Question Answered step-by-step Client Profile:Andrew is a 10-year-old fifth grader who lives with… Client Profile: Andrew is a 10-year-old fifth grader who lives with his parents in the suburb of a large city. He is active in school and enjoys playing with his neighborhood friends. His father (Randy) works in the city and his mother (Joyce) works part-time as a computer programmer from her home office. She takes Andrew to and from school each day and is active in all of his school and extracurricular activities. Andrew is an A-B student who enjoys his school subjects and wants to study to become a doctor one day. The family lives approximately 5 miles from his school. Mr. Burger also is very involved in his son’s activities.Case Study: After picking up Andrew at school 3 weeks ago, Mrs. Burger was involved in a serious motor vehicle accident while driving home. Both she and Andrew had their seat belt restraints fastened. The accident occurred when a van did not stop for a stoplight and struck their car in the side where Andrew was riding. Mrs. Burger sustained lacerations from broken window glass, but Andrew received a closed head injury from the impact. Mrs. Burger was treated in the emergency department of the city hospital and released; however, Andrew was admitted to the pediatric intensive care unit. He was nonresponsive at the scene of the accident, and on admission his Glasgow Coma Scale score was 3 out of 15. He was transferred to the pediatric nursing unit last week. A CD player at his bedside plays music. He focuses and tracks as his parents talk to him, and they perform most of his care, including range-of-motion exercises twice a day. He is receiving oxygen via a tracheostomy collar. He coughs up most of his respiratory secretions, but still requires suctioning every 3-4 hours. He receives enteral nutrition through his gastrostomy tube. This is the first day you have been assigned to Andrew, and during your assessment, you find the client awake and able to respond by nodding and shaking his head for “yes” and “no” when questioned. He moves his extremities spontaneously and on command; however, you note bilateral weakness. His Glasgow Coma Scale score currently is 4-1-5, his vital signs are within normal limits for his age, he weighs 77 lb, and is 1.5 m (5 ft.) tall. His lungs are clear bilaterally and his bowel sounds are present on all four quadrants. He remains incontinent of urine and stool. You overhear Andrew’s mother tell him she is “so sorry” about the accident and she begins to cry softly.Andrew receives all of his medications via his G-tube and is prescribed famotidine 20 mg per G-tube b.i.d., bethanechol 5.25 mg q.i.d., and Levetiracetam 350 mg b.i.d. Discuss Andrew’s medications related to why he is receiving each medication, the safety of the dosages prescribed, and any special precautions needed related to routine of administration.What is your priority concern about Andrew’s urinary and bowel incontinence?How would you explain Mrs. Burger’s comments to Andrew and what might your therapeutic interventions consist of?How can you intervene to help meet Andrew’s growth and development needs?What other health care professions would be beneficial in Andrew’s care? Health Science Science Nursing NURSING 4055 Share QuestionEmailCopy link Comments (0)