment reports no
integrity, indication of Tissue integrity,
impaired impaired
Safety

Your
Description Response Explanation
Anxiety False Status assessment reports no
indication of Anxiety. Patient would be
"at Risk for"
Infection True Status assessment reports dysuria
with presence of bacteria in urine
Knowledge True Status assessment reports new
deficit medical diagnoses and weight loss
Risk for True Status assessment reports IV's and
injury High Blood Glucose.
Esteem

Your
Description Response Explanation
Growth and True Need for adolescence education
development for new diagnosis.


Scenario 1
Hannah is fearful of administering insulin. You must attempt to help her gain
confidence.




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