I have several Pediatric Nursing questions that I need to have answered to fill out a form for Ped. Homecare employment.
A 6 day old infant who has a resp. rate of 70, pulse of 180 & a slight nasal flaring is to be given an oral medication. which acton is to be taken first?
a. Attempt to give the neonate a small amt. of H2O
b. Check the last PaO2 reading
c. Suction the neonate's trachea
I think it's b. It doesn't say that the neonate has a tracheostomy.
Is this right?
Dec 19, '07
A resp rate of 70 Hr r 180 and nasal flare may indicate an acute resp illness. Bear in mind Despite a reasonable sao2 the child may still have a respiratory illness brewing. Check temp an overheated baby can breathe fast and have elevated HR.
Other reasons for elevated HR, RR, and slight nasal flare are: baby has just been fed, or has been crying, or has an underlying cardiac condition eg post ductal lesion once duct closes 3-6 days becomes apparent , therefore needs a 4 limb BP and Sao2, or maybe has thyroid condition check Guthrie done , or an obstructed airway eg mild choanal atresia broncho or trachomalacia , or just mild mucous plugging of nares- try clearing nostrils. ask mum what she thinks may be a family or infant Hx you aren't aware of .
There is insufficient info in the question to make a sound clinical decision so in the real world you keep options open and keep mum informed .
There is no indication that a 6 day old neonate would have a tracheostomy . There is no suggestion that there are any indications for suctioning the trachea remember that there are both oral and naso tracheal suction techniques (trachea is not the same as tracheostomy).
Checking the Pao2 would give additional clinical information and wouldn't harm the child. Why a 6 day old infant is on oral meds is important and relevant to the clinical decisions (eg if on hypothyroid or cardiac meds would reflect in vital signs). Giving H2o is of limited clinical signifiance since if the child is aspirating -a swallow study needs to be done. Only useful clinical indication is that H2o is less irritating to lungs if an aspiration and Sao2 can be monitored during admin. If the child is breast fed though may have difficulty drinking H2o
Doing a saturation is the best course of action given in the questions, but in real home care, answers aren't multi choice ...keep an open mind. Good luck