Clinical Scenario – Written Report
Clinical Scenarios
Scenario Mei
Mei is 10 months old and has been admitted to the paediatric ward in a regional hospital with her mother Morgan,
who will be ‘rooming in’. Mei was referred by her GP who was concerned about Mei’s poor weight gain and
increased lethargy.
Social History
Morgan is a single mother and Mei is her only child. Morgan has poor family support – her mother lives interstate
and her father died when Morgan was a child. Morgan has not worked since Mei was born and misses her work
colleagues.
Medical History
Mei was born at 40 weeks’ gestation following a normal vaginal delivery. There were no complications at birth
and her birth weight was 3,200 grams. Mei was breastfed until 6 weeks of age. Mei did not gain weight during this
period and would vomit after every feed. On the advice of the child health nurse Morgan started Mei on a formula
recommended for babies with reflux. Mei did not gain weight and continued to vomit during and after every feed
with regular periods of diarrhea.
At 6 months old Mei weighed 4,600 grams. The GP thought she may have a lactose sensitivity and suggested
lactose free formula. Morgan again changed Mei’s formula. However, Mei continued to vomit during and after
every feed. She has started on solids, but Morgan reports she isn’t very interested in food and continues to vomit
after dairy products, biscuits, bread and packet baby foods. Her weight gain is very slow and despite regular
check-ups with the GP and child health nurse her weight and energy levels have not increased. Mei is up to date
with her immunisations.
Progress Notes
Mei is alert and bright eyed, but tires easily. She smiles and laughs with her mother and is verbalising, although
does not yet have any words. Mei weighs 5,200 grams.
Mei has been diagnosed with a ‘cows milk protein allergy’. She will be commenced on prescription formula and
requires a nasogastric tube to be inserted for top up feeds.
Morgan is angry about Mei’s diagnosis. She is defensive about Mei not gaining weight and blames nurses and
doctors for not doing enough. Morgan has expressed frustration at the length of time it has taken to get the correct
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diagnosis for Mei and is very upset that her daughter has had to go through this when she has tried her hardest to
get help.
RCH 2016, ‘Allergy and Immunology Cows Milk Allergy’, accessed 20th March 2019
https://www.rch.org.au/uploadedFiles/Main/Content/allergy/Cows%20milk%20allergy.pdf.
World Health Organization 2019, ‘The WHO Child Growth Standards’, accessed 20th March 2019 https://www.who.int/childgrowth/standards/en/.
Analysing a paediatric clinical scenario provided, by using evidence-based approach, taking
a developmentally appropriate approach based on the child’s developmental stage and
incorporating the principles of child and family centred care, and child rights when
communicating and caring for the child and their family. (2200 words)
This assignments must be completed as guidelines below.
You have to answer all of the questions below and may put headings for each section.
Scholarly references:
At least 20 scholarly references from 2014 to 2019.
The appropriate referencing style for this unit is APA Style
Introduction (100 words)
Brief statement identifying and succinctly summarising your chosen scenario and what you will address in the
body of your report
Nursing Care (1000 words)
1. Identify and shortly explain why Inserting a Nasogastric Tube is a relevant aspect of nursing care
currently required by the child for this scenario based on the information presented in the scenario.
2. Describe how you will provide this care (inserting a Nasogastric Tube) incorporating the principles of child
and family centred care, child rights, and the developmental stage of the child.
3. Discuss how the child’s developmental age and stage may impact the way you approach the child and
provide the required nursing care.
4. Discuss how you will incorporate the principles of child and family centred care, child rights while
providing the required nursing care here.
In this section you have to develops child centred effective strategies/approaches to caring for a child or youth
and their family based on the developmental stage of the child through demonstrating exceptional understanding
of the child’s developmental stage by seamlessly integrating highly relevant strategies and approaches to
providing appropriate care for the child and family.
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Communication (1000 words)
5. Identify and describe an issue with communication arising from this scenario.
6. Describe the strategies/ approacheds you will use to communicate and develop trusting relationship with
the child and family incorporating the principles of child/family centred care and child rights Discuss how
will you address this issue when communicating with this patient and family.
7. Discuss how will you incoporate the principles of child/ family centred care when communicating with this
patient and family.
You have to Incorporate the principles of Child and Family Centred Care when communicating with a child and
their family by demonstrates exceptional knowledge and application of the principles of family centred care
when communicating with the child and their family
Conclusion (100 words)
Brief statement concluding what you have discussed in the body of your report.
