Complete the discussion in Group A or B as assigned by the instructor.

Discussion A: Group A will complete initial post, Group B will respond to the post.

Bobby was hospitalized 6 days ago for appendicitis. After an appendectomy following a perforated appendix, he now has an open incision requiring BID dressing changes and contact isolation due to a hospital-acquired MRSA infection. It is anticipated that he will be here for 5-10 more days for long term antibiotic therapy and wound care. He is 13 years old. He has been afebrile for 24 hours. The wound is open with minimal serious drainage.
He is withdrawn and relates “just tired” when you inquire about how he is this morning. Last week he shared his interest in school. Gets A’s in math, computer science and was supposed to be competing in the school science fair this week.

What do you know about the adolescent and the appropriate developmental level?
Keeping his diagnosis in mind, what about visitation?
Is socialization a need?
What other questions should you ask?

Discussion B: Group B will complete the initial post, Group A will respond to the post.

Tina is 5 years old, lives with her mother and grandmother. Mother works 2 jobs to help support her mother and her daughter. Tina is well cared for but is now admitted for a cardiac catheterization due to the Ventricular Septal Defect (VSD) that was noted at birth.
Tina has an extensive history of respiratory infections and a nursing diagnosis of ‘activity intolerance’. Her mother relates that she does not allow her to play organized or competitive games due to her health. Tina smiles broadly when you come in the room to begin the pre-operative checklist. She starts to ask you a question when her grandmother tells her she must stay in the bed. “The nurse knows what she is doing and you will just be in the way.” Tina continues to smile at you but moves back to the bed.
Group A Response:

You begin to explain that the first thing you will need to get done is an I.V. Tina’s grandmother doesn’t give you a chance to ask her to help. She excuses herself and says she can’t watch. She will go to the cafeteria and return later. Tina starts to cry and begins to suck her thumb.

What tools have you brought with you?
How can you comfort Tina?
What methods of communication might you use to help relieve anxiety?
Can you give Tina choices?
How can you successfully get the IV in?

It also needs to be cited and referenced. 

Discussion A
According to Erickson’s theory of psychosocial development, adolescents (ages 12-18) fall under the category of identity vs. role confusion. At this stage, the individual struggle to develop a self of sense and are often asking or questioning what they are of who they want to be in the future (Orenstein & Lewis, 2020). At the same time, adolescents are undergoing several developments are they are integrated into adulthood. Changes in hormones and body can significantly affect body image and even self-confidence. 
Fitting in is an important thing for adolescents as they are at a level of development where they are trying to find a place in society. Therefore, in this case, it is important to consult Bobby if he would like to have friends visit him. The presence of dressing may make Bobby feel sensitive about his body and the image that his friends may have hence the importance to consult the patient on visitation time. On the other hand, socialization is important as it would significantly affect the mental health which would in turn positively impact the recovery process. 
Apart from the social aspect, it is important to inquire about the pain level and also use different scales in determining the level of pain. This would ensure that Bobby is comfortable throughout his stay in the hospital. Occasionally checking on mental health is also important to ensure that isolation of the patient does not negatively impact the recovery process. 
Reference
Orenstein, G. A., & Lewis, L. (2020). Erikson’s Stages of Psychosocial Development. In StatPearls [Internet]. StatPearls Publishing.
 
Response Discussion A
Dealing with adolescents can be particularly challenging because they are at a stage where they are still trying to figure out who they are or what to do. I agree that it is important to consult them on when or if they would like visits and what time if they agree to it. Even in cases where they do not want any visitors, it is still important to suggest it to them in a way that they would not feel pressured. Socialization in this case can help improve their demeanor and make them more positive to the healing process. After all, mental state impacts the recovery process and things such as stress can affect the immune system. 
One thing that could be added on the list on what to ask is the progress in school or even something about the social life. While it is important to maintain professionalism, a nurse should also create a rapport with the patient to find a common ground that would improve the working relationship (Blake, 2015). That is, if the patient feels comfortable with the care received and also believes that the nurse genuinely cares about him, then he would have an easier time opening up to the primary caregiver. In this way, the nurse can collect more information that would improve the care of the patient. 
Reference
Blake, K. (2015). Developing a Patient Care Standard for Adolescents Based on a Nursing Needs Assessment.

Prof. Angela

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