unit HLTENN057 – Contribute to the nursing care of a

Present Problem Alejandro Garcia is a 4-year-old male who presents to the Emergency Department (ED) at 6 pm with his mom and 7-year-old sister. He has a one-month history of being tired, has complained of his legs hurting for four days, and has recently started limping. His mom noticed some red spots on his stomach this morning and a fever of 38.3 C. They do not have health insurance and have no established primary care pediatric provider. The mother states they received most of their medical care via the emergency department (ED). His current weight is 14.0 kg. Alejandro was born at 36 weeks gestation and stayed in the NICU for two weeks due to oxygen needs and feeding difficulties. Mom does not have his medical or immunization history. She thinks the last time he saw a pediatric provider and received vaccines was two years ago in Mexico. Personal/Social History Alejandro, his mother, and his sister recently moved to town so his mother could find work. They have no family here and are experiencing homelessness and living in the family car. Alejandro and his mother are Spanish speaking only. The 7-year-old sister speaks some English, and the family has been communicating by using her as a translator. Alejandro will start Kindergarten this fall, but his mom is having trouble registering for school due to a lack of address and is worried about how she will pay for school. Contextual Factors You are a new nurse working in a suburban community hospital’s ED. You completed your new employee orientation about six months ago and are gaining more knowledge and confidence with each shift. Your hospital has an inpatient pediatric unit but no pediatric ICU. You see all ages of patients in your ED. but the majority of your experience with pediatrics was in nursing school during your pediatric clinical rotation. The ED is busy tonight, and the staffing is short due to ill calls. The hospital recently switched to an online interpreter service due to staffing cuts, and it frequently is not functioning. @ 2023 KeithRN LLC. All rights reserved. No part of this case study may be reproduced, stored in retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of KeithRN

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