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Data:  7 years old girl is diagnosed to ARTHROGRYPOSIS,  due to severe and untreatable bone deformity, after all treatment were unsuccesful, dr amputated both her legs from below the knees.

she had history of cleft soft palate surgery, and 2 years ago she got broken  right arm which both resolved. Her speaking wasn’t clear, i guess because of cleft palate surgery. she complains of pain  and nurse gave her pain med through IV push. The day I took care of her in my clinical day was second post up day. She wore diapers, and in last 36 hours didn’t have any bowel movement. Also she stated of having nausea and feel like she wants to vomit.She didn’t have appetite to eat, just drank water, milk , and small glass of apple juice.

Her medications: !-miralax     8.5 gr        2- Colace    50 mg oral      3-Ketrolac 9mg IV push

her vital signshe was normal for her condition and age. all her lab was normal, except RBC was alittle low.

She is attending public school, but  as a kid with special needs( second grade), due to her surgery she maybe couldn’t attend school for weeks. She has 10 years old healthy brother and one is on the way which all pregnancy test for her mom showed baby is healty. she likes to play, but can’t move that causes her frostration. After ampuation should be in bed rest or chair for a month , till her stumps heals and get prosthetic legs. Ofcourse her parents need lots of teaching how to take care of her, be aware of any sign and symptom of infection, proper diet due lack of mobility to prevent constipation. she caughed alittle but could be able to clear her secretion. her weigh is 16.6 kilos.

please fill out the forms very carefully, make up lab value and drug info sheet for 3 medication she got.

she supposed to discharge next day, after physical therapist teach her mom how to take care of her stumps and change dressings and wraps around her stumps. Also i need 2 nursing diagnosis for this case, each nursing diagnosis should be in different concept map sheet. I mean 2 concept maps with all information regarding that nursing diagnosis.

her assessment didn’t show any sign of cardiac problem, her respiratory rate was ok(20/ min) but caughs alittle, her IV sight was intact and IV sight was in her left hand, so i checked her right hand pulses. I connected to her well and played with her, she was so happy and her mom thanked me to cause her daughter feels better. That was all info.

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