Jack, a 10 month old boy who was diagnosed of croup syndrome (Acute Laryngotracheobronchitis ) by the medical officer in emergency, was admitted to the pediatric ward. He was brought to the hospital due to his abnormal breathing and poor feeding. According to his parents, Jack has a 48 hour history of poor feeding, a clear runny nose, barking cough, high temperature, worsening cough, was grumpy and breathless during feeding. During assessment, his vital signs were beyond the normal range, moderate intercostal and sub-sternal recession were evident and only one wet nappy was noted for the day. Apparently, he is experiencing breathing difficulties and dehydration. In this essay, I will discuss about the relationship between the two priority …show more content…
It works by decreasing swelling of the larynx, usually within six hours of the first dose and it can minimize the need for hospitalization, decrease dose of other drugs and has no long-term consequences. In fact, there was a study about the effectiveness of steroids treatment at the pediatric ward of Hatyai Hospital. Chub-Uppakarn (2007) identified that both inhaled and systemic steroids work within one hour and dramatically reduce morbidity, hospitalization time and intubation. Interestingly, they have concluded that the use of a lower oral dose of a systemic steroid is acceptable and also effective as the larger doses. Another alternative medication that could be given to Jack is the nebulized Adrenaline (Epinephrine). It reduces swelling in the airway and works faster than dexamethasone too. It works for a short time period and may be given every 15 to 20 minutes for severe symptoms (Bjornson,2011). With regards in giving medications, it is the nurse’s responsibility to follow basic principles such as doing hand washing beforehand and doing the right preparation of the medications. Each time the nurse
R.S. has been using the recommended treatment for his condition, which inlcude inhaled short-acting Beta-2 agonist and Theophylline, a bronchodilator, to control his respiratory disease.
R.S. has chronic bronchitis. According to the UC San Francisco Medical Center “Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.” (Chronic Bronchitis 2015) There are many things that can be observed as clinical findings. R.S. will have a chronic cough that has lasted from 3 months to two years or more, and a lot of sputum. The sputum is due to
1. Nine year old Jerry stumbled into a drug store, which is usually open late with very few attendants, gasping for breath. Blood was oozing from a small hole in his chest wall. When paramedics arrived, they said that Jerry had suffered a pneumothorax and atelectasis. Just what do both these terms mean and how do you explain his respiratory distress? How will it be treated?
Ascertaining the adequacy of gaseous exchange is the major purpose of the respiratory assessment. The components of respiratory assessment comprises of rate, rhythm, quality of breathing, degree of effort, cough, skin colour, deformities and mental status (Moore, 2007). RR is a primary indicator among other components that assists health professionals to record the baseline findings of current ventilatory functions and to identify physiological respiratory deterioration. For instance, increased RR (tachypnoea) and tidal volume indicate the body’s attempt to correct hypoxaemia and hypercapnia (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). The inclusive use of a respiratory assessment on a patient could lead to numerous potential benefits. Firstly, initial findings of respiratory assessment reveals baseline data of patient’s respiratory functions. Secondly, if the patient is on respiratory medication such as salbutamol and ipratropium bromide, the respiratory assessment enables nurses to measure the effectiveness of medications and patient’s compliance towards those medications (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). Thirdly, it facilitates early identification of respiratory complications and it has the potential to reduce the risk of significant clinical
Accurso (1997) found that at birth the lungs of CF babies are normal but soon, many become infected with bacteria. This bacterial infections cause chest exacerbations in the patients. A 14-day course of intravenous antibiotics is usually given to the patients (CF Trust, 2011). CF patients constantly seek medical attention for various reasons and in most cases, because of the exacerbations. However, hospital-based care is not always favoured by the patients, as it is disruptive for them and their families, taking patients away daily, work activities and social lives for considerable amounts of time (Sequeiros and Jarad 2009). Both consultants and physiotherapist encourage less interruptive patient-administered homecare....
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial secretions (Koenig & Truwit, 2006). VAP occurs when the lower respiratory tract that is sterile is introduced microorganisms are introduced to the lower respiratory tract and parenchyma of the lung by aspiration of secretions, migration of aerodigestive tract, or by contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of patients who are receiving mechanical ventilation in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial for the patient or healthcare organization. VAP adds to increase healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increase length of stay, morbidity and high crude mortality rates of 20-50% (Foglia et al., 2007)(Craven & Hjalmarson, 2010). Currently, the PICU has implemented all of the parts of the VARI bundle except the daily discussion of readiness to extubate. The VARI bundle currently includes, head of the bed greater then or equal to 30 degrees, use oral antiseptic (chlorhexidine) each morning, mouth care every 2 hours, etc. In the PICU at children’s, the rates for VAP have decreased since the implementation of safety ro...
Croup: Croup is another common airway inflammation caused by virus that can affect the trachea, larynx and possibility the bronchi (Murray, Sidani, & Zoorob, 2011) thus causing infection in the upper respiratory tract. Murray et al. describes it as the most common illness in children under the age of 6 to 36 months and cause for cough mostly when a child cries; acute stridor and hoarseness in febrile children (Murray et al., 2011). It can be a life-threatening situation in the life of the young infant and the family. Croup symptoms exhibit as hoarseness, barking cough, inspiratory stridor, and respiratory distress. I chose this diagnosis as my first preference because when I read the mother’s subjective report it matches that of croup symptoms: a barking cough, no fever, severe at night and when the baby cries, fatigue due to excessiveness of the tears, pain due to inflames and swollen of the airway. Murray et al., led us to understand that the etiologies of this viral causing agent can be traced to the parainfluenza viruses, type 1. (2011). This virus is commonly spread through contact or droplet secretion.
In the Shadow of Illness, the book describes different experiences of families who have or had children with cystic fibrosis (CF). CF is an inherited disease that is passed on from the mother or father who is a carrier, but doesn’t have the condition. Doctors have figured that in this scenario, the parents are likely to have a child with CF. Individuals with CF have to take Cotazymes to help the pancreas digest food. If the person does not take these enzymes, the food goes straight through them as diarrhea. Also, the person’s lungs are affected by a thick mucus that must be removed or thinned before it clogs. Doctors recommend the patient to perform daily breathing exercises that prevent the mucus from thickening; for example, swimming
Liam is a previously healthy boy who has experienced rhinorrhoea, intermittent cough, and poor feeding for the past four days. His positive result of nasopharyngeal aspirate for Respiratory Syncytial Virus (RSV) indicates that Liam has acute bronchiolitis which is a viral infection (Glasper & Richardson, 2010). “Bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It describes a clinical syndrome of cough tachypnoea, feeding difficulties and inspiratory crackles on chest auscultation” (Fitzgerald, 2011, p.160). Bronchiolitis can cause respiratory distress and desaturation (91% in the room air) to Liam due to airway blockage; therefore the infant appears to have nasal flaring, intercostal and subcostal retractions, and tachypnoea (54 breathes/min) during breathing (Glasper & Richardson, 2010). Tachycardia (152 beats/min) could occur due to hypoxemia and compensatory mechanism for low blood pressure (74/46mmHg) (Fitzgerald, 2011; Glasper & Richardson, 2010). Moreover, Liam has fever and conjunctiva injection which could be a result of infection, as evidenced by high temperature (38.6°C) and bilateral tympanic membra...
The Cumulative Index to Nursing and Allied Health Literature (CINAHL) was used to find peer-reviewed articles, using query terms such as: aspiration pneumonia, ventilator, and prevention. In addition, the TWUniversal search engine was utilized to find peer-reviewed articles, with the key words: aspiration pneumonia, ventilator, and enteral.
Probably one of the most well known ways for using steroids other than for the building of muscle for competition is for it's quick healing results of inflamed or swollen joints after just a few days of use.
(10) Levi B.H., Thomas N.J., Green M.J., Rentmeester C.A. & Ceneviva G.D. (2004), jading in the paediatric intensive care unit: implications for healthcare providers of medically complex children. Paediatric Critical Care Medicine 5 (3), 275–277. (11) Ward. E [1990] Ch. 359.
Person, A. & Mintz, M., (2006), Anatomy and Physiology of the Respiratory Tract, Disorders of the Respiratory Tract, pp. 11-17, New Jersey: Human Press Inc.
...ering to medication antibiotics which fight off infections, bronchodialators used to decrease dyspnea relieve broncho spasms , and pulmonary rehabilitation help betters their condition. The nurse expects the patient to be able to perform suitable activities without complication, avoid irritants that can worsen the disease (contaminated air) and reduce pulmonary infection by abiding to medications.
Firstly, nurses are expected to practice evidence-based health care hence a mastery of information about the essential and safe dose of drugs for a patient is very important for a nurse. Consequently, it could be the determinant between the life and the death of the patient. Pharmacology is a discipline which is mandatory for the nurse to excel in to be efficient in discharging his/her duties. Understanding which drug to use, the right dosage, the expected side effects which may occur and the contra-indications of the various drugs are key in the preservation of