Discuss the significance of jerods clinical manifestations

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Reference no: EM133860710

Case Scenario: Newborn

Gender Male

Age: Neonate

Setting: hospital

Ethnicity: Black American

Coexisting conditions: Myelomeningocele

Psychosocial: Parental anxiety

Client Profile:

Jerod is the name Joanna and Jim chose for their first child. Jim accompanied Joanna to all of her prenatal visits. When the routine ultrasound was performed at 32 weeks' gestation, Jerod was diagnosed with hydrocephalus and a myelomeningocele. His parents were initially devastated, but remained very excited about their son's birth. Joanna was scheduled for a caesarean section at 38 weeks' gestation and the couple were anxious about Jerod's condition and his treatment following birth.

Case Study

Jerod is delivered by caesarean section and transferred to the pediatric intensive care unit (PICU). On admission to the nursery he weighs 3.4 kg (7.5 lb) and is 8 cm (20 in.) in length. His vital signs are:

Temperature: 37° C (98.6° F) Pulse: 144 beats/minute Respirations: 40 breaths/minute
He has bulging fontanels and a high-pitched cry. His head circumference is 40 cm (15.8 in.) and his chest circumference is 34 cm (13.4 in.). In the lumbar region of his spine, the nurse notes a sac-like projection. When Joanna and Jim visit the nursery, they stroke Jerod and caress his fingers and toes. Joanna begins to cry and comments to the nurse, "I so wanted to breastfeed Jerod, but now I guess I can't."

Questions

1. Discuss the reason for Jerod being delivered by caesarean section.

2. Discuss the significance of Jerod's clinical manifestations.

3. What is hydrocephalus?

4. What is a myelomeningocele and how is it related to hydrocephalus?

5. Discuss the incidence and etiology of hydrocephalus and myelomeningocele.

6. Discuss the complications associated with Jerod's myelomeningocele.

7. What are the priorities of care for Jerod on admission?

8. Discuss Jerod's parents' actions when visiting Jerod in the nursery and how the nurse should respond to Joanna's concern about breastfeeding.

9. Discuss the priority nursing interventions when caring for Jerod's myelomeningocele prior to surgery.

10. Jerod's myelomeningocele is surgically repaired and a shunt is placed for his hydrocephalus. Discuss the two types of shunts used to treat hydrocephalus and which is most common.

11. Discuss the complications that may occur in a child with a ventriculoperitoneal (VP) shunt and an atrioventricular (AV) shunt.

12.. Discuss the teaching priorities for Jerod's parents prior to his discharge from the hospital home.

Reference no: EM133860710

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