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LYDIA HALL’S CORE, CARE, AND CURE MODEL

The model consist of 3 C’s. The 3 circles are: (1) the patient’s Body, (2) the Disease affecting the body and (3) the Person of the patient.

Nursing functions in all professions to different degrees.

3

circles, but

it is interconnected with other

Core

It pertains to person aspect which is cared for by therapeutic use of one self. With the help of the nurse, the patient will be able to use the reflective technique which will aid in clarifying the motive and goals. Thus, it facilitates the process of increasing the patient’s self-awareness. Therefore, this aims to provide more control over the patient’s own behavior, even if she must behave on the basis of her feelings and not on the basis of her knowledge. In line with the study, the patient showed her concern based upon on her own knowledge and judgment which opposes the principle of this model. So, the group helped the patient in modifying her behavior.

Care

It is concern with the delivery of health care by nurses which is the exclusive domain of nursing. Furthermore, this includes all ‘’hands-on’’ intimate bodily care such as feeding, bathing and toileting that will result in a comforting and nurturing relationship. This also develops a closer relationship between the patient and the nurse that will represent the teaching-learning aspect of nursing. In relation with the situation, the group was able to implement the different independent nursing interventions that contribute to patient’s wellness.

Cure

It tackles the medical care and treatment of the pathological condition. Hence, this is shared with the physician that equates collaborative and dependent nursing interventions in administering different medications and treatments. The nurse functions in this role as an investigator and potential cause of pain related to skills such as injections and dressing changes. In the said case, the patient received the appropriate medical management.

DISCHARGE PLAN

Medications

Instruct and explain to the mother that the medication, especially the

antibiotics, is important to continue depending on the duration that the doctor ordered for the total recovery of the patient. Inform the mother of the side and adverse effects of the drugs she is giving to her daughter.

Instruct to report immediately any side or adverse effects when taking

the prescribed drug such as nausea, vomiting, diarrhea, rashes. Take the entire course of any prescribed medications. After a patient’s temperature returns to normal, paracetamol is administered if fever occurs. Avoid using paracetamol more than 5 days.

Instruct the mother to avoid over-the-counter drugs without the consultation of the physician to avoid any drug-drug interaction.

Exercise

 

Encourage the mother to have her daughter rest from time to time for faster recovery.

Treatment

 
 

Comply with the established treatment regimen given by the doctors including prescribed medications.

Encourage the mother to expose the patient to early morning sunlight

Advise the mother to provide tepid sponge bath when fever occurs

Provide oxygen therapy during active convulsion to alleviate the

difficulty of breathing.

Hygiene

Encourage and explain to the mother that it is vital to maintain proper hygiene by frequently washing her hands.

Out-patient

It’s important for the toddler to have her follow-up check up to ensure and have the patient’s progress monitored.

Diet

Encourage the mother to continue breastfeeding the patient. Instruct the mother that the head must be in upright position when breastfeeding to avoid aspiration and let the baby burp after feeding.

REVIEW OF ANATOMY AND PHYSIOLOGY

∑ It’s important for the toddler to have her follow-up check up to ensure and have

Temperature control in children is not completed until approximately five years of age. This may be due to the immaturity of the nervous system. The maintenance of body temperature is mainly coordinated by the hypothalamus, a central control center containing large numbers of heat-sensitive neurons called thermoreceptors. It is an important homeostatic mechanism which allows the body enzymes to work efficiently within a narrow range of 36.5–37.5 ºC. In response to a change in temperature, the peripheral thermoreceptors transmit signals to the hypothalamus, where they are integrated with the receptor signals from the preoptic area of the brain.

The ‘normal set point’ in childhood reflects a decreasing basic metabolic rate (BMR) as the child grows. The body temperature of the three-month-old child is 37.5 ºC, whereas at thirteen years it is 36.6 ºC. Even as the temperature regulatory mechanisms mature through childhood, babies and small children are highly susceptible to temperature fluctuations, as they produce more heat per kilogram of body weight than older children. Changes in environmental temperature, increased activity, crying, emotional upset and infections all cause a higher and more rapid increase in the younger child. The younger the child the less able he or she is to vocalize the feeling of hot or cold or to do something about it. All children may also become too cold. Small individuals who do not have warm clothes and warm homes will not grow if the temperature of their environment is consistently low. They will use much of the energy from their food intake to generate heat (metabolic rate) and leave no spare calories for tissue growth. The smaller the child, the larger the surface area for heat loss in relation to body mass. The head of a small child is relatively larger in proportion to the rest of the body, and covering the head in a cold environment conserves heat for growth. Schoolchildren may experience a sequence of small growth spurts and at times be relatively thin with minimal body fat. At the swimming pool, for example, where children enjoy jumping in and out of the water as they play, thin children may become cold more quickly than their fatter friends who have an insulation layer beneath their skin. Heat can generated through the metabolism of the liver, muscles, and other chemical activities. When children are exposed in a cold environment, it can result to hypoglycemia, elevated serum bilirubin, metabolic acidosis, and increased metabolic rate. When heat loss occurred, non-shivering thermogenesis (NST) heat production takes place in the subcutaneous tissue, hypothalamus, and spinal cord to compensate for the sudden change in temperature. Heat loss transpires through the contact in a cold environment, vasodilation, sweating where the preoptic area of the brain stimulates secretion of water to the skin for evaporation. There are different areas in the body where we can measure the temperature such as axillae, tympanic membrane, and mouth.

BENIGN FEBRILE CONVULSION

Fever is among the most common symptom usually seen in infections and can often be a cause for concern for apprehensive parents. In children, a fever can appear quite suddenly and resolve just as quickly although significantly high temperatures may be recorded during the episode. Although a fever may be a sign of the body’s natural defenses against an infection, there are times when a fever can occur without any clear indication of an infection. High fevers may lead to fits (convulsions), often indicating a need for immediate medical intervention.

What are febrile convulsions?

A febrile convulsion is a seizure in young children caused by a sharp rise in body temperature (fever). Febrile convulsions otherwise called febrile seizures (fever seizures) or febrile fits (fever fits) can cause a lot of concern among parents

because of its sudden onset and frightening nature

A convulsion triggered by

.. sudden fever is usually harmless and normally does not indicate a long term or ongoing problem like epilepsy. It is important to note that episodes such as these occur in relation to a rapid rise in temperature, & is not related to the duration of the fever or the degree of temperature.

What causes of fever seizures?

As previously mentioned, most fever fits occur as a result of a sudden rise in body temperature but it may also develop as the fever is declining.

Usually, the fevers that trigger febrile convulsions are caused by an infection in the infant’s body, such as middle ear infections, or other bacterial or viral infections of the nose & throat. A less common, but more serious cause of such fevers is an infection of the child’s brain & spinal cord, such as meningitis. The risk of fever seizures can also increase after some common childhood immunizations.

What are the symptoms of febrile fits?

A child experiencing a febrile convulsion may display the following signs and symptoms:

A fever, usually higher than 38.9 C

Loss of consciousness

Jerking of the arms & legs

Eyes rolled back in the head

Difficulty breathing

Vomiting & urinating

Crying or moaning

Based on the symptoms, there are two types of febrile convulsions:

A simple, benign febrile fits is an episode of convulsions that lasts for less than 10 minutes. The nature of convulsions is generalized in that the entire body goes into spasm or becomes stiff. After the episode of fits subside, the child is normal and suffers no after effects although they may act confused and be quite sleepy.

In atypical febrile fits, the episode of convulsions lasts for more than 15 minutes. The nature of convulsions affects only one part of the body and the seizure occurs more than once in 24 hours. The child may show signs of after effects or damage of the brain.

How are fever seizures diagnosed?

Febrile fits is diagnosed by the doctor by careful history taking with due consideration given to the age of the baby and the family history

In addition, blood investigations and a lumbar puncture is indicated in special situations to rule out any infection. A lumbar puncture involves taking a sample of fluid that surrounds the spinal cord to look for any signs infection.

How are fever seizures treated?

When a child starts having fits, parents must remember not to panic. The infant should not be restrained & no attempt should be made to stop the seizure movements. The child should be placed on his or her side to ensure that the airways remain clear and remove any objects or food from the mouth. Measures must be taken to control the fever & reduce the temperature by removing clothing, applying cool washcloths to the face & back and sponge the rest of the body with cool water. The child must be taken to the doctor when the spell passes.

Most febrile seizures stop on their own within a couple of minutes. If the fit last for longer than five minutes, or if the infant has repeated seizures, immediate medical attention is required.

How to prevent fever seizures?

Simple benign febrile fits can be prevented from recurring by taking the following precautions :

As soon as the fever begins, the temperature has to be brought down immediately by paracetamol

syrup administration and tepid sponging. Until the child recovers completely from the fever episode, he has to be watched carefully for any sudden rise in temperature.