Mason is a 7-year-old boy who is at his primary care physician for a routine physical examination. Mason’s mother expresses concern about childhood obesity and is worried that he sleeps too much.
Subjective Data: Mason has been eating more than usual. Mason sleeps between 11 and 12 hours a day. Mason plays team soccer.
Objective Data
Height: 121 cm
Weight: 23 kg
Vital signs: temp, 37º C; pulse, 78 bpm; resp, 22 breaths/min; blood pressure, 102/62 mm Hg
Height: 90 cm
Mason has a normal physical examination for his age.
Questions:

What should the nurse tell Mason’s mother when discussing her concerns about childhood obesity?
What can Mason’s mother do to help Mason maintain a healthy weight?
Mason’s mother has questions about his joining a soccer team. What should the nurse tell her?
Case Study: Brain Tumor

Caroline is an 11-year-old girl who has an inoperable brain tumor. Caroline has been admitted for palliative care. Her mother, father, and two siblings are with her.
Subjective Data: Caroline complains of a severe headache. She states that she is “afraid to be alone.”
Objective Data
Vital signs: temp, 37.8º C; pulse, 120 bpm; resp, 24 breaths/min; blood pressure, 110/60 mm Hg
Caroline is unable to walk unassisted.
Her pupils are unequal 4 mm right and 6 mm left.
Questions:

What is the most immediate priority for Caroline?
How can Caroline’s nurse help with Caroline’s fears?
How can Caroline’s nurse maintain professional boundaries?

3. Case Study: Hyphema
Johnny is a 10-year-old boy who seeks care after being hit in the right eye with a stuffed snake by his brother 15 minutes before arrival.
Subjective Data: Johnny complains of light sensitivity. Vision in the right eye is blurred.
Objective Data
Vital signs: temp, 36.8º C; pulse, 90 bpm; resp, 18 breaths/min; blood pressure, 110/60 mm Hg
Pupils: Left, 3 mm briskly reactive to light. Right, 3 mm and sluggishly reactive to light
Visual acuity: Right eye unable to see chart; left eye 20/15
Approximately a 30% hemorrhage is noted to the anterior chamber of the right eye with an intact globe.
Questions:

Johnny is at risk for what complications?
What measures may help prevent these complications?
What should the nurse do in this situation? Prioritize these actions.