How can you answer these questions based on patients information?… How can you answer th

How can you answer these questions based on patients information?… How can you answer these questions based on patients information?1. What concepts do you think are important in this scenario and why?2. What abnormal signs and symptoms did you recognize and how did you prioritize your care of this patient?3. How would you change your actions or interventions if you had a second chance to care for this patient?4. How would you apply what you have learned from this scenario to future patients? PEDIATRIC NURSING Burgel, Isabella  Sex : F Age:  18  M BMI…PEDIATRIC NURSING Burgel, Isabella  Sex: F Age: 18  M BMI: 18.2MRN: 4938994 Room: 283Health Care Provider: W Allen, MDWeight:  26 lbs 7 oz Height:  2′ 8″Code Status: FullIsolation: NoneFood Allergies: NKADiet:·      Special Diet: Feedings per home regimen Alerts:0 1·      Strict intake and outputDrug Allergies: NKAEnv. Allergies: NKAHospital Floor: Pediatric Height:  2′ 8″Patient History:Isabella Burgel is an 18-month-old Hispanic female who was diagnosed with Down syndrome at birth, and was noted to have a heart murmur.While awaiting surgery to repair her atrial septal defect (ASD), Isabella Burgel had a percutaneous endoscopic gastrostomy (PEG) tube placed four months ago to manage her weight gain more accurately.She is being admitted to the general pediatric unit after being seen in the pediatrician’s office this morning. She has had a fever, cough, and runny nose for four days.Monday  15:15You enter Isabella Burgel’s room and introduce yourself while cleaning your hands with antibacterial foam. The patient is sitting on her mother’s lap while listening to her mother read a book. The patient is slouched down and has red watery eyes and a runny nose. You notice that she is wearing glasses. You ask the patient’s mother, Amanda Burgel, how Isabella is doing today.”She seems a little perkier. At least she’s looking at the book while I’m reading to her,” Amanda states.You ask if it’s okay to review some of the admission information she has already been given. She reaches across the patient and picks up a notebook that contains her home information. “This has everything you need to know.”Looking through the notebook, you see that Isabella Burgel receives the following medications: Prescription MedicationsName EnalaprilDose/Form 0.58mg pillRoute POFrequency BIDLast Dose Mon 08:00Indication High blood pressureEntry By W Allen, MD  Prescription MedicationsName FurosemideDose/Form 23mg pillRoute POFrequency BIDLast Dose Mon 10:00Indication Fluid retentionEntry By W Allen, MD  Prescription MedicationsName DigoxinDose/Form 87mcg pillRoute POFrequency BIDLast Dose Mon 10:00Indication Heart FailureEntry By W Allen, MD After reviewing the medications, you ask the patient’s mother, “When is Isabella scheduled for her ASD repair?”She answers, “In about two months. We have been able to manage her heart function well with her meds.””I see that Isabella wears glasses. How long has she had those?” you ask.Her mother responds, “We just got them last week. But she does really well with them; she never tries to take them off.”As you continue reviewing Isabella Burgel’s health history, you note that she receives feedings via her g-tube:Pediasure 1100 mL divided into 4 feedings at 0800-1200-1600-2000 over an hour with use of feeding pump.”Did Isabella receive her first two feedings today?” you ask her mother.”I managed to give her the 8am feeding, but we missed the one at noon. Patient MonitoringChart Time Mon 13:30Temperature (F) 100.1Pulse (Beats/min) 134Respiration (Resp/min) 68Blood Pressure (mmHg) 116/62Oxygen Saturation (%) 87% Order Day/Time Mon 13:30Provider Orders1. Admit to pediatric floor general care area2. Vital signs every 4 hours.3. Strict intake & output.4. Weigh on arrival to room.5. Tylenol 15 mg/kg by mouth or per rectum every 4 hours as needed for temperature greater than 101.5 fahrenheit6. Home medications: Enalapril 0.58 mg by mouth twice dailyFurosemide 23 mg by mouth twice dailyDigoxin 87 mcg by mouth twice daily7. Feedings per home regimen8. Nasal wash for RSV, respiratory viral panel.SignatureW Allen, MD  Progress NotesDay/Time Mon 14:45Progress NotesAdmitted from ER for further medical evaluation and treatment of undefined mild respiratory illness. Lives with parents and brother. No pets, no smokers. Home medications and feeds as per mom. Lab results as noted. S/P Peg placement for at 14 months to manage appropriate weight gain. Awaiting ASD repair. Followed by GI and cardiology. Immunizations as per mom. Updated mom at bedside.SignatureW Allen, MD  1.     Which is not a potential symptom of an ASD? Fast heart rateMurmur on auscultationFast respiratory rate with activityDifficulty feeding 2. Which intervention would be most appropriate for Isabella Burgel? -Increase the free water in her fluids since she has been febrile and is on a diuretic.-Weigh all of Isabella’s diapers.-Consider sodium supplements.-Place a sign on the door stating “This patient is respiratory syncytial virus (RSV) positive.” 3.     Which is not a common characteristic of a child with Down syndrome?A protruding tongueFloppy muscle toneMongolian spotsShort stature  Monday16:20While you are reviewing Isabella Burgel’s notebook, her mother asks if any of her lab results are back, specifically the RSV or flu. Order Results  Order Nose CultureType LaboratoryPriority RoutineFrequency One TimeStatus ResultedOrder Date/Time Mon | 13:45 Laboratory Results – Nose CultureResults – Postive for RSV Reference Range – NegativeSpecimen – Nose Culture Health Science Science Nursing BSN 246 Share QuestionEmailCopy link Comments (0)

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