HI! can you make a INTRODUCTION PAPER

HI! can you make a INTRODUCTION PAPER about the case of the toddler and the growth and development of the toddler below? Thank You! Case Scenario: Second Degree Accidental burn at Right Hand Course in the Ward Marty, a 27 month old toddler was admitted to the ER due to 2nd degree burn. During the interview the mother, Mrs. Lorraine said that she left Marty playing on the sofa while she was preparing their lunch. She went outside the house to throw the garbage and suddenly she heard Marty crying in pain. She then saw Marty near the frying pan and it seemed that Marty stood near the pan and dipped his hand. According to the mother she never thought that Marty would be curious about what she was doing and that he would climb up near the stove. When asked what she did before going to the hospital, she said that she just placed the hand over the running water, cleaned the burned area and called her husband, Mr. George to meet her at the hospital. You were assigned to Marty’s care and was asked to do a thorough assessment and to conduct an interview regarding Marty’s growth and development. Lorraine states that they live with Marty in a house with his father George, an industrial engineer, 35 yrs old, Lorraine is a stay at home mom, 32, who have been married for 12 years. Marty’s older brother, Josh is 7 years old and in the first grade. Marty had a normal birth and his mother Lorraine mentioned that there were no complications or struggles during birth. Marty was born at 1:33PM on August 12, 2019 weighing 6.3 pounds. Marty now weighs 27.5 pounds. He got his first tooth at 6 months. He sat up by himself and started crawling around eight months and was walking around at 13 to 14 months. One of the recent activities that showcased his fine motor skills was his throwing a ball overarm in short distances, stretching out arms to catch it, rolling the ball using the arms and hands and even kickin it. He does things with both hands, but most of the time he shows signs of being right handed. He can do the puzzles that require putting pieces into an indented board, but he cannot do the puzzles that create a whole picture yet. One area that Marty struggles with is being able to crawl down stairs backwards. He probably would be able to do this but around 18 months, he fell down a couple of stairs and now is scared, so he scoots on his bottom down the stairs. At this time his parents are guiding Marty with his toilet training, he has a lot to learn to control his bladder and bowel movement. He was always reminded by his mother to go to the toilet to pee or move the bowel and eventually not use a diaper while at home. Marty enjoys simple dances and rhythms especially when he hears music. One thing that he loves more than anything is humming to the rhythm of the song and repeating what his mom Angie says. He eats very well. He loves to munch steam carrots and fruits like apple and a piece of orange. He has recently started to eat at the dinner table on a seat with the rest of the family. Marty still sleeps through the night and then takes one hour to two hour nap during the afternoon. During his 2nd birthday, his father George gifted him a ball that has different cut out shapes on it. He usually bonds with his mom by playing with it. He then has to find the shape that correlates with the hole in the ball and put the shape into the hole. One way his mom works with his cognitive development is by having Marty name each color of the missing piece before he puts it into the ball. Marty is learning and able to name at least 4 out of 8 different colors. When he draws he mostly scribbles and when asked about what he drew, he does not answer, he only points at it and says his universal word, “Josh” (his brother). He would also imitate others, one person that he imitates regularly is his brother. He also learned how to put objects in and out of containers. He loves to play in the water whenever he bathes every day, he learns how to put shampoo in his hair, make a bubble drop and splashes the room with a lot of water. His mother will facilitate the proper final rinsing of water to remove soap suds in his body. He knows how to dress himself with a simple shirt without a button. Marty babbled loudly as an infant and his first word was “Dad” as Angie stated. At 24 months, Marty talks with words and gestures. The words are not always clear, especially when he is excited. His gestures mostly consist of pointing to objects in his story. He learned the word no, but did not always respond to it. During the last couple of weeks, he has started to put together two or three word sentences. One of them are “I out” “love you” and ” I am Marty” . He does not like to sit still enough for most stories, but he will watch “Frozen” over and over. He does not know the names though. To him, it is called, “fishy”. He also likes Sesame Street, more specifically he likes Elmo and he knows his name. If he sees the object get hidden he will look for it, but he will not just go and look for an object if told, unless it is his shoes. Marty has started to show signs of memory and assimilation. One example of this is since he has been told that pots and pans that his mom is cooking with are hot, he told Josh that the pizza pan he was holding was hot. He just pointed and said “hot, hot”. Marty will respond to simple directions. For example, if you ask him to pick up his trash, like a wrapper, he will throw it away in the trash bin. He will also pick up his toys if instructed, most of the time. He has also started to use problem solving to figure things out. His mother Lorraine used to shut doors to keep him out of things, now he has figured out how to open doors so that he can still get to the things he wants and her mother will not let him have. Mrs. Lorraine also noticed that he started to climb up the stairs and never imagined that he would climb over even up to their stove because she clearly instructed their children not to go near the kitchen stove. The family bonding for Marty started before he was even born by his father George talking to him during the pregnancy. Lorraine avoided any possible teratogens and even avoided caffeine. She also stated that she drank a lot of water and ate a lot of fruit during the pregnancy. Since Lorraine reads to Josh every day, Marty got read to at the same time. Marty seems to be pretty open about his emotions. When he is mad, he screams. When he is hurt, he cries. When he has done something wrong and has gotten in trouble he simply looks down and gets sad. He has grown up with mom Lorraine being home with him. Marty is known as a tornado, not because of temper but because he is very energetic and into everything. He enjoys playing with everything from anyone’s shoes to Little People toys. He enjoys being around people and has a blast playing with his toys or with his family members. At times, whenever Marty gets upset and shows his frustrations, or resist what his parents tell him to do like most children of his age. He show tantrums and can go through many different moods within a short period of time. He does have a security blanket, and as long as he has it he is usually okay. One Christmas break, the family hosted a small party with cousins and friends. Marty is observed to be playing beside his cousin Ronan without interacting, but in a few more minutes they will be imitating and copying what the other will be doing. When he is around his cousin Ronan crying, he exhibits his caring attitude towards him by occasionally giving him his blanket to try to calm him down. On one specific time, Marty threw a fit at McDonald’s because his dad George would not let him hold his cup. His parents rule is he is not allowed to hold his cup unless there is a lid on it, so he started throwing a fit by kicking and screaming but his dad cooperated with him and calmed him down. The resolution was they would both hold onto the cup as he took the drink. Physical examination: After endorsement you were asked to perform a physical assessment of Marty. During the physical examination, Marty was crying uncontrollably and his mother and father were calming him down. They were trying to give him his blanket but continued to be irritated and crying out of pain and pointing towards his right hand. He has an IV in his left metacarpal vein, intact and patent with D5 LR 1 liter @ 112 ml/hour at a level of 950ml. His eyes were already swollen. There seems to be no difficulty in breathing upon assessment. When the mother was asked how many teeth Marty has she said that she counted recently and noticed he has around 20 teeth total. She was planning to have him schedule a dentist appointment in the coming days. No other unusualities were noted at the mouth. His skin is fair, soft and warm to touch. The affected hand started to have blisters, redness is noted around the area and looks shiny. Aside from that there were no other unusualities in the extremities. As soon as Marty quieted down, you continued your physical assessment. It revealed that he has a protuberant abdomen and walks with a wide stance. He is still wearing his diaper but according to the mother they already started potty training him. He sometimes has bed wetting episodes but they understand that they do not need to punish him for that just like the training they did with his brother Josh. He most often inform them if he needs to use the potty. Labs were taken and to follow up results. Medications were ordered and started. Marty was placed on I and O monitoring q hourly for 24 hours cc/cc then to shift to q 4 hours thereafter. You have instructed the mother to keep the affected hand elevated and to call out if there are other concerns Weight: 27.5 pounds Height: 85. 8 centimeters Head circumference: 41.6 centimeters Chest circumference: 43 cms Vital signs : T= 36.3 degrees Celsius , RR= 29cpm, HR= 98bpm, BP: 100/65 Medication : MMR (1st dose) given on 13 months of age Hepatitis B vaccine (3rd dose) given on 15months of age Haemophilus Influenza type b (Hib) 3rd dose given on 15months DTap vaccine ( 4th dose) given on 18months Ascorbic acid (Ceelin) 5ml P.O, OD Iron + Vitamin B Complex (Ferlin syrup) 1ml P.O daily November 9, 2021 Vital signs: BP: 100/60 PR: 96 RR: 20 Pain: 4/10 Seen by Dr. Lariosa at 10 am with orders and carried out. Dressing was done by Wound Management Nurse The affected area was clean and dry. Marty is calmer when talked to but cries when he feels pain. He can be soothed easily compared yesterday upon admission. His IV site remained patent and intact with an IV of D5 LR 1 liter with flowrate decreased to 100ml/hr at 10 am. According to the mother he was able to void approximately around 80 ml according to the nurse who weighed his diaper. He drinks a lot of water and milk with a total of 100 ml since 7 in the morning. At 2 pm, the mother reported that Marty defecated once around 11 am. Had a total intake of 350 ml. He was able to void again twice and the mother said that it was around 120ml. November 10, 2021 Vital signs: BP: 95/60 PR: 96 RR: 21 Pain scale: 2/10 Seen by Dr. Lariosa with orders and carried out. Advised to go home the next day with home medication to be instructed. Dressing was done by Wound management Nurse The affected area remained dry and healing well. Marty was in a much better mood. Plays with his mother and toys. The mother was telling you that she was glad that they came immediately in the hospital. She said that she should learn more on how to keep her son safe. That with Marty’s age anything can be expected. SCIENCE HEALTH SCIENCE NURSING NURS 10

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