FORUM 4 (for grp 4)- CARE OF THE SCHOOL-AGE CHILD

CARE OF THE SCHOOL-AGE CHILD

CARE OF THE SCHOOL-AGE CHILD

by Mark Eliezer Nalunne -
Number of replies: 2

ASSESSMENT CUES

Subjective Cues:

  • The mother verbalized that the grandmother buys the client pizza or fried chicken everyday when she is at work.

  • The client has been missing school because he always gets stomach aches whenever he is about to go to school.

Objective Cues:

  • BMI: 25 kg/m2

NURSING DIAGNOSIS

Overweight related to high frequency of restaurant or fried food as evidenced by the client eating pizza and fried chicken when her mother goes to work

GOALS AND OBJECTIVES (NOC)

A. Nutritional Status (1004)

B. Weight Loss Behavior (1627)

C. Exercise Participation (1633)

Goal:

After performing the nursing intervention, the client and family will establish:

  • diet modification that promotes weight control using the concept of a balanced intake of nutrients 

  • physical exercises and activities that increase energy expenditure

Objectives:

At the end of the nursing intervention, the client and family will:

  • Enumerate one of the three kinds of food included in the “Pinggang Pinoy”

  • Develop and come up with a structured family meal plan

  • Identify physical activities that help in weight management and craft an active exercise program incorporating informal exercises

  • Verbalize understanding of the need for a lifestyle change to maintain a healthy body

NURSING INTERVENTION (NIC)

A. Nutrition Management (1100)

B. Nutritional Counseling (5246)

C. Weight Management (1260)

D. Exercise Promotion (0200)

The nurse will: 

1. determine the family and client’s food intake and eating habits

Rationale:  To determine contributing factors to overweight

2.  determine the family and client’s nutritional status and ability to meet nutritional needs

Rationale:  To determine the family and the client’s state of health in terms of nutrition

3.   Initiate Discussion: "How Can You Be Healthier? "

Rationale: The nurse should be cautioned against applying a nursing diagnosis to an overweight or obese person who does not want to participate in a weight-loss program. Motivation for weight loss must come from within.

4. Discuss the three kinds of food included in the “Pinggang Pinoy” as well as the perception of the needed diet modification.

Rationale: To educate the client about the different kinds of food included in the “Pinggang Pinoy” as well as the perception of the needed diet modification.

4. Assist the family in determining guidelines most suited to meeting nutritional needs and preferences 

Rationale: To aid the family in making a structured family meal plan 

5.  Provide food selection while offering guidance towards healthier choices

Rationale: To assist the family in selecting food for the structured meal plan that is appropriate for meeting nutritional needs

6.  Presents and introduce various exercise that helps in weight management.

Rationale: To know the different exercises that help in weight management

6. Conduct health teaching about the importance of lifestyle change

Rationale:  Educating the family about the proper information will help the family understand more the importance of lifestyle change

EVALUATION

The client and family identify one of the three kinds of food included in the “Pinggang Pinoy”

The client and family will make and establish a structured meal plan

The client and family identify and develop an active exercise program.

The client and family verbalize understanding about lifestyle change.

 

In reply to Mark Eliezer Nalunne

Re: CARE OF THE SCHOOL-AGE CHILD

by Mark Eliezer Nalunne -
Here is the continuation of the identified problems for the case study:

ASSESSMENT
Subjective Cues:
The client has been missing school because he always gets stomach aches whenever he is about to go to school.
 
NURSING DIAGNOSIS
Fear related to age-related fears as evidenced by school refusal
 
GOALS AND OBJECTIVES (NOC)
A. Fear Level: Child (1213)
B. Coping (1302)
C. Social Support (1504)
 
Goals:
After performing the nursing interventions, the child will have:
1. Verbalized willingness to attend school.
2. Increase and improve attendance in school.
 
Objectives:
At the end of the nursing intervention, the client will:
1. Verbalized the importance of attending school
2. Improve confidence and decrease dependence on adults
3. Verbalize participation in counseling
 
NURSING INTERVENTION (NIC)
A. Counseling (5240)
B. Family Support (7140)
C. Anxiety Reduction (5820)
D. Relaxation Therapy (6040)
 
The nurse will:
1. Assess the behavioral and verbal expression of fear
2. Determine factors to the school refusal
3. Familiarize the client with the school environment
4. Allow verbalization of the fear or anxiety
5. Explain that fear is a normal and appropriate response of the body
6. Introduce relaxation activities to ease the fear and anxieties of the client
7. Conduct counseling sessions with the client and family
8. Refer the client to a child psychiatrist for further assessment
 
EVALUATION
The client will verbalize the importance of attending school
The client will improve confidence and decrease dependence on adults.
The client and family will verbalize participation in counseling
 
Rationale of the Identified and Anticipated Problems:
Overweight related to high frequency of restaurant or fried food as evidenced by the client eating pizza and fried chicken when her mother goes to work - This problem was identified as one of the problems of the client because of his BMI and high consumption of fried foods everyday. This needs to be addressed because health conditions associated with obesity may arise.  Being overweight is closely related to a variety of chronic diseases like cardiovascular diseases including stroke and heart disease which are one of the leading causes of fatality in the world. Diabetes is another associated condition of overweight which can cause blindness, limb amputation, and dialysis treatment. Moreover, excess weight can result in musculoskeletal problems, such as osteoarthritis (World Health Organization, nd). With this, being overweight is the priority nursing diagnosis.
 
Fear related to age-related fears as evidenced by school refusal - This was identified as one of the nursing problems as stated that he was missing school because of stomach ache. It is important to address and look into this in order to assess and determine the child's mental and emotional well-being.
 
Reference:

World Health Organization. (nd). Obesity. Retrieved from https://www.who.int/health-topics/obesity