Question: Case Study The Emergency Room Just Called The Floor To Notify You Of An Admission At 1630. Lucas Benjie, An 8 Month-old Navejo Indian Is Being Admitted. He Arrived In The Emergency Room One-hour Ago, Having Vomiting Spells And Seven Or Eight Diarrhea Stools Daily For The Past 4 Days. He Has Had Five Stools This Morning. His Mother Described The Stools …

Case Study The emergency room just called the floor to notify you of an admission at 1630. Lucas Benjie, an 8 month-old Navejo Indian is being admitted. He arrived in the emergency room one-hour ago, having vomiting spells and seven or eight diarrhea stools daily for the past 4 days. He has had five stools this morning. His mother described the stools as green and mucousy. Vital Signs in ER 103 ®F, 152,28, 100% Pulse Ox on Room air. The nurse was unable to obtain a blood pressure after multiple attempts. Weight 8kg. Poor skin turgor; sunken fontanel, pale and lethargic with whiny, irritable cry. The urine specimen obtained is dark yellow and had a strong odor. He has a severe diaper rash. At 1530, an IV was started in ER, 500CC D5%.45NSin Lucas’ right hand. Also a CBC was sent to the laboratory. At 1700, Lucas arrives to the floor, accompanied by his mother. The admission orders read: Admit to Akron 7200 DX: Gastroenteritis, 5% dehydration VS with Nuero checks q2hrs. D5%/0.2NS @ 35cc/hr until child voids. After Benjie voids, add 4 meqkCat 500cc Q 8hours Notify Dr. Smith if child had not voided in 2 hours Strict 1&O Daily Weights NPO Repeat CBC, Stool c/S, Urine C/S and specific gravity Contact Isolation Desitin Cream to Diaper Rash PRN Use a separate sheet of paper to answer these questions. 1. Define Gastroenteritis. 2. From the moment Lucas arrives to the floor, list in the order of occurrence, your actions admitting Lucas. Explain the rationale for each action (you do not have to cite) 3. Are the fluid orders and KCL order safe for Lucas? (Write your calculations) 4. Are there any other orders you need at this point to safely care for Lucas? If so, what should they be? 4. Are there any other orders you need at this point to safely care for Lucas? If so, what should they be? 5. While changing Lucas diaper, Ms. Benjie tells you that he has been sick because a stranger came to the reservation last week and the medicine man was out on a “sing” Explain the philosophy of health and illness as it relates to the Navajo Indian culture. 6. Ms. Benjie requests that her uncle, a medicine man, performs a “sing” in Lucas’ room. Describe the role of the Navajo Medicine Man. 7. What would your reaction be to the mother’s request of a “sing”? 8. For a child with 5% dehydration, what changes in the CBC would be expected? 9. Lucas was admitted to the pediatric unit. You are the RN in charge, which room is the best choice and why? a. Room 201: Private Room b. Room 203A: with a 6 month old boy with bronchitis Room 206A: with a 5 year old girl with a heart defect d. Room 208B: with a 12 month old girl with gastroenteritis e. Room 2012: with a 10 year old boy with a fracture femur, close to the nurses station 10. Lucas is NPO. Mrs. Benjie wants to know when her child will be able to eat again. What would your communication/education consist of to provide the mother with the plan of care? What would you say to her?