You enter Isabella Burgel’s room while cleaning your hands with… You enter Isabella Burg

You enter Isabella Burgel’s room while cleaning your hands with… You enter Isabella Burgel’s room while cleaning your hands with antibacterial foam, and say good morning to the patient’s mother, Amanda Burgel. Isabella Burgel is laying in her crib with the head of the bed flat, and is in obvious respiratory distress. You note that she is tachypnic with subcostal and substernal retractions. You can hear an audible grunting from Miss Burgel on expiration. The patient begins with a strong cough, and promptly vomits her partially digested morning feeding. You roll her over so that she does not aspirate her feeding. You reach for the suction and clear her airway. She feels hot to the touch.Once she has stopped vomiting and is in no immediate danger, you elevate the head of her bed, and prop her up on a pillow. You gather supplies to bathe her, a set of EKG leads to attach her to the cardio-respiratory monitor, and a probe for the pulse oximeter in her room.[LEARNER ACTION: Document the respiratory assessment.]You attach Isabella Burgel to the monitors and take her vital signs.Vital signs:Temperature : 101 degrees Fahrenheit, axillary…Heart Rate: 132 beats/minute, apical…Respiratory Rate: 56 breaths/minute…Blood Pressure: 120/84 mmHg, right upper extremity, lying supine…Oxygen Saturation: 89% on room air, digital finger probe…[LEARNER ACTION: Document the patient’s vital signs.]You step out of the room and gather a humidifier for the patient’s comfort and a nasal cannula. You change the alarm limits on the monitor to the following: high heart rate 160, low rate 80, and respiratory rate 70. Isabella Burgel’s perfusion to her lower extremities is 2 to 3 seconds.You insert the nasal cannula into Isabella Burgel’s nostrils and titrate the oxygen flow to 2 liters. The patient’s mother helps you bathe her and you leave her gown off to help cool her.[LEARNER ACTION: Document the nursing interventions used to improve the patient’s oxygen status.]While using the EHR, you notice that there is no output charted since the beginning of the previous shift.You ask the patient’s mother,”I noticed when we bathed Isabella that her diaper was dry. Do you know when her last wet diaper was?””I changed her last night around 2230. She vomited again at midnight, but her diaper was dry then. Do you think the night nurse changed her diaper when I was asleep?” Amanda Burgel responds.”The last diaper charted was at 2300, so I don’t think so. And we know that she just vomited her 8am feeding, ” you state.”She just had some Tylenol at 0600, so I can’t give her another dose yet for her fever. I am going to notify Dr. Allen of her repeated emesis. I think she may be dehydrated, and I am concerned that she has not absorbed her cardiac medications.”[LEARNER ACTION: Review the previous vital signs, and verify the time the last dose of Tylenol was given is accurate. In a misc. nursing note explain your findings.]Isabella Burgel’s mother agrees and thinks you should call Dr. Allen. You leave the room to do so.When you have completed the above tasks, click Complete this Phase.  Health Science Science Nursing BSN 246 Share QuestionEmailCopy link Comments (0)

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