You are alive in a ample burghal pediatric dispensary after-hours.
A mother brings her 6-month-old daughter, Vivi Mitchell, to the dispensary for rhinorrhea, congestion, fever, and cough. Aloft assessment, you analyze the adolescent has asthmatic aloft auscultation and on inspection, you analyze retractions.
The adolescent is in beneath than 10th percentile of weight and has a cardiac history of Patent Ductus Arteriosus (PDA).
Born at 36 weeks gestation.
Mother states this adolescent doesn’t go to day affliction but her two alternative accouchement ages 2 and 3 do appear daycare.
T- 102.1 HR 140 RR 40 BP 83/58 Pulse ox 96%
A besom for respiratory syncytial virus (RSV) is positive.
Doctor orders - Nasal ball assimilation and acrid drops PRN, Tylenol 15mg/kg Q4 PRN for fever, Albuterol nebulizer in appointment and advance po fluids as tolerated.
After the albuterol neb treatment, respirations are 36 and oxygen assimilation is 100%. Asthmatic has diminished. Mom is an ER assistant and the doctor feels adequate that she has a nebulizer at home and can acknowledgment to pediatric afterhours or ER if needed.
Client is absolved with these orders:
methylprednisolone 0.4 mg/kg articulate BID for 3
Albuterol Q4 hours for 24 hours, again Q 6 hours for 24 hours, and Q6 as needed.
Call if bare above-mentioned to the Q4 dose.
Manage agitation with Tylenol and abide hydration and nasal ball assimilation Q6 while awake.
Acknowledgment for re-evaluation in 3 days
Describe the pathophysiology of bronchiolitis and analyze the best accepted animal causing this infection. What class testing can affirm your suspicion?
Describe the pathophysiology of PDA and why the history of PDA is cogent in this scenario.
What accident factors abode Vivi Mitchell at a greater accident for the development of bronchiolitis?
What are the adapted signs/symptoms of bronchiolitis?
Vivi Mitchell been assigned the afterward medications; acetaminophen, albuterol nebulizer, corticosteroids. Provide the account for why anniversary medication has been included as allotment of her medical administration and explain any abeyant contraindications accompanying to these medications.
You are designing Vivi Mitchell’s plan of care. Analyze two antecedence nursing diagnoses to accommodate in your plan. For anniversary nursing diagnosis, analyze two SMART goals, and two interventions for anniversary goal.
What abbreviate and abiding accessible complications should the assistant anticipate?
What applicant apprenticeship is adapted for Vivi Mitchell as she is absolved from the after-care clinic?
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