The Goal Of Creating A Nursing Concept Map Is To Create A Pl

The Goal Of Creating A Nursing Concept Map Is To Create A Plan Of Care

The goal of creating a nursing concept map is to develop a comprehensive and individualized plan of care for a pediatric patient, specifically a 6-month-old child diagnosed with bronchiolitis caused by respiratory syncytial virus (RSV) and a history of patent ductus arteriosus (PDA). This approach involves integrating assessment data, underlying pathophysiology, diagnostic findings, and current clinical interventions to ensure holistic and targeted nursing care. The concept map serves as a visual tool that helps nurses organize and connect relevant patient information, prioritize nursing interventions, anticipate potential complications, and coordinate care effectively. By doing so, it enhances critical thinking, promotes thorough assessment, and guides the implementation of best practices tailored to the child's unique needs, especially considering comorbidities like PDA that may influence respiratory and cardiovascular stability.

Paper For Above instruction

Creating a nursing concept map for a pediatric patient with bronchiolitis involves a detailed understanding of the child's clinical presentation, underlying health conditions, and current interventions. In this scenario, Vivi Mitchell is a 6-month-old infant presenting with respiratory distress signs—wheezing, retractions, fever, and cough—confirmed by a positive RSV test. The presence of PDA and premature birth further complicate her clinical management, requiring a nuanced approach that considers both respiratory compromise and cardiovascular considerations.

A comprehensive assessment begins with evaluating Vivi's vital signs: her temperature is elevated at 102.1°F, her respiratory rate is increased at 40 breaths per minute, and her oxygen saturation is maintained at 96%. These indicators suggest active respiratory distress but stable oxygenation following interventions. The presence of wheezing and retractions signifies airway obstruction and increased work of breathing, common in bronchiolitis, especially in infants with smaller airway calibers. Her weight below the 10th percentile raises concerns about her nutritional status and potential vulnerability to dehydration, especially considering increased respiratory effort.

The nursing care plan must incorporate multiple interconnected components. First, airway management is paramount, necessitating nasal bulb suctioning and saline drops to clear nasal secretions, relieving nasal congestion and improving airflow. The current nebulizer therapy with albuterol aims to bronchodilate the airways, reducing wheezing and improving ventilation, which is evidenced by the decrease in respiratory rate to 36 and oxygen saturation improvement to 100% after treatment. Monitoring for side effects of medications, such as tachycardia or tremors, especially in infants, is essential.

Second, fluid management should be prioritized, with encouragement of oral fluids to prevent dehydration. Given her age and illness, vigilance for signs of hypovolemia is necessary, especially since increased respiratory effort can lead to insensible fluid losses. IV fluids may be considered if oral intake is inadequate or dehydration becomes evident.

Third, fever management is addressed with acetaminophen (Tylenol) at 15 mg/kg every 4 hours as needed, to reduce discomfort and metabolic demand. Continuous monitoring of temperature and assessment of comfort levels are vital in responding effectively to her symptoms.

The patient's cardiac history of PDA influences her care, particularly concerning her respiratory status. Although her PDA may not currently be causing significant shunting or heart failure symptoms, it necessitates cautious monitoring for signs of increased pulmonary blood flow or heart failure, especially if her respiratory status deteriorates. Her prematurity also predisposes her to more severe bronchiolitis and potential complications, requiring careful observation and potential escalation of care.

Family education is pivotal, particularly given the mother's background as an ER nurse, which can facilitate clearer communication and adherence to management plans. The mother is already knowledgeable about nebulizer use and DS, which supports home management of wheezing episodes following initial treatment. Education should include recognizing worsening symptoms such as increased respiratory rate, persistent hypoxia, lethargy, or inability to feed, which would warrant prompt return to the clinic or emergency department.

The importance of infection control measures to prevent the spread of RSV should also be emphasized, including minimizing contact with other infants and maintaining hand hygiene. Since Vivi’s siblings attend daycare, guidance on minimizing exposure during peak RSV season is crucial, particularly for infants with underlying heart or respiratory conditions.

Finally, the nursing care plan should include coordination with the healthcare team for ongoing assessment and potential escalation if her condition worsens. This may involve additional diagnostic testing, supplemental oxygen, or hospitalization if her respiratory distress progresses or if signs of heart failure appear.

In essence, creating an effective nursing concept map involves synthesizing assessment data, current interventions, and understanding the pathophysiology of bronchiolitis alongside her congenital heart defect. This organized visual tool supports comprehensive, patient-centered nursing care, fostering prompt response to changes in her condition and optimizing recovery while preventing complications.

References

• American Academy of Pediatrics. (2014). Respiratory syncytial virus. In: Red Book: 2012 Report of the Committee on Infectious Diseases. American Academy of Pediatrics.
• Berkowitz, I. D., & Christakis, D. A. (2017). Pediatric nursing: Content review for the NCLEX®. Elsevier Health Sciences.
• Hewlett, J. (2019). Pediatric respiratory illnesses: Bronchiolitis. University of Michigan Health Library.
• Leung, J. M., & Giebel, B. (2019). Pediatric Cardiovascular Disorders. In: Kliegman et al., Nelson Essentials of Pediatrics. Elsevier.
• Meissner, H. (2013). Respiratory syncytial virus prophylaxis: an update. BMJ, 346, f676.
• McMorris, M., & McKenzie, L. (2017). Pediatric nursing: A case-based approach. Jones & Bartlett Learning.
• Roberts, K. (2018). Pediatric primary care: A culturally competent approach. Elsevier.
• Roth, S., & Cole, E. (2020). Pediatric nursing: Caring for children and families. Elsevier.
• Shields, C. (2016). Pediatric emergency nursing: A comprehensive review. Springer Publishing Company.
• Wolters Kluwer. (2018). PICOT question formation. In: Nursing research & statistics. Lippincott Williams & Wilkins.