Case 2 Baby Travis Jones has been admitted to your ward with bronchiolitis. He is accompanied by his mother, Jenny and her new partner Joe. Travis is 18 months old and both Jenny and Joe are aged 21 years. On completing the admission, you notice that both Jenny and Joe ask where they can go to have a cigarette. On admission the observations you record for Travis include: T 37.8, HR 152, RR 60, oxygen sats 94%. There is moderate chest recession and some tracheal tug evident. Weight is 15kgs. Travis was born at term, was bottle fed on formula and still has 4 bottles a day. His mother reports all he has eaten today was some hot chips from McDonalds on their way to hospital. Jenny said she did not have any food at home to feed Travis this morning. Travis has been immunised and these are up to date. There is a strong family history of asthma. Travis has a younger sister who is 4 months old. You notice that this baby appears to have a runny nose and conjunctivitis. Travis appears appropriate in his milestones; however, you may assess this more formally. The doctor has asked that Nasal oxygen be commenced at 2 litres a minute. Part A This case study requires you to: Apply the physiology and pathophysiology to this patients’ current condition. Apply evidence based principles to correctly assess this patient. Detail the types of assessment you would do now for this patient in their current state. Use a systems framework to do this. eg CNS, CVS, Respiratory, Abdo, renal and social/ other. Plan the appropriate care for this patient, being aware of the prioritisation needed. Highlight 3 main areas. Part B Travis has been in hospital for 4 days and is preparing to be discharged from hospital. Please outline the discharge advice for this family and what educational considerations may be needed for this family considering the principles of equity, self-determination, rights and access to this case.
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