Nursing Report: A Case Study on Lithium Battery Ingestion in a Child

This nursing report presents a case study of a 2-year-old child, Charlie, who ingested a lithium button battery, leading to pain and distress. The report details the assessment process, including clinical manifestations and risk factors associated with battery ingestion in young children. It covers the nursing diagnosis, emphasizing the importance of a collaborative approach and timely interventions such as X-rays and endoscopy. The planning, implementation, and evaluation sections focus on educating parents about preventative measures and the safe handling of batteries. The report highlights the critical role of nurses in providing holistic care and emphasizes the need for prompt medical attention to prevent severe complications like esophageal burns and potential organ damage. The report underscores the significance of parental awareness and the importance of keeping batteries out of reach of children.

Nursing

Table of Contents
Introduction......................................................................................................................................2
Assessment.......................................................................................................................................2
Nursing Diagnosis............................................................................................................................4
Planning, implementation and Evaluation.......................................................................................6
Conclusion.......................................................................................................................................7
References........................................................................................................................................8

Introduction
Nursing is a practice which relates to provision of autonomous and collaborative care to
individuals in health institutions (Alexander and et. al. 2015). All the activities and efforts of
nurse in such institutions are aimed to improve health, provision of care and prevention of
illness. In present context, pathophysiology is being considered as it helps in identifying
functions and symptoms of affected organs, carried out specifically for diagnosis and patient
care. This report consists with a scenario of a 2 year old child named as Charlie, who has
ingested one lithium button battery by which Charlie is suffering from too much pain and crying
very loudly and feeling distressed . On the other hand, assignment will also put light upon risk
factors that stays present for the children of infant age group along with the discussion of nursing
consideration and emergency actions. Last section for this report will be focused upon providing
information through which parents with similar age group could be educated.
Assessment
This case study focuses on a 2 year old child named as Charlie. The child has been taken
to a local emergency department as he has ingested at least one lithium ion battery. Parents who
have accompanied the child are very anxious whereas the kid himself is sobbing and suffering
from too much pain. A kid swallowing batter can be life threatening as they can burn the
Esophagus and burn a hole in the same. The reason for same is that electrical current present in
the battery can cause heat and burning within 2 hours of dissolving the content inside the body.
When a child ingest lithium button battery he/she may feel pain, vomiting, cough, fever and
increase heart rate. It is essential, when a small kid like Charlie ingest such type of thing like
lithium button battery, they must be taken to the nearest hospital immediately for the further
medical evaluation. The reason is that delay in medical treatment may cause irreparable damages
to the child. There is a high probability that Chewing will remove the cap which is packed and
will result in leakage of substance present in the battery. This will harm the child and can burn
the tongue of Charlie, along with the food pipe which is hard to operate and may cause severe
problems airway burns and holes to esophagus. Therefore, ingestion of such type of button
battery will not only kill the child but can also make them paralysed. Clinical manifestations are
said to be objective when noticed by a physician and subjective when perceived by the patient
(Ball and et. al. 2014). The symptoms when a child ingest or swallow a lithium button battery are

as follows – gagging, vomiting, stomach pain, drooling, wheezing, coughing. Also, the child may
began foaming and may show signs of discomfort. When these symptoms take place then parents
must take the child to the emergency department just like parents of Charlie did in this case.
Also, parents can have initial assumption about the disease by looking into activities such as
sweat and chills, cough or new cough, sore throat or new mouth sore.
The main causes of Charlie's problem, are major negligence of the parents and caretakers,
they are not aware about the battery powered products present in their home. The main reason of
this problem is not covering battery compartment of all electronic products with tape. Also, loose
batteries are placed anywhere in the home, which can be ingested by small kids when found
unsecured (Brennan & Bakken, 2015). These types of button batteries are mainly found in
hearing aids, toys, electrical watches, TV remote, key fobs, etc., and are loaded with dangerous
chemicals. The elements are harmful for the child and may result in serious health complications.
Along with this, the main risk by swallowing the lithium button battery is that, it may make
Charlie suffer from severe damage to the rectum (medical treatment of battery, 2019). In
addition with this, battery can block the food pipe and burn the mouth of the child which can
cause too much pain. This will him haul and cry loudly, same as Charlie was doing. Also this can
harm the inner body part such as stomach, lungs, arteries, kidneys, etc. More risk of ingesting the
lithium battery is that this batteries are having the sulphuric acid, which can cause major damage
to the skin of the child. Furthermore, the reactions and effects of these batteries are very bad as
this can damage all the internal organs of the child just like in the case of Charlie.
Nursing Diagnosis
Nursing diagnosis is an attempt to find the several problems which may be faced by the
patient. There are various nursing considerations which such as midwife standard for practice.
Some of them promotes health and well being through evidence based practices, engaged in
professional relationships and respectful partnerships, women centred care, etc. (Cañadas-De la
Fuente, and et. al. 2015). Among this, the women centric care is related with the present case,
which defines about potential problem which may be faced by Charlie due to ingestion of lithium
ion batteries. The symptoms such as sobbing and uneasiness of child are analysed by nurse so
that critical action could be taken. Considering the circumstances and critical nature of the
problem it is best to offer care through collaborative approach. The positive results are related
with the entire identification of the button battery due to which injury was caused (Tourangeau

and et. al. 2016). This can only be achieved through conducting a X-ray which determines the
current location of battery. When the proper identification is done then physician starts the
treatment of the child which includes intubation, flexible endoscopy and general anaesthesia to
remove the battery. Moreover, rigid esophagoscopy is used to lodge the upper part of the body.
At this condition, parents are not allowed to give anything to the child which is eatable by mouth
as it may worsen the existing circumstances. The only approach which is recommended to parent
is to admit their child for close observation and assessment post occurrence of such symptoms.
The problem of Charlie was assessed by his parents when they saw blood in his vomit. His
parents rushed to hospital to admit him in emergency department, X-ray was done which made it
clear Charlie has ingested the one lithium button battery. Immediately after the X-ray, physician
started his treatment (Carpenter, 2018). Along with this, the Family-centric care service is an
approach which defines and describes how to work with the children and families. Their work is
to improve the quality and security of the care of patients by helping them to have smooth
communication with healthcare professionals.
When the child like Charlie swallowed the lithium button battery, the first step their
parents must consider is to take them to the nearest emergency department or to the nearest
A&E. Furthermore, the second step is to consult the nurse and tell them that the child has
ingested the lithium button battery and mention the symptoms shown, if any. This will help the
staff recognize the type of button the child has eaten, next you should not wait for any symptoms
or signs which can further complicate child's health. (battery ingestion and prevention, 2019).
Along with this, make sure that the child should not be given anything to drink and eat, also, they
must be provided the treatment and required an anaesthetic in order to operate (Douglas, and et.
al. 2014). The next step is that the child should be taken for X-ray, so that the doctor can find out
where the battery is located which will further help in operating the child and removal of
ingested substance. This action needs to performed promptly after performing a X-ray so that
further complication to child's health could be eliminated and normalcy is achieved. The required
tools for doing x-ray and operation are as follows – X-ray dis-fraction equipment, X-ray machine
and the plastic sheet, along with the high voltage x-ray radiator. The equipments required for the
operation are Surgical lights, gel pads, cushions and mattresses, sterilization and cleaning
equipment, surgical table with surgical accessories, etc.

This is to be identified that certain nursery actions are performed to solve the problem or
issues from which Charlie is suffering. The potential primary actions are removal of battery
which can be accomplish by the endoscopy, taken out through the mouth, food pipe and stomach.
In case, this not available then the removal of battery can be done through other approach as
well. This will help to remove the button battery which is ingested by the Charlie. Along with
this, the X-ray is to be done to recognize that where is the button battery is placed inside body, so
that the removal of that should be done as soon as possible (Hayden and et. al. 2014). Along with
this, at the time of x-ray Charlie can wear a lead apron to protect his other body parts. Along
with this, the child should not given any thing to drink or eat such as milk, because this can
prevent the further complicate evaluation of injury. Furthermore, giving medicines can cause
vomit which will worsen the current condition.
The holistic health considerations are explained by the certain needs of the child, which
includes the following such as Age appropriate. According to this, a child below 3 years can not
take care of themselves, so it becomes the responsibility of their parents to provide shelter and
food. Along with this, parents are under duty to provide them the physical safety (Cultural needs,
2018). Also their mind are developing and Charlie is distressed by this problem so the parents
must secure them emotionally, The medicines which are given to Charlie should given in the
form of liquid as he is a child of 2 years and having problem in mouth and food pipe (Hoeve,
Jansen & Roodbol, 2014). The parents of Charlie must offer holistic care which involves
physical and emotional support so that a child recovers ideally from the accident. Also, the need
of self-esteem, self confidence and a healthy outlook on life, can only be offered by parents and
mentors through undertaking of right approaches. There is a needs to emphasize on mental and
physical health so that child develops ideally. Along with this, the cultural needs of Charlie is
that he need to navigate through complex and cultural interdependent modern world, because
exposing the small children to other culture at early age helps to develop their tolerance and
appreciation of cultural differences and diversity.
Planning, implementation and Evaluation
This section focuses of the report focuses on providing information which could be
helpful for parent and can be supportive in eliminates such happening as in case of Charlie. The
ingestion of batteries can cause serious complication to health of a child therefore, parents are
recommended to keep spare batteries out of reach of children and are secured. As, children are

unaware about what they are taking in, therefore it is responsibility of their parents to take care
and to keep away such items which are small in size and contain harmful chemical like lithium.
This can cause ample number of problems to child like airway burns and holes to esophagus, the
reason being lithium is a warm chemical therefore, it have power that it can burn the food pipe
and tongue of that child. Along with this, it recommended to parents that they have to keep all
such items securely and wrapped properly for discarding. This can be considered as one most
significant approach through which such incidents could be eliminated (Morley, and et. al.
2014). Along with this, it help them in curing their child from getting contaminated with any size
of lithium battery and other consumable items which can be hazardous for a child. Also, it is
recommended to other parents that, they have to keep products out of reach of children or at a
height where a child cannot reach. This approach which will be relieving for parents as it is not
possible for a child to reach up to that height and consume the same. This help parents in taking
proper precaution, so that their child do not face any such condition which child similar to one in
the case study. Along with this, another think which is recommended to other parents is, if in any
condition, their child use to ingest any battery or product of lithium, then they have to provide
proper medical treatment to their child as soon as possible (Shin, Park, & Kim, 2015). This will
help them in facing less problems, which lithium product can cause in body of that child. As
there are several harms of this, because it can burn food pipe and tongue of kid. There were
many cases came in front where a child ate something which caused him or her to death.
Therefore, for parents it is recommended that they have to take their child immediately to
hospital for medical facilities as fast as possible in any such occurrence. Doing this will help
them in saving life of their child and also help them in minimizing chances of further
complication to a child's body. The final recommendation offered to parents of child is that, they
have to provide information and This will help them in increasing knowledge about the harms of
consuming lithium for children, so that awareness in society get increased (Sanford and et. al.
2015). Along with this, it is vital for parents to spread and share knowledge which they have
regarding what precaution they have to take and also what cure they have to provide to their
children. Doing all these will help parents to keep their children away and safe from lithium
batteries.

Conclusion
From the above mentioned report, it has been concluded that the nursing is the profession
for providing the care to the sick persons who are ill. In the present report the scenario of Charlie
has been discussed, which revolves around a child ingesting a lithium ion battery which results in
sobbing and immense discomfort. The primary diagnosis involved an X-ray which focused
around identifying the location and performing a minor surgical procedure for removal of
ingested battery. The suggestions to other parents are also recommended so that they can protect
their children which revolved around securing such items and discarding them in an ideal
manner.

References
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Morley, J. E. and et. al. (2014). International survey of nursing home research priorities. Journal
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Sanford, A. M. and et. al. (2015). An international definition for “nursing home”. Journal of the
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Shin, S., Park, J. H., & Kim, J. H. (2015). Effectiveness of patient simulation in nursing
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Tourangeau, A. E. and et. al. (2016). Nursing-related determinants of 30-day mortality for
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ONLINE WEBSITES
Cultural needs. 2018. [Online]. Available through: <https://www2.health.vic.gov.au/hospitals-
and-health-services/patient-care/older-people/palliative/palliative-emotional>
battery ingestion and prevention. 2019. [Online]. Available through:
<https://www.chop.edu/centers-programs/kohls-injury-prevention-program/lithium-
button-batteries>

medical treatment of battery. 2019. [Online]. Available through:
<https://www.emedicinehealth.com/battery_ingestion/article_em.htm#battery_ingestion
_medical_treatment>