Adam is 17 year old recently admitted to respiratory ward from ICU…
Question Adam is 17 year old recently admitted to respiratory ward from ICU… Adam is 17 year old recently admitted to respiratory ward from ICU with diagnosis of hypoxic brain injury. Adam has tracheostomy inserted whilst in ICU to assist clearance of secretions due to poor cough strength and increased secretions, and to facilitate weaning from mechanical ventilation. Background- Adam was admitted to respiratory ward 6 days ago after a 3 week admission in ICU secondary to an acute asthma attack. During his ICU admission, he was diagnosed with non focal seizures caused by hypoxia and is currently controlled with sodium valproate. He has size 8 ported tracheostomy inserted to facilitate weaning from mechanical ventilation and aid in securing his airway. History- Adam past medical history include brittle asthma and he has number of hospital admission related to his asthma. He also has complications related to asthma treatment which includes steroid induced diabetes mellitus secondary to prolonged and repeated use of corticosteroids. From family- His mother reports that Adam does not appear well today and his hands feel cool and he is coughing more. Meryl tells u that she put another blanket over him as he was shivering. She says Adam squeezed her hand and know she is here. She indicated that god saved him and her church community is praying for him. Assessment- On assessment, Adam is positioned supine in bed, you elevate his head to 45 degrees, his NGT feeds are running at 83ml/hr and needs to be changed next hour. The external length of his NGT is at 40cm at the tip of nose. On auscultation, he has course crackles, tactile fremitus, you suction his tracheostomy and clear some creamy secretions. NVSEye opening 3, verbal response – 1 tracheostomy, motor resonse-4, pupils-4mm, limb power upper and lower-severe weakness, temperature- 12 am: 36.6, 4am: 36.8, 8am: 37.4, 10am: 37.9. Respiratory rate- 19, 18, 22, 29 (times as of temperature). SpO2- 95, 95, 97, 92 via 4l oxygen therapy Swedish nose. Pulse- 87, 92, 86, 106 BP- 126/78, 134/82, 154/94 (BP not monitored 4am). BGL- 7.6, 6.4, 8.1, 7.3 Test report- wbc- 15.7 x 103/ul, platelets- 323,000/ul, hemoglobin- 129g/l, urea- 7.1 mmol, creatinine- 108umol/l. I would like to know the signs ans symptoms, priority problem and 2 interventions for this case. Thank you. Health Science Science Nursing NURSING NSB236 Share QuestionEmailCopy link Comments (0)
