Pediatric Health Issues and Interventions
Added on 2020-03-04
15 Pages3970 Words58 Views
Materials Science and EngineeringDisease and DisordersNutrition and WellnessHealthcare and Research
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IntroductionThe case scenario describes the clinical condition of a three years old male child (Elias) exhibiting the clinical history of delayed motor development, irritability and malaise. The patient appears emotionally dependent of his parents and influenced with vitamin D deficiency. The child is affected with the pattern of impetigo as evidenced by the appearance of crusty yellow sores over his nose and mouth. Delay in patient’s motor development might relate to an abnormality of congenital origin that might have affected his walking capacity (Malak, Kostiukow, Krawczyk-Wasielewska, Mojs, & Samborski, 2015). The developmental motor delay is also related to the pattern of neuronal degeneration leading to the over-expression of peroxidase coding genes. Delayed motor development remains highly prevalent in children with a history of periventricular brain injury and pre-term birth (Campbell, et al., 2012). Delay in child’s motor development adversely influences his cognitive and adaptive abilities during childhood (Ghassabian, et al., 2016). The timely acquisition of motor milestones is highly significant for the normalphysiological development of the growing child. The timely identification of the pattern of developmental delays in children is necessarily warranted with the objective of configuring remedial as well as rehabilitative interventions for the systematic enhancement of the developmental outcomes (Gupta, Kalaivani, Gupta, Rai, & Nongkynrih, 2016). Irritability in children is clinically manifested in terms of the outcomes includinggrouchy and sulky mood as well as inadequate temper outbursts. The defects in the developmental trajectory of the growing children contribute to the pattern of their anger predisposition across the community environment (Leibenluft, 2017). Patient’s malaise leads to the experience of uneasiness and discomfort requiring assessment by the nurse professional in the clinical setting (NIH, 2017). Patient’s vitamin D deficiency increases his predisposition towards the development of symptoms including fatigue, muscle weakness and pain and disturbed thought processes
(Weyder, 2014). The cases of vitamin D deficiency appear subclinical in the growing children (Michie, 2010). Vitamin D deficiency is highly prevalent across the children population. Accordingly, the affected children remain highly predisposed towards the development of immune system disorders and associated manifestations (Weyder, 2014). The pattern of impetigo experienced by the patient warrants the requirement of undertaking diagnostic interventions for evaluating the extent of Staphylococcus aureus colonization in the patient’s skin (Pereira, 2014). This research paper evidentially discusses the assessment strategies, medical management approaches, nursing interventions and care plan warranted for improving the health outcomes of Elias across the community environment. Assessment StrategiesThe clinical requires utilizing HINT (Harris Infant Neuromotor Test) diagnostic tool with the objective of assessing the pattern and intensity of child’s delayed motor development (Harris, 2016). The HINT intervention considers the circumference of patient’s head for analysing the development of microcephaly in patients affected with developmental delays. The pattern of child’s movement and play activities, supine position and passive range of motion, resting extremity posture and visual following as well as existence of stereotypical behaviour requires analysis through HINT tool for evidentially tracking the level of delayed motor development and associated clinical manifestations (Harris, 2016). The clinical requires assessing the level of patient’s communication in the context of clinically correlating the same with the progression of his delayed motor development. The reciprocal delay in patient’s communication (if tracked) evidentially correlates with the delay in his motor development and walking capacity (Bhat, Galloway, & Landa, 2012). The pattern of patient’s irritability warrants the requirement of investigating the development of DMDD (disruptive mood dysregulation disorder) or SMD (severe mood dysregulation) by the
attending clinician and nurse professional (Krieger, Leibenluft, Stringaris, & Polanczyk, 2013). The pattern of patient’s SMD (if diagnosed) would reveal his elevated inclination towards negative stimuli reflected through abrupt behaviour. The nurse professional might also observe distractibility, pressured speech, agitation and insomnia (in the patient) that might emanate under the influence of SMD (Krieger, Leibenluft, Stringaris, & Polanczyk, 2013). The pattern of patient’s irritability could also relate with the elevated frequency of his temper outburst that proves to be inconsistent with the level of his physiological development. Such a pattern is indicative of the development of DMDD in the affected child (Krieger, Leibenluft, Stringaris, & Polanczyk, 2013). Patient’s known pattern of vitamin D deficiency requires the utilization of the laboratory evaluation of the active concentration of calcidiol in accordance with the standard prescribed by the Institute of Medicine (Lee, So, & Thackray, 2013). Severe deficiency of vitamin D is affirmed with the serum calcidiol concentration of less than 5ng/mL. However, mild tomoderate insufficiency is indicated by the findings of 4-15ng/mL (Lee, So, & Thackray, 2013). In the presented clinical scenario, patient’s mother requires the increased consumption of vitamin D (i.e. 4000-6400 units/day) in the context of improving the level of vitamin D in the affected patient. The enhancement of vitamin D in breast milk reciprocally elevates its level in the developing child through breast feeding intervention (Lee, So, & Thackray, 2013). The mother of the breastfeeding child also requires consuming the food items with vitamin D content in the context of accomplishing his vitamin D deficiency. These food items could include cow’s milk, egg yolk, cod liver oil, shrimp, swiss cheese, fresh mushrooms, cereal fortified, butter, yogurt, swiss cheese and raw Atlantic herring (Lee, So, & Thackray, 2013). The clinician as well as the nurse professional requires evaluating the type of child’s impetigo (i.e. bullous or non-bullous) for its effective treatment (Hartman-Adams, Banvard, & Juckett , 2014). The physical examination of patient’s integumentary system assists in finding out the pattern of non-bullous
of bullous impetigo in the affected patient. The appearance of yellowish of honey coloured or crusty yellow sores on the face of the child is indicative of the development of non-bullous impetigo manifested by Staphylococcus aureus (Hartman-Adams, Banvard, & Juckett , 2014). Medical ManagementThe medical interventions warranted for effectively treating the manifestations of patient’s delayed motor development attribute to the administration of AAC (augmentative and alternative communication) approaches, motor based behavioural interventions, electromagnetic brainstimulation treatment and RIT (reciprocal imitation training) (McCleery, Elliott, Sampanis, & Stefanidou, 2013). These interventions facilitate the systematic improvement in patient’s behaviour, language, play activities, walking and communication as well as socialization skills. AAC technique utilizes sign language approaches to facilitate the pattern of speech in developmentally delayed children (McCleery, Elliott, Sampanis,& Stefanidou, 2013). This intervention also uses picture exchange methods for improving the level of patient’s communication. The motor basedbehavioural remediation strategy assists in the systematic manipulation of patient’s anatomical structures associated with the production of sound (McCleery, Elliott, Sampanis, & Stefanidou, 2013). This manipulation is materialized by the clinicians through the administration of various play activities. Electromagnetic brain stimulation technique transmits low intensity intracranial current to the patient’s cerebral cortex with the objective of enhancing brain functionality (McCleery, Elliott, Sampanis, & Stefanidou, 2013). RIT is a gesture-based intervention that helps in engaging the children in various learning activities for the systematic enhancement of their overall mental and behavioural functionality (McCleery, Elliott, Sampanis, & Stefanidou, 2013). pharmacotherapeutic management of paediatric irritability warrants the utilization of drugs in accordance with the associated aetiology and psychosocial manifestations. These drugs could include clomipramine, fluvoxamine, fluoxetine,
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