Charlie is a 5- year-old Native-American boy

Charlie is a 5- year-old Native-American boy and his sister Cindy is a 4-month-old girl. They live in Northern Arizona on the Kaibab-Pauite Reservation. Charlie and Cindy have both been brought into the local community clinic by their mother. They are both exhibiting symptoms of cough, fever, runny nose, and sneezing. Tests have confirmed that they positive for Influenza A. The clinic nurse gathered some health information and recorded the assessment findings below. Explain specific physical, psychological, social, cultural, and spiritual nursing implications to consider when caring for pediatric patients such as Charlie (5-year-old) and Cindy (4 month-old) as opposed to an adult patient. Identify differences in how you would carry out physical head-to-toe assessments for Charlie and Cindy (be specific for both), as opposed to how you would assess an adult patient. Identify all the abnormal findings in the case study. Which patient (Charlie or Cindy) would you be most concerned about and why? What risk factors have caused one to be sicker than the other? Why do you think the other is not as sick? Chose your favorite or most known developmental theorist. Describe what stage Charlie is in according to that theorist. How does this developmental stage influence how you would interact with the child? Charlie – 5 years old BP= 95/52 (low) T= 38.3 (oral) P= 150, irregular (Apical) palpable R= 30 02 sats = 94% on R/A via pediatric finger pulse oximetry probe Weight = 17.9 kg (39.5 pounds) Height = 108 cm (42.5 inches) Lying on the stretcher quiet, anxious and scared Nasal flaring with suprasternal and intercostal retractions noted upon breathing Chest has audible coarse wheezes throughout Skin is dry, flushed, and warm to the touch Unable to palpate anterior or posterior fontanelles Nasal mucosa and throat are both red Abdomen soft, not distended, tender, with bowel sounds hyperactive in all 4 quadrants Has had 3 large loose brown stools in the last 24 hours Appetite is poor, not drinking sufficient amounts due complaints of a sore throat History of asthma Cindy – 4 months old BP= 94/50 T= 37.9 (axilla) P=168 (Apical) R= 40 02 sats= 96% on R/A via infant foot pulse oximetry probe Weight = 7.0 (15.4 pounds) Height = 64.0 cm (25.2 inches) Lying in the crib crying and restless Is abdominal breathing Chest has decreased air entry to the bases Skin is dry, flushed, and warm to the touch Anterior fontanelle is palpable, diamond shaped; Posterior fontanelle is not palpable Nasal mucosa and throat are both red Abdomen is soft, distended, with bowel sounds in all 4 quadrants Has had 3 small mushy yellow stools in the last 24 hours Continues to be exclusively breastfed adequate amounts every 2 hours No history of any prior illnesses

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