URN: XXXXXXXXXX |PATIENT: HERMIONE GRANGER
DOB: 15 APRIL 2016 | PAEDS, USQ HOSPITAL
SITUATION:
Miss Hermione Granger, a 5-year old girl, was
ought in by ambulance accompanied by her mother
following a collision with a car whilst riding her bicycle. The collision was at low speed. The injuries she
sustained include a suspected fracture of her left tibia and fibula, multiple grazes across her legs and
feet, left hip, and shoulder. She has a 5cm laceration on her left elbow. Hermione was wearing her
helmet but has sustained a small graze above her left eye
ow.
BACKGROUND
Miss Hermione Granger has no past medical and surgical histories. She lives at home with her parents
and a younger
other. Miss Hermione Granger was born at 38 weeks gestation with no neonatal
complications. Her immunisation is up to date.
ASSESSMENT
Her Glasgow Coma Scale (GCS) is 15, moving right upper and lower limbs with mild weakness, mild
weakness in left upper limb and severe weakness in left lower limb. Both her pupils equal and reactive to
light. Her vital signs are as follows: Heart Rate 130 bpm Respiration 30 bpm Blood Pressure 120/60
mmHg SaO2 99%. She was crying due to the injuries she sustained. All blood investigations were done,
and results were unremarkable. CT Trauma done and was normal (Fig 1) including her left tibia and fibula
(Fig 2).
RECOMMENDATION
Continue neurological observations. Miss Hermione Granger will be kept Nil by Mouth (NBM) until she is
awake. She has had IN Fentanyl STAT administered prior to CT Trauma and a second dose during the
procedure. Miss Hermione Granger has analgesia prescribed as well as intravenous therapy.
XXXXXXXXXXFigure 1: Ct Head
Figure 2: Left Tibia and Fibula
Paediatric Neurological Observation Record: Glasgow Coma Scale
NAME: HERMIONE GRANGER
DATE OF BIRTH: 15 APRIL 2016
URN: XXXXXXXXXX
GENDER: Female
A fall in GCS of 2 or more points requires
eview by Medical Officer
Date
Time
< 1 year > 1 year
Eyes open
Opens
spontaneously
Opens
spontaneously
4 X X
C= Eyes closed
y swelling
Opens to voice Opens to
voice
3
Opens to pain Opens to pain 2
No response No response 1
Best ve
al
esponse
Cues
a
les/cries
appropriately
Uses
appropriate
words/ phrases
5 X X T=
Endotracheal
Tube OR
Tracheostomy
I
itable cry/
grimace
Uses
inappropriate
words/ phrases
4
Cries only to pain Persistent
crying and/ or
screaming
3
Grunts Moans to pain 2
No response No response 1
Best motor
esponse
Moves
spontaneously
Obeys
commands
6 X X
+ Reactive
- No reaction
S Sluggish
C Closed
Withdraws to
touch
Localises to pain 5
Withdraws to pain Withdraws to
pain
4
Abnormal flexion Abnormal
flexion
3
Extension Extension 2
No response No response 1
Glasgow Coma Scale Score XXXXXXXXXX
Pupils
Right
Size 4 4
Reaction + +
Left
Size 4 4
Reaction + +
Limb
movement
Arms
Normal power
Record
(R) right
(L) left
Separately if
there is a
difference
Mild weakness RL RL
Severe weakness
No response
Legs
Normal power
Mild weakness R R
Severe weakness L L
No response
Fontanelle
Sunken Dehydrated
C= Crying
√ present
Soft Normal X X
Tense Raised ICP
Bulging Raised ICP
Initial LN LN
WHAT YOU NEED TO DO
— After reading the case study and reviewing all the charts in this workbook, respond to the task questions
using the link below.
PRESENTATIONS REQUIREMENTS
— Question 1 to 5 must be written using formal academic sentence structure (compete paragraphs that are
grammatically co
ect, with in-text referencing, and no dot-points, figures, or tables)
— Question 1 to 5 must be written in third person
— An introduction and conclusion paragraph are not required
— Referencing: USQ APA 7th (https:
usq.pressbooks.pu
apa7/ ) and references need to be cu
ent, the last
7 years
Question 1
The initial assessment of the child’s overall condition is of crucial importance. The initial assessment of an unwell
child includes the paediatric assessment triangle: appearance,
eathing and circulation to skin; primary survey that
focuses on basic life support, patient assessment and immediate management; secondary survey with a detailed
history of the event and physical examination; and ongoing assessment. Discuss and justify with evidence-based
literature one (1) reason for this (2 marks)
Question 2
Intranasal delivery has been used for several different purposes including vaccinations. Discuss and justify with
evidence-based literature two (2) reasons that contraindicate the use of this route in patients (4 marks)
Question 3
Describe and justify using peer-reviewed evidence three (3) nursing interventions that should be implemented to
educe the risk of complications to this patient (9 marks)
https:
usq.pressbooks.pu
apa7
Question 4
Identify and discuss one (1) priority problem for Miss Hermione Granger during her admission to the Paediatrics
Ward. Justify the priority with peer-reviewed evidence (3 marks)
Question 5
Coping with stress reactions is common after a serious illness, injury, or a hospital stay. Even though it is the child
who is ill or injured, the whole family can be affected. It’s normal for the parents to feel overwhelmed trying to help
the family and themself to cope. Discuss and justify with evidence-based literature three (3) nursing interventions
that could help alleviate stress experienced by parents in this situation (9 marks)
Reference
LAB ASSESSMENT MARKING RUBRIC
REMINDER: Each question on the case study has been allocated with individual marks- please refer to questions in case study
Marks (1.5 mark) 1.5 marks 1.2 marks 0.9 mark 0.6 mark 0.3 mark 0 mark
Academic writing High level of academic
writing.
Co
ect terminology and
professional language.
Skilful use of language that
conveys meaning with
clarity and fluency.
No e
ors in tense, spelling,
punctuation, or grammar.
Good level of academic
writing.
Generally, uses Co
ect
terminology and
professional language.
Uses language that
effectively conveys
meaning with clarity and
fluency.
Minimal e
ors (2-4) in
tense, spelling,
punctuation, or grammar.
Satisfactory level of
academic writing.
Uses co
ect
terminology and
professional language
for some of the
esponses (answers).
Uses straightforward
language that generally
conveys meaning.
Occasional e
ors in
tense, spelling,
punctuation, or
grammar that reduce
eadability.
Limited level of academic
writing.
Inco
ect terminology
and professional
language frequently
throughout the
esponses (answers).
Language used means it
is frequently difficult to
determine meaning.
Frequent e
ors in tense,
spelling, punctuation, or
grammar that reduce
eadability.
Unsatisfactory level of
academic writing.
Uses inco
ect
terminology and
professional language
throughout the responses
(answers).
Uses language that often
does not convey meaning
or is difficult to determine
meaning.
Frequent e
ors in tense,
spelling, punctuation, or
grammar that interfere
with effective
communication. Serious
problems with mechanics
of language.
No submission.
Marks (1.5 mark) 1.5 marks 1.2 marks 0.9 mark 0.6 mark 0.3 mark 0 mark
Referencing All aspects of APA
eferencing are technically
co
ect in reference list
and in-text referencing
High level of academic
sources used.
Minimum of 10 peer
eviewed journals accessed
in addition to other
sources to support work.
Most aspects of APA
eferencing are technically
co
ect in reference list
and in-text referencing.
Generally high level of
academic sources used
8-10 peer reviewed
journals accessed in
addition to other sources
to support work.
Infrequent e
ors in APA
eferencing in reference
list and/or in-text
eferencing.
Mostly academic
sources used with some
non-academic sources.
Some peer-reviewed
journals accessed in
addition to other
sources to support work.
Frequent e
ors
consistent in APA.
eferencing in reference
list and/or in-text
eferencing.