Question

The nurse is taking care of a 9-year-old patient with a history of spina bifida. The patient has limited sensation below his knees and has an infected sacral decubitus. He has been admitted for antibiotic therapy for the decubitus and evaluation of the need for a skin graft. The nurse positions the patient on his right side, supporting his lower back with pillows and placing the call bell close to his right hand. The patient states he does want pillows near his feet and prefers to dangle them over the side of the bed. The nurse returns to reassess and reposition the patient 2 hours later, turning the boy on his left side with pillow support for the lower back. She examines the decubitus and sees that the dressing is intact without evidence of further complications. When the parents arrive at their son’s room, they complain to the nurse that she allowed the boy to dangle his feet over the edge of the bed. The nurse explains the boy’s request and emphasizes that she positioned the patient as ordered.

1. Identify the clinical problem(s) in the case study.
2. Discuss appropriate education for this patient.

Answer 1

Spina bifida is a condition in which baby's spinal cord fails to develop properly .It mainly occurs in the womb during pregnancy.Its a birth defect.

Patient has infected sacral decubitus i.e., the decubitus ulcer or wound or ulcer on the lower back (sacral region).

Clinical problem in the study-

1.As this is sacral decubitus,nurse should convince the patient and tell him about the complications of the request he demands.

2.Proper guidance should be given to patient as he is only 9 year old. According to his comfort he is demanding but he does not know the bad impacts or complicated conditions of that.

Appropriate Education for the patient -

1.Patient is only 9 year old , so he should be encourage and become an active member in his health preventions.

2.Repositioning should be done after 2 hours as preferred for sacral decubitus condition with continuous and effective monitoring.

3. He should be told that he should not see his comfort while the undergoing treatment and must follow the order of the nurse to avoid any complications.

4. Maintain proper body alignment as directed.

5.He must be told about keeping pressure off these areas at all times .