Reference no: EM133848139

Case Study

Philip, a 14 month-old child recently diagnosed with type 1 diabetes, presents to the pediatric metabolic/endocrine clinic with severe gastrointestinal distress, fever, dehydration, lethargy, and loss of appetite. His mother is very distressed and appears tired; she is sleep deprived and worried about her child, who she says has had a "stomach bug" for 2 days. Recently divorced, she asks to speak to a social worker concerning her impeding loss of living situation and lack of resources to pay for a move. Her 4-year-old child is currently staying with the maternal grandparents, whose own health status is poor.

Upon assessment, the child's vital signs are heart rate of 132 beats/min, respiratory rate of 42 breaths/min, axillary temperature of 101.3 F, oxygen saturation of 91%, blood pressure of 99/42 mm Hg, and significant glucosuria and ketonuria. A fingerstick blood glucose test finds the child's fasting blood glucose to be 372 mg/dL, so intravenous fluids and insulin are initiated to address his dehydration and hyperglycemia. When asked about the child's insulin intake, the mother provides an insulin log but many entries are not filled in.

The pediatric health care team gathers in the clinic room with the mother and explains the child needs to be admitted to the pediatric unit for further testing and supportive care. Very distressed, the mother states she is overwhelmed and confused by the child's diabetes regimen and feels as though she lacks the ability to care for the toddler.

Question:

How can the pediatric healthcare team support this mother given her feelings of distress and despair?