Carrie Richards, a 3 month old female, was admitted to the hospital…

Question Answered step-by-step Carrie Richards, a 3 month old female, was admitted to the hospital…  Carrie Richards, a 3 ½ month old female, was admitted to the hospital with respiratory distress due to respiratory syncytial virus, long with dehydration and inadequate nutritional status. The mother expresses concern that Carrie Richards has lost weight and is “acting hungry.” Upon arrival in the Emergency Department Carrie Richards exhibited substernal retractions, nasal flaring, with oxygen saturation of 89% on room air, coarse respirations with wheezes and crackles noted in both lungs, T 99°F HR 156 RR 56. Carrie Richards weighed 4.5 kg. IV fluids was ordered D5 0.45 NS with 10 mEq of KCl/100 mL to run at 40 mL/hr. Carrie Richards provider also ordered monitoring oxygen saturation with pulse oximetry, Acetaminophen 45 mg q4H for temperature above 101 degrees or for irritability, Racemic epinephrine and Albuterol inhalation were ordered as well as laboratory workup for baseline information. Transmission-based precaution was ordered, Oxygen at 2 liters through nasal cannula, low oral suction as needed, vital signs every 4 hours. Carrie Richards was admitted to the Pediatric Unit with additional orders for consultation with dietician to assess nutritional needs and possible teachings to the mother. Carrie Richards vital signs: Oxygen saturation at 96% on oxygen at 2 L/min via nasal cannula, T 98.5°F, HR 113, RR 47. The nurse conducted her assessment with the following findings in addition to her vital signs and oxygen saturation, Carrie Richards’ lungs clear bilaterally with no adventitious lung sounds, respiratory rate regular and even, pharynx mildly reddened, brachial and pedal pulses palpable, capillary refill at 3 seconds. Carrie Richards’ mother asked whether the IV is “feeding” her baby and if her baby will start gaining weight by IV alone.   1.    Explain the pathophysiology of bronchiolitis. 2.    What is the relationship between respiratory syncytial virus (RSV) and bronchiolitis? 3.    Discuss infant growth and development as it relates to respiratory tract function. 4.    List the data that are consistent with bronchiolitis that Carrie Richards is exhibiting. 5.    What do these observations indicate as far as Carrie Richards’ health status is concerned? Do you think Carrie Richards is mildly or severely ill? Explain. 6.    What are the rationales for the orders for IV fluid, medications, pulse oximetry, and lab work? 7.    Nasal washing was performed on Carrie Richards while she was in the Emergency Department. If you were assisting with the nasal washing procedure, would you anticipate restraining her? If so, how? Would you have Carrie Richards’ mother help? What factors would you consider in deciding what to do? (Hint: Check Carrie Richard’s physical status and behavior while she was in the Emergency Department.) 8.    Which is consistent with the type of isolation being used for Carrie Richards? Select all that apply. (Hint: Review the Physician’s orders in her chart.)_____ Private room only_____ Semi-Private room with another patient who has the same infection_____ Use of clean gloves_____ Use of sterile gloves_____ Negative air flow room_____ Wearing of a gown when anticipating contact with patient or contaminated surfaces 9.    What other infections-control precautions, aside from isolation, need to be implemented? 10. Based on your assessment, list any observations that reflect the status of Carrie Richard’s oxygenation. 11. When performing the assessment on Carrie Richards, which developmental findings are normal for a 4-month-old? Select all that apply._____ Reaches for overhead objects with fingers_____ Coordination between eye and body movements_____ Moro, rooting, and tonic neck reflexes no longer present_____ When on abdomen, can lift the head and shoulders and look around_____ Sits alone momentarily 12. When taking Carrie Richards’ temperature, which method is the most appropriate to use?a.    Axillaryb.    Oralc.    Rectald.    Tympanic 13. What is the proper position to hold the pinna of the ear when using a tympanic thermometer on Carrie Richards?a.    Down and backb.    Up and backc.    Straight back 14. What are Carrie Richards’ vital signs? Are they within normal range for her age? 15. Carrie Richards is of African-American descent. What is the best way to assess color in a dark-skinned person? 16. If you missed anything, go back to Carrie Richards’ room and reassess her. Because the Electronic Patient Record (EPR) format is generic, you may not have data for all areas listed. Even so, you do need to make sure you are recognizing significant assessment data. Review data trends since admission. Why is continued monitoring necessary? 17. In the event that Carrie Richards’ condition begins to deteriorate, what changes might be anticipated? Select all that apply._____ Decrease in heart rate_____ Nasal flaring_____ Increasing respiratory rate with activity_____ Decrease in pulse oximetry reading_____ Restlessness_____ Cyanosis of nailbeds 18. _____ Carrie Richards’ condition can be described as deteriorating. (True or False) 19. Carrie Richards is at risk for dehydration. What parameters must be included in the observation of the condition? 20. How is Carrie Richards receiving oxygen? 21. Sometimes oxygen is delivered using a mist tent. What are the nursing responsibilities for care of an infant in a mist tent? Are there any advantages to using a mist tent rather than a nasal cannula? 22. How is Carrie Richards’ oxygen status being monitored? What should the nurse be looking for? 23. Documentation is important. what information is necessary for documenting observations associated with Carrie Richards’ oxygen saturation levels?  24. Oxygenation assessment is ongoing. In older children and adults, the nurse can easily assess respiratory status in response to play or other activity. How can this ongoing assessment be carried out in an infant? 25. Develop a list of the major nursing interventions for Carrie Richards relevant to her diagnosis. Health Science Science Nursing HED MISC Share QuestionEmailCopy link Comments (0)