Assessment
G.J is an African American, a five-year-old boy who is brought up in a Christian setting home by his parents. The mother is aged 32 years, the father is 35 years and has a brother who is 4 years. The primary language that is used at their home is English. G.J was taken for medical evaluation and admitted diagnosis was asthma. His mother reported that the boy developed respiratory symptoms at two months of age but she thought that it was not that serious. G.J has been reported to have wheezes, coughs, and a running nose. The boy had sleepless nights due to the wheezes, coughs and vomiting.
G.J was allergic to dogs, seasonal allergies including mold allergies. The hallmark of his illness was that a cold would always trigger his asthma. G.J. would miss school because of asthma. He had never had any emergency room visits, and had never been hospitalized. His asthma symptoms would typically worsen with the weather changes in the spring and fall; the cold winter months were often particularly difficult. According to his mother, he also regularly grinds his teeth at night.
G.J. was delivered normally and the mother had no complications. He weighed 3.0 kilograms at birth. He currently weighs 19.8 kilograms which is fine for his age. He is 43 inches in height. As it was reported by his parent, G.J was a healthy boy who had no illness. He has never been involved in any accident and had not taken any operation. This was his major hospitalization. The father reported that his immunizations were updated.
Developmental milestones
Fine Mortal Level
G. J’s developmental assessment revealed that his fine motor skills were fine because he could take small actions such as grasping objects between the thumb and fingers and could use his lips and tongue to taste objects (Hockenberry and Wilson, 2000, p. 468). He could also feed himself, play, write and draw some funny pictures and he could color them.
Gross motor development
GJ’s developmental assessment clearly indicates the normal fine level of development (Hockenberry and Wilson, 2000, p. 477). G.J was able to grasp objects, point at objects and people, lift and transfer objects from one place to another. He could also exchange items from one hand to the others. G.J could sit, crawl and at the age of 8 months he could stand and walk while holding unto furniture. He could also walk at 15 months and at 2 years he could kick a ball. Now he is five years and he can ride a bike without balancing problems.
Language development
According to his mother, G.J had Language delay a condition whereby he developed with the right sequence but at a slower age. This affected his social life because people could not understand his needs (Hockenberry and Wilson, 2000, p. 25). G.J took speech therapy when he was three years old.
Cognitive development
G.J was having no problems with cognitive development. He is able to understand what people said. He could listen to instructions and get whatever he is being asked by his mother. He also had reasoning and he could remember his things like toys at a tender age of 2 years. He could not confuse his toys with his brother’s toys. Now that he five years he does not have problems in learning, he remembers what they covered in class and can give the right description to pictures or drawings. This therefore indicated that he had a normal cognitive development (Hockenberry and Wilson, 2010, p. 556)
Social development
G. J’s social development had some problems at his early ages because he took long to pronounce sensible words. Sometimes he could just cry to be given something and this brought conflict with his brother. These problems also extended when he went to school, he could not freely socialize and form relationships with his classmates. He sometimes feared his teacher and he could not cooperate in games or molding. Mum and dad both shares responsibility. Child bonds very well with both parents G.J could bond very well with both parents
G.J developed some problems when he lost appetite. This has greatly affected his growth because his height is 43 inches and his weight has also been affected because right now he weighs 19.8 kilos G.J does not eat much and he mostly prefers to eat junk foods like cheese sticks. He only ate 10% of his food. This is not recommendable to a child of his age because they require a lot of energy for their development (Hockenberry and Wilson, 2000, p. 560).
G.J being diagnosed with asthma is on medication that is composed of Albuterol. It is used to prevent and treat wheezing, difficulty breathing and chest tightness caused by lung diseases such as asthma and chronic obstructive pulmonary disease. Albuterol inhalation aerosol is also used to prevent breathing difficulties during exercise (Treece, 2010; Casale, 2010). It works by relaxing and opening air passages to the lungs to make breathing easier. Albuterol controls symptoms of asthma and other lung diseases but does not cure them and so they will help to open his airways (Castro-Rodriguez and Rodrigo, 2009).
G.J. was also given Ampicillin and sulbactam which are antibiotics in the penicillin group of drugs (National Asthma Education and Prevention Program, 2007). They fight bacteria in your body. Ampicillin and sulbactam are antibiotics in the penicillin group of drugs (Polit, 2008). These drugs fight bacteria and they will help to reduce the effects of the allergies that G.J. has developed.
Analysis
According to Duvall’s developmental stages of the family, G.J. is in stage II: Families with pre-scholars being the first born in the family which upgrades from stage one (Hockenberry and Wilson, 2010). The parents live together and they share responsibilities in the family. They involve their children in the house chores. G.J. bonded well with his parents and they both take responsibility of G.J. hospital care. His family is extended because it has both parents and the two kids.
Planning and Implementation
Below are the two internet resources I believe to be helpful both G.J. and his family:
Internet Source I is sponsored by US National Library of Medicine, the largest library in the world that explains all about asthma. It is the encyclopedia of all diseases, their causes incidence, and risk factors, symptoms, signs and tests, treatment, home care, prognosis, complications and prevention. This site will be helpful for both parents and caregivers of children suffering from asthma. It will help the caregivers and parents to know the home based care for such children. It will also help the affected people to know about allergies so that they can avoid whatever they are allergic to.
Internet Source II gives information about asthma medicine and asthma help. It has tabs where you can get information about the cause of asthma, what triggers asthma, diagnosis, symptoms, treatment, medical help and how to deal with children with asthma.
Short-term goal: Through each assessment, G.J will:
- Achieve social skills and language development will be efficient for his age within the scope of his present abilities during the hospitalization and speech therapy.
- While in hospital G.J. will gain good nutrition for his age without problems in vomiting. For this goal, I observed G.J.’s eating habits keenly and had no signs of vomiting. His eating habits changed from taking 10% of his food to 50%. This was a good sign that he was progressing well.
- During hospitalization all the parents were involved in the medical care of their son. They could ask questions and were free to give G.J.’s past history.
- Within each assessment and hospital stay, G.J. will show some signs of improvement like decrease in coughs and the wheezes will reduce. For this goal, continuous breathing assessment will be taken and the parents will be advised to keep him warm and away from the things that he is allergic to like pets and moulds.
Long-term goal: Through each assessment, GJ will:
G.J. will attain steady gain in weight pattern and progress towards age-appropriate size upon discharge and at home. For this goal, daily weight during hospitalization will be maintained to evaluate the amount of weight G.J. gain in the hospital. Teachings on correct feeding techniques will be given to parents and caregiver, and return demonstration will be required for proficiency. Also restriction on unhealthy diets as well as education on healthy nutrition will be given to family in an understandable language to rid any discrepancies in G.J.’s dietary intakes.
- By discharge and at home, G.J. will maintain weight gain toward goal with normalization of laboratory values and be free of signs of malnutrition. For this goal, G.J.’s laboratory test should be done again in the hospital to evaluate improvement in results. Family must be thought by medical team on signs and symptoms of malnutrition, and infection, and when to seek doctor’s advice.
- G.J will not experience any incidences of wheezing, coughs, vomiting or any other sign for asthma. For this goal, progressive assessment will be carried out as well as proper dressing and preventions of allergic conditions. The parents will be required to report to the staff about any signs and symptoms of asthma.
- G.J. will have no breathing problems. For this goal, medication should according to doctor’s prescriptions. The family members should continually inspect G.J.’s condition. The parents would also be encouraged to visit the websites that were provided for any information regarding to asthma conditions.
References
Brozek J.L., Bousquet, J., Baena-Cagnani, C.E., Bonini, S., Canonica, G.W. and Casale, T.B. (2010). Pediatric Airway Management and Respiratory Distress Self-Study Module. Allergy Clin Immunol, 126 (3), 466-76.
Bush, A. and Saglani, S. (2010). Respiratory System. Lancet, 376 (9743), 348-61.
Castro-Rodriguez J.A. and Rodrigo, G.J. (2009). Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Ediatrics, 123 (3), 519-25.
Hockenberry, M.J., & Wilson, D. (2010). Wong’s nursing care of infants and children. St. Louis, MO: Mosby Elsevier.
Monte, C. (2000). Malnutrition: A Secular Challenge to Child Nutrition. Jornal de Pediatria, 3 (1), 285-297.
National Asthma Education and Prevention Program. (2007). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville: NIH publications.
Polit, D.F. (2008). Nursing Research: Principles and Methods. Philadelphia: JB Lippincott Company.
Rogers, C.A., Burge, H.A. and Spengler, J.D. (2011). British Management guideline on the Management of Asthma. Journal of Urban Health; 84 (2), 185–208.
Rutishauser, C., Sawyer, S and Bowes, G. (1998). Quality-of-life Assessment in Children and Adolescents with Asthma. European Respiratory Journal, 5 (1), 486-494.
Treece, J.W. (2010). Elements of Research in Nursing. St. Louis: Mosby.