what are some nursing interventions and educational topics you would want to address with the family.

Scenario A is a three-month-old infant who has multiple fractures to her ribs and suffered a head injury after falling from his bed while sleeping. As a nurse, the following are the pertinent history I would ask the infant’s mother:

1. Was the baby alone or with someone? Is the infant falling alone, or was he with someone else? Was anyone present at the scene of the fall?
2. What was the height of the bed above the ground?
3. Did the baby cry or become unconscious from the fall? Is it possible to estimate how long the infant took to regain consciousness.
4. Is the baby sleeping and eating normally ever since the fall?
5. Are the infant’s symptoms a mix of vomiting and seizures?
6. Are there any hospitalizations or injuries that the infant has had previously?

After reviewing the infant’s history, I will conduct a complete physical exam. To prevent any further injuries, I will be very gentle with the infant if they have rib fractures. These are the techniques that I use for physical assessments:

1. Inspection: I would inspect the infant’s head for signs of trauma, such as swelling, bruising, or lacerations. I would also inspect the infant’s chest for signs of rib fractures, such as asymmetry, bruising, or crepitus.
2. Palpation: I would gently palpate the infant’s head for any areas of tenderness or swelling. I would also palpate the infant’s chest to assess for tenderness and to localize the site of the rib fractures.
3. Auscultation: I would auscultate the infant’s lungs to assess for any signs of respiratory distress or decreased breath sounds due to the rib fractures.
4. Neurological Assessment: I would assess the infant’s level of consciousness, pupil size and reactivity, motor and sensory function, and reflexes.

These are the types of nursing interventions I’d recommend:

1. Pain Management: Because the infant suffered rib fractures I would offer pain management. This includes positioning the infant so that the pain is minimized, giving analgesics when needed, as well as non-pharmacological intervention such as distraction, swaddling or kangaroo treatment.
2. Monitoring: Since the infant has a head contusion, I would monitor the infant’s neurological status closely for any signs of deterioration, such as changes in level of consciousness or seizures.
3. Nutrition and Hydration: I’d ensure that my infant receives adequate nutrition and water, especially in the case of feeding problems or any other symptoms.
4. Prevention of injury: I will educate the parents regarding ways to protect their child from falling and other injuries. This includes ensuring that the baby sleeps in a secure environment, and supervising him during playtime.
5. Collaboration with other health professionals: If I suspect child neglect or abuse, I will work closely with my social worker, physician and social worker.

The following topics are important to me in terms of education and would be discussed with my family.

1. Signs and symptoms of neurological disease or respiratory distress require urgent medical attention.
2. Baby with broken ribs should be treated promptly.
3. Safety sleeping techniques and fall prevention strategies
4. Follow-up visits are important and patients must adhere to their treatment plan.
5. Referral to resources in the community, including parenting classes, support group, and child protective services.