Ms Collins has arrived at your GP
Ms Collins has arrived at your GP Surgery for her 2 and 4-year-old children’s immunisations and health checks. However, she has brought her other children with her as well. All the children appear gaunt and irritable and have repeatedly asked their mother for food. Their mother appears disinterested in her children and sits quietly waiting for you to start the health assessment and immunisations. Below are her Children’s details and initial observations. Name Charlotte Sonny Asher Chloe Age 7 year old 4 year old 2 year old 6 weeks old BMI 120cm : 19 kg 115cm : 13 kg 85cm : 13kg 50cm : 3kg Initial Obs Appears Shy and reserved, trips over the bed which is right in front of her and does not appear to hear when her mother speaks to her Mother states toilet training not going well. Sits on the floor with his toy bear in the middle of the treatment room. Does not lift her head or smile when encouraged. Appeared very sleepy although mother stated had just woken up. History Diagnosed with Epilepsy 12 months ago Teeth are discoloured with chips in the back molars Still crawling when at home not walking independently Long labour, required oxygen at birth Current Issues Does not have many friends at school Son states it hurts when he urinates every time, his words are not formed very well, and the mother has to translate for you. Unable to walk alone and just throws building blocks around the room does not stack them or play with them Only breastfeeds for 5 minutes then falls asleep again. According to the children’s BMI what would you class their nutritional status as What fluid and nutritional deficits could the children be developing? Outline a plan of care you would recommend for each of the four children using a problem-solving approach. Include your rationale for the recommendations you have made
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