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November 12, 2024
Judy is a 7-year-old kid who was first diagnosed with a common cold and low-grade persistent fever, which was ultimately identified as leukemia. The youngster had signs of lethargy, restlessness, pallor, fever, and seemed anorexic. Additional signs were weight loss, widespread petechiae, unexplained bruises, and reports of joint and bone discomfort. The youngster lives with her parents.
The customer was first diagnosed with a simple cold, which was then revised to leukemia. Nonetheless, some symptoms of leukaemia had raised concerns for Judy's parents. They suspected that the progressively emerging symptoms indicated a latent terminal illness. Her parents believe that Judy’s death is imminent. As a result of this notion, people are experiencing profound anxiety, dread, and melancholy. Consequently, the primary concerns for the family are the suitable therapy for Judy and her parents' anxiety and sadness around her health.
The family-centered strategy used in Judy's rehabilitation will comprehensively evaluate the urgent and specific needs of both Judy and her parents. This method will enhance communication between experts and family members, making the latter an essential component of the care team. A joint intervention strategy will be designed to meet the primary needs of the client and her family. The treatment plan will be focused on rehabilitation, geared towards specific goals, and concentrated on the individual.
The objective of the care plan is to satisfy Judy's multifaceted needs and alleviate the worry, fear, and despair experienced by her family members. The primary areas of attention in the treatment plan will be Judy's acute joint and bone pain, nutritional imbalance, and her parents' concern (Pitman et al., 2018). This care plan essay will delineate the family-centered approach to be incorporated in Judy's care plan, identify the priority areas requiring attention, present the subjective and objective data supporting the diagnosis, and outline an SMSRT goal-based care plan addressing three primary needs of the family.
The family-centered approach adheres to the same concepts and fundamental ideas as the person-centered care method. This methodology seeks to strategize, implement, and assess healthcare using strategies rooted in mutually advantageous cooperation among healthcare professionals, patients, and their families (Kokorelias et al., 2019). The partnership guarantees that healthcare practitioners are attentive to the preferences, needs, health goals, cultural requirements, and objectives of the client and their family members (Rait, 2015). This method fosters collaboration among professionals, patients, and their families, acknowledging their responsibilities in enhancing the quality and safety of client care. The four fundamental characteristics of the family-centered approach are dignity and respect, knowledge sharing, involvement, and cooperation (Adib-Hajbaghery & Aghajani, 2015).
In the aforementioned situation, dignity and respect will be maintained in the collaborative connection between the client and the professional by honoring the cultural, health, and care perspectives of the client and their family members (Adib-Hajbagher & Aghajani, 2015). Judy's viewpoint on rehabilitation and health must be included into the treatment plan. The viewpoints of Judy's parents on her best interests should be included into the care plan. To foster respect, the parents' values, health beliefs, and knowledge will be taken into account throughout the formulation of the care plan. To uphold the dignity and respect of the client, the client's personal information will be maintained confidentially, and the ultimate care choice will be made by the family members (Lin et al., 2013). Professionals may advocate for the client, but the care choice will be made together. The care plan will include the care plan for Judy's parents, who are exhibiting symptoms of despair and anxiety (Archer et al., 2012). Pessimistic ideas might obstruct parental engagement in the care plan and hinder their caregiving abilities. In conjunction with Judy's care plan, the professional must refer the parents to psychiatric help if necessary, since it is crucial for them to maintain a positive outlook on the prepared care plan.
Moreover, the doctors must publicly provide impartial and comprehensive information about the diagnosis and the other treatment options accessible for Judy. Judy's parents will get prompt, precise, and relevant information on Judy to facilitate informed decision-making. A paternalistic attitude will not be used.
Judy's parents will be actively urged to participate in the decision-making process about her care at all levels. The pros will not make any paternalistic decisions. This concept is linked to the notion of information dissemination.
Collaboration will be facilitated between family members and specialists to achieve a conclusive choice. There should be an agreement between the two parties to prevent misunderstandings and disputes that might hinder communication. In this environment, professionals must motivate the client and the client's parents to engage actively in the care plan, as this will enhance the parents' self-determination, self-agency, duties, and responsibility in Judy's care (Choi et al., 2014).
The four potential nursing diagnoses for Judy are severe pain, anxiety, unbalanced nutrition, and exhaustion. The objective evaluation of acute pain may be conducted via a pain scale. Judy reported experiencing discomfort in her joints and bones. The manifestation of symptoms such as weight loss, weariness, and lethargy suggests a nutritional imbalance. A blood test may assess the nutritional composition in Judy's body. Anxiety is shown by symptoms of restlessness, lethargy, and irritability. Anxiety in children may be objectively assessed by the administration of anxiety measures. Petechiae may result from viral or bacterial infections or may indicate significant underlying health issues such as leukemia. The objective signs of petechiae consist of unexplained bruises and little red patches on the whole body. This is the manifestation of leukemia.
The nursing diagnoses previously examined include acute pain, petechiae, anxiety, and unbalanced nutrition. These diagnoses have been prioritized because to their interference with Judy's usual functioning. Acute joint and bone pain may lead to mobility impairments, depression, and irritability. The intense discomfort requires prompt intervention, since it may lead to irritability, despair, and worry in Judy. Nutritional imbalances or inadequacies may intensify tiredness, promote weight loss, and increase susceptibility to other infections. Prioritizing dietary balance is crucial to diminish the likelihood of illness and weariness. Prolonged nutritional shortage may impair the body's ability to restore lost nutrients. Meeting the body's minimal dietary requirements may significantly reduce the likelihood of illness.
The interrelation between mental and physical health indicates that Judy's experiences of worry and dread may exacerbate her health, making her body more vulnerable to infections. Chronic stress, worry, and anxiety may impair the immune system's capacity to combat infections to which the body may have been exposed. The dread and anxiety may hinder Judy's capacity to maintain resilience and positivity toward his illness. Children afflicted with leukaemia often experience sadness and the apprehension of never achieving recovery. A youngster as young as Judy may comprehend the notion of death. In this scenario, the nurses must ensure that her parents refrain from discussing the negative implications of the diagnosis in Judy's presence. This may exacerbate her dread and anxiety around the diagnosis. Hope and optimism among uncertainty and worry might result in favorable health results that may expedite healing.
Fatigue is a critical diagnosis for Judy, as it may signify an underlying nutritional deficiency, infection, or compromised immune system (Davis, Viera & Mead, 2014). If fatigue is not emphasized in the diagnosis, it may not receive appropriate intervention, resulting in a decline in her condition. Fatigue may disrupt everyday activities, resulting in diminished productivity, impaired mobility, decreased concentration, vertigo, cephalalgia, and somnolence.
The primary nursing diagnosis is acute pain associated with reflex muscle spasms and tissue damage owing to malignancy, corroborated by Judy's reports of joint and bone discomfort. To alleviate the discomfort, the objective for her should be to enhance the pain to an acceptable and controllable degree. The SMART objective is to identify two non-pharmacological techniques to alleviate pain within a two-week timeframe. The solution include instructing the child and parent in distraction techniques, including rocking or holding, parental affection, participation in simple games, use of hand puppets, blowing bubbles, shaking rattles, and watching television or listening to music together (Scates et al. 2020). This will enhance Judy's focus on non-pain stimuli and diminish her awareness and perception of pain. Another intervention for pain treatment involves instructing parents on the administration of thermal modalities, including heat and cold. Malanga, Yan, and Stark (2015) said that heat alleviates pain by enhancing blood circulation to the affected location and diminishing pain responses. Cold compression alleviates pain, muscular stiffness, and inflammation by diminishing the production of nociceptive chemicals and inhibiting the transmission of pain signals (Heinonen and Laukkanen 2018).
Judy's second objective is to reduce the pain score to below 4 on the Wong-Baker Faces Pain Rating Scale within two weeks. The objective may be attained via the implementation of effective interventions. The first intervention involves instructing Judy and her parent on the use of the rating scale to assess the level of either past or current pain. This entails requesting Judy to establish a goal by identifying a pain level that enables her to function efficiently and comfortably. If the pain level remains elevated for an extended duration, she must take measures to alleviate it or inform her parents or healthcare team to facilitate the implementation of effective pain management strategies (Lawson et al. 2021). This objective serves as a foundation for directing and modifying the treatment plan as necessary. Additionally, an intervention that aligns with this goal is to examine Judy's pain experience and its cultural implications alongside her family. Matsuoka (2021) asserted that this approach aids in identifying how to assist the individual through culturally sensitive nursing practices.
The secondary diagnosis is a nutritional imbalance associated with an elevated caloric need and difficulty in consuming an adequate caloric intake owing to cancer, hence precipitating weight loss. The objective established to rectify nutritional imbalance is to provide sufficient sustenance to Judy. The first SMART objective is to enhance Judy's appetite using two ways during a three-week timeframe. The first technique is to instruct her parent on the approach of consuming frequent and modest meals. An equal distribution of daily calorie intake would aid in preventing stomach distention, hence enhancing hunger and improving tolerance. The second intervention is instructing Judy and her family on the effective maintenance of optimal oral hygiene after meals. The maintenance of oral hygiene enhances appetite, since the condition of the oral mucosa is crucial for the capacity to eat (Rocha et al. 2018). The oral mucosa is inherently wet and generates sufficient saliva, which aids in food digestion. The secondary objective is to ascertain Judy's nutritional requirements within a week. The first step is recommending a zinc supplement. Amin et al. (2020) assert that supplemental zinc positively influences nutritional status and promotes weight gain. This would decrease the incidence of infections and mitigate bad effects associated with chemotherapy, hence enhancing quality of life. The second strategy is including vitamin C into her regular regimen. Mastrangelo et al. (2018) asserted that leukemia arises from vitamin C deficiency and is therefore associated with biochemical scurvy. Consequently, leukemic individuals need nourishment throughout the therapy phase.
The third diagnosis is anxiety related to leukaemia, since it was determined that Judy exhibited signs of distress and concern. The objective, in this instance, is to alleviate the tension experienced by Judy and her mom within one week. McFarland et al. (2019) said that managing cancer is very challenging at any advanced stage, especially when the child is 7 years old. Nonetheless, it is essential to address it. The first action recommended for both individuals is counseling. Van Schoors et al. (2019) said that counseling has had a beneficial effect on cancer patients. It encompasses relaxation training, mental visualization exercises, familial and social support, and constructive coping ideas. Judy's parents must maintain a cheerful perspective; their sadness and depression will exacerbate her anxiety. Consequently, therapy may be seen as an effective intervention that enhances the psychological and emotional dimensions of the patient, enabling her to experience happiness and maintain a good perspective on life. The second intervention, in this instance, is to engage in an activity that might significantly enhance quality of life. McTiernan et al. (2019) said that physical activity is associated with enhancements in mental health conditions, including depression and anxiety. This is because physical activity enhances Judy's energy levels, enabling her to be active and optimistic. This will enhance the quality of life for critically sick individuals. Aerobic exercise, also referred to as cardio, is a kind of exercise that elevates the heart rate, fortifies the heart and lungs, and mitigates symptoms of sadness. This is advantageous because of its inherent flexibility, allowing it to be executed at any location and time without constraints. Consequently, Judy must engage in physical activity, particularly exercise, at the designated time with her parent's assistance to effectively manage her chronic sickness and discomfort.
The fourth diagnosis is weariness related to leukaemia, since it was determined that Judy had exhaustion and lacked the motivation to engage in any activities. The objective is to diminish tiredness within one week. The first intervention involves including energy-dense foods, including fruits, whole grains, legumes, dairy products, and starchy vegetables such as potatoes, maize, and peas. The family must be cognizant of her dietary requirements to provide the items that will assist her in combating weariness. The second intervention entails sufficient rest to facilitate energy conservation. This will enable her to get energy and maintain fitness consistently.
In conclusion, Judy has been diagnosed with leukemia and has varied demands, while her parents are exhibiting indications of sadness and worry. The treatment plan was designed to include both subjective and objective data on Judy's symptoms. The evaluation report of Judy will be evaluated, and a collaborative approach will be used to include the perspectives and preferences of Judy and her family members. The SMART framework has been used to create three care plans for Judy, which will be assessed and adjusted as necessary.
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