NURSING

Case One:

You see a 7 year old child for a WCCU.  The mother is present for the visit and reports that during the past 12 months he has become more clingy.  He will separate from his parent as long as he can see them nearby.  For example, he will play soccer, but will turn around every 3-5 minutes to make eye contact with is mother and becomes agitated if he cannot see her in the crowd.  He was excited about going to a Boy Scout overnight camp but then refused to go because his mother could not go with him.  The mother also reports that he has begun to have significant nightmares about 4 times a week.  He has moved from his bedroom where he slept with his younger brother to a palette on the floor next to her bed because he is afraid to go to sleep?  The child is at the 50% in weight and height and his vital signs today are normal.  You have done both a vision and hearing screening both were normal.  Physical exam is normal except you note a soft systolic murmur during his exam.

What management do you suggest based on your reading and research?
Include any pharmacologic interventions if appropriate.
Include non-pharmacologic interventions if appropriate.
Create a plan of care to teach a parent parenting skills that promote a childs healthy self-perception.
List three strategies that can be used by a pediatric provider to identify victims of child maltreatment.
What biases and beliefs must the provider overcome to identify at-risk children?
How will you as a health care provider resolve any conflicts between your personal views and professional practice in discussing sexuality, sexual orientation or birth control?
What are unique issues related to values, beliefs, and spirituality of preschoolers? school-age children? and adolescents?
How can assessment of values and beliefs incorporated into the preventive care of each of these age groups?

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