Pediatric Concept Map

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Scenario 1 PBL 2008

Ved Lionel Long

Psychopathology

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Richard Bailey - 16 Yr old male - Cellulitis, Pulmonary Emoboli, and Transient Bacteremia - Post Surgical Septic Knee Joint

Family

Sister - 10 year old

Father - Secondary Care Giver

Mother - Primary Care Giver

Pathophysiology

Pulmonary Emobli

Found due to inactivity

Bacterial Infection

Cellulitis above incision

Post Surgical Knee Joint Infection

Growth and Development

Anxiety

Feels Lonely and Anxious being in the Hospital

Vital Signs

Chest Pain upon Deep Breathing

Work of Breathing

Level of Conciousness

Fever

102.5

Patient History

Allergies

Coconut, Nuts, Gluten, Latex, Penicillin, ceftriaxone (Rocephin)

Pulmonary Embolism upon admission

Celiacs Disease

Increasing Pain for 3 days

In Bed, not moving around

Fever over 102.5

Left Knee Surgery to repair ACL/meniscus

Pharmacology

Senna docusate

Stool softener to prevent constipation

Norco

Opioid/Acetaminophen analgesic combo for pain

Oxacillin

antibiotic for bacterial infection

Topical Emollient (Eucerin)

topical ointment for cellulitis

Enoxaparin (Lovenox)

Low Weight Heparin to prevent blood clots

Surgical Intervention

I & D

Drains placed bilaterally on left knee

screw replacement ACL/Meniscus repair

aspiration of left knee

Nursing Interventions

Nursing Diagnosis

3. Altered Family Process

2. Risk for Infection

1. Risk for Impaired Gas Exchange

Ambulation as tolerated

Non-Weight Bearing Left Leg until drains removed

L Knee Brace continuous when not in CPM

CPM - 8 hrs Qday

Radiology

CT Scan for Chest

IV Access

PICC line left brachial

Labs

Blood Cultures

D-Dimer / Fibrinogen

Hgb / Hct

PT/INR/aPTT