Name

: Fatih Haris Maulana

NIM

: 131411123079

CLASS

: B17 / AJ2

CASE STUDY EIN 2

A three-year-old boy is brought to the emergency room by his parents. The parents report that
for the past two days the child has had a fever - the temperature has been as high as 40 C - and he
has been listless and his oral intake has been well below normal. The child has no prior medical
history and does not take any prescription medications. The parents have been giving the child
acetaminophen whenever his temperature was above 38 C. The parents are basing this decision on
what they read on the internet: 1) that a high fever can cause permanent brain damage and seizures;
2) that the normal temperature shouldnt be higher than 39. Neither parent can remember how much
acetaminophen they give the child with each dose or how often they have given it and the mother
says you can buy acetaminophen at any drug store, and they wouldnt sell it over-the-counter if it
wasnt safe. They have also been giving the child ibuprofen every once in a while because again,
they had read on the internet that using acetaminophen and ibuprofen was a better way to lower a
fever than using either one alone.
After reviewing the history of the current illness and examining the child, the physician
makes the diagnosis of otitis media and prescribes an antibiotic. The physician informs the parents
that a temperature of 40 C is not unusual in cases of otitis media, higher fevers are not uncommon,
and except for cases of hyperthermia, the seriousness of the illness does not correlate with the degree
of fever. She also tells the parents: 1) a high fever in a child who has a simple infectious process will
not cause brain damage; 2) treating a fever will not prevent febrile seizures; 3) lowering a fever that
is caused by a simple, easily treated infectious process will not decrease the time it takes for the
illness to resolve, and; 4) a fever is considered to be a defense mechanism and a fever may decrease
the length of an infectious illness. A fever can be treated, she notes, if it is > 38 C, but this is an
arbitrary number and lowering the fever is not the goal; the goal is to lower the fever to make the
child comfortable and help increase oral intake. Finally, she advises the parents that there is no
evidence that alternating anti-pyretics is more effective than using one alone and that overusing overthe-counter antipyretics, especially acetaminophen and especially in the context of giving this drug to
a child who has a fever, can be dangerous and cause liver damage.
From the given case study, please do the following:
1. Write a table of data analysis
2. Write a nursing diagnosis and intervention based on NIC and NOC

DATA ANALYSIS
No.
1.

Focus Data
Subjective Data :
The parents says that for
the past two days the child
has had a fever - the
temperature has been as
high as 40C and he has
been listless and his oral
intake has been well
below normal.
The boys mother says
you can buy
acetaminophen at any
drug store, and they
wouldnt sell it over-thecounter if it wasnt safe.

Etiology
Lack of information about the
desease and the treatment

Problem
Deficiency of
Knowledge

Objective Data :
The parents have been
giving the child
acetaminophen whenever
his temperature was above
38C.
The parents are basing this
decision on what they read
on the unclear source from
internet.
Neither parent can
remember how much
acetaminophen they give
the child with each dose or
how often they have given
it
They have also been
giving the child ibuprofen
every once in a while
because again
NURSING DIAGNOSE
1. Deficiency of Knowledge related to Lack of information about the desease and the
treatment

NURSING CARE PLAN

Nursing Diagnosis and
Supporting Data
ASSESSMENT AND
DIAGNOSIS
Deficiency of
Knowledge related to
Lack of information
about the desease and
the treatment

Expected Patient Outcome

PLANNING

Short term goals:

Patients family will
understand how to know the
temperature and febris
characteristic on otitis media

Nursing Interventions
INTERVENTION

Rationale
PRINCIPLE

1. Explore patients
1.
current knowledge
base about current
condition.
2. Give health education 2.
Long term goals:
on disease and patient
Subjective Data :
1.
Patients
family
will
care
The parents says that
know management of 3. Evaluate readiness to 3.
for the past two days
febris
learn.
the child has had a
2. Patients family will
fever - the
understand disease
temperature has
processes, etiology,
4. Begin with simple
4.
been as high as 40C
clinic manifest and
explanation
of
the
and he has been
the treatment of the
abnormality, the
listless and his oral
desease
suspected etiology.
intake has been well
5. Allow ample time for 5.
below normal.
patients questions
The boys mother
and responses to
says you can buy
information
acetaminophen at
any drug store, and
they wouldnt sell it
over-the-counter if it
wasnt safe.
Objective Data :
The parents have
been giving the child

EVALUATION
Expected outcome
Nursing intervention

1.

Patient verbalized
Teaching should be base on
knowledge of the
current level of
etiology, effects and
understanding.
treatment for the
disease condition as
so that the patient knows
evidenced by
the disease, treatment and
Reported of
prevention for febris
understanding of
High anxiety or denial may
condition disease
interfere with ability to
process and
understand and use new
treatment
information.
2. Patient participated
simple explanations are ore
in treatment regimen
likely to be understood by
the patient.
Information may be
determine the extent of
knowledge of the patient and
the patient's family
challenged the explanation
given about the disease.

acetaminophen
whenever his
temperature was
above 38C.
The parents are
basing this decision
on what they read on
the unclear source
from internet.
Neither parent can
remember how
much
acetaminophen they
give the child with
each dose or how
often they have
given it
They have also been
giving the child
ibuprofen every
once in a while
because again