Question

Gloria is an 8-year-old girl who is admitted to the pediatric unit with a history of cystic fibrosis and difficulty breathing. (Learning Objectives 3, 4, and 6)

 A. What would the nurse know to include in the health history?

 B. When conducting a physical assessment on Gloria, what will the nurse do in relation to the child's cystic fibrosis?

 C. What tests would the nurse expect to be ordered for Gloria?

Answer 1

Cystic fibrosisis is a genetic disease in which mutation to CFTRI gene.

1. The nurse should include the following in the health history;

- the genetic or family history of disease.

- include respiratory and gastrointestintal system assessment

- obtain details of past and newborn history of the child

- obtain the family genogram of three generation.

-obtain the history of present complaints.

2. While conducting physical examination;

- respiratory assessment includes

Inspection, palpation, percussion and auscultation

In inspection symmetry of chest expansion, rate, any exertion in breathing.

In palpation tactile fremitus, thoracic expansion, any tenderness etc

In percussion, check for any hyperresonance

In auscultation, check for abnormal breath sounds.

- check for sputum culture and routine examination.

The child has to undergo sweat chloride test and genetic testing.

The gastrointestinal system includes;

- evaluation of weight loss

- BMI

3. The tests to be ordered are

- sweat chloride test

- sputum test

- orophargyeal swab culture to check for any infection

- pulmonary function test

- chest xray

- pancreatic enzyme tests

- tripsinogen test

- echocardiography