Reference no: EM133653981 , Length: 3 Pages

Assignment - Pediatric Assessment: PDA with RSV

This assignment aims to develop a care plan for a child with bronchiolitis. The nursing interventions would reflect the underlying respiratory syncytial virus with patent ductus arteriosus (PDA) history.

Competency

Apply the foundations of pediatric nursing when caring for clients with health alterations.

Scenario

You are working in a large urban pediatric clinic after hours.

A mother brings her 6-month-old daughter, Vivi Mitchell, to the clinic for rhinorrhea, congestion, fever, and cough. Upon assessment, you identify the child has wheezing upon auscultation and on inspection, you identify retractions.

• The child is in less than 10th percentile of weight and has a cardiac history of Patent DuctusArteriosus (PDA).
• The child is in less than 10th percentile of weight and has a cardiac history of patent ductus arteriosus (PDA).
• Born at 36 weeks gestation.
• Mother states this child doesn't go to day care but her two other children ages 2 and 3 do attend daycare.
• Temperature: 102.1F, pulse: 140 beats/minute, respirations: 40 breaths/minute, blood pressure: 83/58mmHg, pulse oximeter 96% on room air.
• A swab for respiratory syncytial virus (RSV) is positive.

Doctor orders - Nasal bulb suction and nasal saline drops PRN, Tylenol 15mg/kg Q4 PRN for fever, albuterol nebulizer in office, and encourage oral fluids as tolerated.

After the albuterol nebulizer treatment, respirations are 36 breaths/minute and oxygen saturation is 100% on room air.

Wheezing has diminished. Mom is an ER nurse and the doctor feels comfortable that client has a nebulizer at home and can return to pediatric after-hours clinic or ER if needed.

Client is discharged with these orders:

• Methylprednisolone0.4 mg/kg oral BID for 3
• Albuterol Q4 hours for 24 hours, then Q 6 hours for 24 hours, and then Q6 hours as needed. Call the doctor if needed before the Q4 dose.
• Manage fever with Tylenol and continue hydration and nasal bulb suction Q6 hours while awake.
• Return for re-evaluation in 3 days.

Instructions

In a two to three-page paper, respond to these requests for information:

• Describe the pathophysiology of bronchiolitis, including the most common causative organism.
• Analyze risk factors associated with bronchiolitis.
• Choose diagnostic testing for bronchiolitis and support with rationale.
• Explain the signs and symptoms of bronchiolitis, including specific examples from the scenario.
• Describe the pathophysiology of PDA, including why this is significant for this scenario.
• Describe the rationale for use and contraindications for each of the prescribed medications.
• Select two priority nursing diagnoses for this scenario, including supporting rationale for your choices.
• Write two SMART goals for each nursing diagnosis.
• Choose two interventions for each goal, including supporting rationale for your choices.
• Describe potential short and long-term complications, including specific examples and supporting rationale.
• Apply information from the scenario to create a plan for discharge teaching.