Evan, an 8 month old boy has been brought to the ED. His parents state Evan has been SOB, with an increased wheezy cough. His nasal secretions are thick, and mucousy and he appears to have a productive cough, thick mucousy phlegm, lung sounds are wheezy bilaterally. His parents also report that he seems to have an ongoing sinus infection and cough that never seems to clear up despite antibiotics and nebulizers. Mom states Evan is a good eater but does not seem to thrive. She states his bowel movements are daily but really almost slimy and foul most of the time and wonders if he has allergies that they have missed somehow. The ED physician has examined Evan and has ordered some labs to evaluate Evan for Cystic Fibrosis. The physician has ordered: an IRT, (Immunoreactive trypsinogen), A sweat test, a chest xray, and genetic testing for CF. The parents state they are new to the area and have not established care with a pediatrician. Both deny family history of CF.

Include:  Introduction of client/client issues. (Example:  describe your client think assessment)  One paragraph (minimum) pertaining to Erikson.  Identify stage of development referring to Erickson and give examples of how your client is meeting or not meeting these stages (example: client may be of chronological age but not cognitive age). 
Include pathophysiology of disease process and how disease impacts the client. Example: will disease impact clients growth and development now or in the future, will activities or diet be impacted etc.  Indicate any medications that may be prescribed for this condition.  After reviewing the medications incorporate data regarding medications:  include all information (like information on a drug card) and determine how this medication will be administered in a safe manner with clear explanations. Think:  will medication be short term or long?  Client education: Is this something that could be prevented via education, diet or life style changes? Keep in mind that other factors may be involved (example:  obesity leading to diabetes.  Early education for the family at risk? Diet changes early in the family? Exercise? school or community education effort?)
–    At least 2 evidence-based references from the last 5 years should be included.
–    Provide accurate nursing assessment information
–    Demonstrate understanding of diagnosis, treatment and potential complications
–    Utilize evidence-based principles to guide nursing understanding and clinical judgement.
–    Develop plan of care based upon clinical understanding.
–    Demonstrate understanding of roles of professional team members
–    Must be in APA format, and conform to rules of grammar, punctuation and spelling.