BACKGROUND INFORMATION 3 year old white female, restrained…
Question Answered step-by-step BACKGROUND INFORMATION 3 year old white female, restrained… BACKGROUND INFORMATION3 year old white female, restrained passenger in motor vehicle which was broadsided at high rate of speed. At the scene she was found unresponsive with no resp. effort and intubated at the scene. During intubation she vomited. Arrived in the ED immobilized on backboard and cervical collar. Ventilated on 100% O2, and Ringer’s Lactate.Provide rationale for the actions at the accident scene.PRIMARY & SECONDARY SURVEY (Complete on HPS)Airway Patent -intubatedBreathing Rales RML resp rate 18Circulation Cap refill 4 seconds, extremities cool/mottled Heart rate 80’sDisability Unconscious, & unresponsive to finger pinch or sternal rubHEAD TO TOE ASSESSMENT (Complete on HPS)Head, neck Immobilization collar in place- no noted external head trauma-bruise over rt eyeChest Bruise over rt lateral chestCV HR 80’s, cap refill 4 sec at fingertips & 3 sec at sternumGI + BS, bruise over LUQGU foley with small amt amber urine outputMS bruise rt arm & lt legRADIOLOGYXrays and CT of C-Spine revealed:6 mm dissociation of C1 from the occiput = Posterior translocation of C21 mm separation of C6 and C7Head CT negativeChest x-ray, middle lobe infiltrateWHAT DO THESE FINDINGS SAY ABOUT CLIENTS INJURIES- All other x-rays, negativeINITIAL LABS- NORMAL, HIGH OR LOW?ABGs- ph7.21paO2 59, pcO2 58,HCO3 24, BE – 4.SaO2 85% Hct 22.5Hgb 8.1 Electrolytes, normalMatch 2 units of PRBCINTERVENTIONS IN EDMechanical ventilation with 100% O2, SIMV 30, Vt 150 (10cc/kg), PEEP 5Ringers Lactate infusing at maintenance rateHigh dose steroid protocol for spinal cord injury (SCI)•Admission to PICUQUESTIONS RELATED TO CASEExplain the ventilator settingsAnalyze blood gases and lab data.Why was Ringer’s Lactate chosen as the maintenance? What are the priorities for ED management?Discuss the implications for spinal cord injury.Discuss the reason for administering a corticosteroid.Given this child’s history and physical findings name 3 actual or potential nursing diagnoses Health Science Science Nursing Share QuestionEmailCopy link Comments (0)
