any one here ever have any experience with this...(peds)

  1. Not looking for medical advice as I know it is not anyones place to give.....just wondering if anyone has ever had experience with this happening & what was found to be going on as a cause........
    My child was admitted almost 2 weeks ago to the ICU for what ended up being urosepsis...and had to be put on ventilation continuosly due to some distress as well, low b/p etc etc. Well they can't get her off the vent as of right now due to high resp rate & some minor distress....not horrible but enough to want to keep her on it for now for some support....and everything lab wise is fine now so far.....but now the problem is high fever constantly which tylenol or motrin, even combined together are not touching. Her heart rate is normally in the high 60's but since being admitted has not gone below high 80's & currently today was in the 110's..(she is 17 & devlopmentally delayed)......she is normally hypothermic 90-93 degrees as a baseline due to neuro status ...her temp has been 99-101 continuosly and her fever is not breaking, however she had temps intermittantly over the last week, but they would break with tylenol & weren't that high..only very minimally a temp like 95 which with her is a temp. They did blood cultures and nothing has shown up yet.........they did more today and are waiting for the results to see if something may show up now................I am just wondering if any of you nurses here have ever had any experience with something like this in the past & what did anyone find out as to what was causing this sort of thing.......this has never happened before ..fevers yes but never with all this not going away..................I am stumped as are the docs at the moment who have been caring for her...she was all set to come home because she had no temps this past sat & sun then bam.......since yesterday it has been like this & now I am getting very nervous.......I was thinking maybe her body is saying it's had enough.......I don't know what else to think ......because this can't be a good thing......they don't say anything as far as being very very concerned as of yet that it could be very bad.....but I have a gut feeling it may be bad.................I think they are hoping something does grow in the culture so they know something is definetly causing this , not that they want that to be but I am at a loss.........plus on top of this my uncle is in the hospital 4 days now with lung cancer, not doing so good & my daughters great uncle died yesterday from lung cancer (2 opposite sides of the family too, no relation) and he never smoked a cigarette a day in his life either.....not fair!!! Can anyone pour anymore on top of my shoulders?? Oh ya, and I start back to school my final semester on Sept 5th with all this going on .........
    Last edit by KellieNurse06 on Aug 22, '06
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    About KellieNurse06

    Joined: Sep '05; Posts: 528; Likes: 23

    11 Comments

  3. by   Altra
    Hugs to you & your daughter, Kellie :icon_hug:
  4. by   KellieNurse06
    Quote from MLOS
    Hugs to you & your daughter, Kellie :icon_hug:
    Awww thanks alot!!! I am just scared & figured someone must of dealt with something like this at some time....... you are a doll..thanks a bunch!:icon_hug:
  5. by   traumaRUs
    Kellie - so very sorry for your problems - that is a LOT to handle all at once. Please know you and your precious daughter are in my thoughts. Take care.
  6. by   GooeyRN
    Im so sorry. I hope that your daughter gets better soon. I hate to see children sick. Its not fair!
  7. by   KellieNurse06
    aww thanks! you guys are the bestest!
    Well her nurse today who has taken care of her forever up there had her today as her patient..she argued to get a ct scan & kub by the sounds of it.....guess what they found...Pyelonephritis of the right kidney!!!!!!!!!!!
    So that explains the fevers, high heart rate...and I am hoping the vent problem of weaning....................because I bet this is what she had when she was admitted, it just wasn't obvious at that time..................anyway hopefully this will be taken care of..and not that it's a good thing but at least we have a reason for this fever stuff and hr issue.............I bet it's hurts so she is not breathing normal so thats why the vent has been helping her because she slept on cpap apparently last night with no issues & was very comfortable............go figure!
    Anywho thanks a bunch! I have a feeling everything will be moving in the right direction finally !
  8. by   MrsMommaRN
    i hope things get better for your daughter soon. hugs and prayers.
  9. by   CaseManager1947
    Just from what you tell in your posting, it is obvious that docs are looking in the blood stream, the likely 1st culprit, but by far not the only one. Is she on abx that work with what is cultured out of the urine??? or is there a kneejerk rocephin or levaquin rx? What about lungs??? VAP is another concern, and those typically are comprised of MRSA or Psuedomonas. Do you have an intensivist or pulmo specialist managing the vent?? if not why not??--- ask for one! kidney with pyelo -- good GU man and renal tofollow to make sure others don't screw up the long term plan for her which would be 2 functional kidneys, and able to empty them. Keep us posted .


    Morghan, ARNP
    Case Manager
  10. by   KellieNurse06
    Quote from CaseManager1947
    Just from what you tell in your posting, it is obvious that docs are looking in the blood stream, the likely 1st culprit, but by far not the only one. Is she on abx that work with what is cultured out of the urine??? or is there a kneejerk rocephin or levaquin rx? What about lungs??? VAP is another concern, and those typically are comprised of MRSA or Psuedomonas. Do you have an intensivist or pulmo specialist managing the vent?? if not why not??--- ask for one! kidney with pyelo -- good GU man and renal tofollow to make sure others don't screw up the long term plan for her which would be 2 functional kidneys, and able to empty them. Keep us posted .


    Morghan, ARNP
    Case Manager
    Hey thanks! Wow....wish you were working at this hosp!
    They had her on cipro for the Urosepsis.....they know she had gotten it from a UTI that went to kidneys then to blood...but I think they obviously didn't look farther into it......which is why they finally did the ct scan today.....
    She does have a pulmonary Dr but he moved to another hospital..she does see him but I have her to to this hospital because they know her so well on the unit she has to go to......... they know everything she's had up to where good sticks are and everything for the last 10 years without even having to look up her info........ unfortunately all her docs except her GI have went to a busier hospital. so she goes to them on outpatient .....
    She is on o2 24/7,& sleeps on a vent only at night at home on a/c w/peep because her lungs are junk from sepsis from pancreatitis 2 years ago (hypoventilation?).....she had to be put on an oscillating vent to get enough support 2 yrs ago....they told me that was one of the downsides from it...but we had no choice at the time, she wouldn't of made it....... ........ The ct scan showed her right kidney (the infected one) to be enlarged & her left kidney to be smaller than normal...weird, but she does have bad scoliosis too. She also has one leg very swollen with edema so hopefully this hasn't caused permanent damage to her kidneys.............so I am betting another week or so IF she gets back to her norm............I am all set with the hospital business now.....:stone If her vent status still doesn't change she may have to go to rehab & get weaned there before she gets something else staying in the hospital....... Well thanks for the input! I'll let you know how everythings going & what happens.....................
    Thanks for your input! I appreciate it!!!
    Last edit by KellieNurse06 on Aug 24, '06
  11. by   begalli
    Quote from KellieNurse06
    Pyelonephritis of the right kidney!!!!!!!!!!!
    OUCH! Poor thing. Thank goodness they found the pyelonephritis, but my goodness, what took so long! I hope your darling is getting the pain relief she so obviously needs for both comfort and healing.

    I can relate KellieNurse to having that feeling that everything is sitting squarely on your shoulders and just keeps building with no relief in sight. I experienced 5 close family deaths within a 9 month period during the end of 2004 - mid 2005. It started with my dad and ended with the tragic accidental death of my 16 year old nephew.

    Sounds like you have been dealing with major health issues with your daughter for all of her 17 years. But I would imagine that doesn't change the way each and every new round of problems effects you. She's your baby. Our kids aren't suppossed to be sick. Like another poster mentioned, it isn't fair!

    I think it's really important that you not feel as though you have to do it all and be there for everyone. That was my biggest mistake and it affected my physical and mental wellness more than I ever imagined it would. It really sneaks up on you.

    What is most important is being there for yourself and your daughter. Get as much rest as you can and don't forget to eat healthy foods. Your body is in overdrive! I hope you are getting support from others (organization or group?) whose children are effected by similar problems?
    Last edit by begalli on Aug 24, '06
  12. by   begalli
    When my daughter was 19, she had pyelonephritis. She was admitted to the hospital and had a morphine pca. I am just saying that this is an extremely painful condition. I would be making sure that your daughter's pain is addressed consistently, that non-verbal s/s of pain are assessed thoroughly and treated.
  13. by   KellieNurse06
    Hey thanks everyone! Begalli..you rock! lol! I feel bad....you lost alot of people in such a short time! OMG that's soooo sad!!! .....Are you doing ok though? Geez That's gotta be THE worst.........

    Ummm ok they had to place a PICC line today under flouroscopy......in...no problems!!!! So they are starting Ceftriaxone .....and she will be on an iv antibiotic for about 2-4 weeks...one person says 2 weeks ...another says 4 weeks........whatever.. a dozen on one hand and 12 in the other... ...just want her better.....:stone
    Ok I actually told them 1st thing this morning when I got there.....I want her to have something a bit more stronger than tylenol &/or motrin for the pain.....plus it may help her hr to go down if there is less pain ..and hey...maybe the temps too....I don't know alot but I did learn something in nursing school so far...lol........they gave her codeine & ativan .can we say 360 degree turn around???? Ya it was so great to actually see her sleeping peacefully & her old cool self by the way her body felt temp wise, haven't seen her anything but irritable & tense & burning up the last 2 weeks...and they were trying to get the temp down and like her nurse yesterday said to me....WHY is there a temp..............ummm...ya she is the only one who was thinking why......... the doctors kept checking blood cultures ............well I bet the cipro they had her on just masked everything enough that nothing was culturing..so they obviously thought there was no explanation........... lo and behold.........thanks to that nurse who knows my daughter....they found the problem!!! So now all depending on if this infection starts resolving and IF she can get off that vent will be the factor of rehab or not until she can get off it and back to her usual........whatever happens is meant to happen....
    And yes I have tons of support..I belong to a moms with special kids site...so I have plenty of support there.......but at home is another story.....I am one person & thats it........so if she does go to rehab I am being blunt & pulling no punches that I have school & I am one person & I am in my final semester & I will be there when I can........
    She went to a place a long time ago for vent weaning .....(worked well) and when I would leave (cuz I had school & lots of other stuff at home I had on my shoulders) the people would say " oh, you're leaving?" Like I don't do anything else.. I was an hour & 20 minutes away from home...and if I was at school that was another hour on top of it...cuz my school is in RI , an hour south of my house...
    I have sacrificed 17 years for this child who is my rock, heart & soul........regardless of her problems...and she has always fortunately lived at home..........lots of people just assume she doesn't & are shocked when I tell them...................like it was mentioned by the previous poster....she is my baby regardless.......
    SO I am going to put that right out on the table up front IF that is what ends up happening. I feel like I have to apologize sometimes but why????
    The only time I am ever away from her is when I am at school & for little errands & stuff.........but geez! Plus I have been through so many hospitalizations with her it's not a shocker to me anymore as if it was something that just happened yesterday................if it was a matter of life & death I wouldn't leave her side of course..........that happened 2 years ago & I was glued to her side for 4 days then she began to pull through thankfully................so sorry for the looooooooong message ...lol!
    I really appreciate all the thoughts...you are all sooooo wonderful! I will keep you all updated on any changes since you took time out to respond to my post...I really really am grateful! Thanks a bunch :icon_hug:
    Last edit by KellieNurse06 on Aug 24, '06

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