Scenarios

Chapter 18 Children's nursing and health promotion

James is 13-year-old boy who was admitted to the children's ward last week via Accident and Emergency after being knocked off his bike on his ride to school. He was not wearing a crash helmet and suffered a broken tibia. He also had multiple lacerations to his arms. He was very lucky and did not have any serious head injury.

James is due to be discharged home in 5 days' time. He will be going home with a leg in a plaster cast that goes from just below his knee to the tips of his toes. James also has a number of dressings on his arms from the lacerations that are still healing. He is still finding his leg painful and is taking regular analgesics.

• 1. What health promotion needs should be discussed before James is discharged?

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  Correct answer:

  • Care of a plaster cast.
  • Wound care and dressing changes for his arms.
  • Mobility issues to ensure minimal muscle wastage while the cast is on.
  • Hygiene issues such as washing and dressing.
  • Ways to protect himself from injury in the future including wearing a helmet.

• 2. What role might the children's nurse play in accident prevention?

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  Correct answer:
  

  • Advise about prevention, e.g. stair gates, keeping chemicals out of reach, placing cots away from blinds.
  • Identify and treat accident-causing conditions, e.g. visual or balance disorders, diabetes, epilepsy.