Case Study 1 Mark is an 8-year-old boy who has presented to the emergency department in the local hospital with right iliac fossa pain. On further assessment by the emergency registrar, appendicitis...


Case Study 1


Mark is an 8-year-old boy who has presented to the emergency department in the local hospital


with right iliac fossa pain. On further assessment by the emergency registrar, appendicitis is


suspected. He is made nil by mouth, commenced on IV therapy and admitted to the paediatric


unit for a surgical review for possible theatre that evening.


The surgical team agree that the signs and symptoms are associated with a possible


appendicitis and take Mark to theatre for an appendectomy.


The handover on return to ward is that the surgical team found a gangrenous perforated


appendix with peritonitis. Mark has returned to the ward with a nasogastric tube insitu on free


drainage, morphine PCA, IV therapy and triple IV antibiotics.


Due to the severity of the infection and the potential complications, Mark will need to remain in


hospital for 10 days of IV antibiotics and pain management.


Mark is the oldest of five children and his parents own and run an Indian restaurant in the city.


Case Study 2


Jayda is a four-month old girl admitted to the paediatric unit via emergency with vomiting,


decreased feeds no bowel actions and intermittent spasmodic abdominal pains. During the


spasmodic pain episodes, Jayda would draw her legs up and have a high pitched cry.


After a diagnostic ultrasound, intussusception was the cause of the presenting symptoms and


Jayda was admitted to the ward. Her treatment plan included observation, electrolyte monitoring


and IV therapy and antibiotics until a contrast enema could be implemented to correct the


intussusception.


The approximate length of stay for Jayda will be 2 days, during which time, Jayda’s mother is


informed that the rotavirus vaccine that Jayda had at 4 months has increased the incidence of


this condition amongst infants. Jayda’s mother is now having serious doubts regarding future


vaccines for Jayda.


Assessment 1 and Rubric Page 3 of 6


Case Study 3


Steven is a 15-year-old indigenous boy who lives in a remote town in rural Australia. Steven was


diagnosed with asthma at the age of two. His asthma has been well managed over the years


predominantly with relievers and preventers with the occasional need for steroidal antiinflammatory


medication.


Steven has presented to the local hospital complaining of shortness of breath and relays to the


triage nurse that he has a past history of asthma.


A health history taken by the triage nurse on arrival reveals that Steven has had a two-year


history of smoking cigarettes and is not always compliant with his asthma medication or


management plan.


Steven lives with his mother and his 6 brothers and sisters.





Oct 07, 2019
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