Case Study of an Eighteen Month Old Toddler In Respiratory Distress

This paper will discuss the weaning of patients off of a mechanical ventilator. It will look at the problems associated with prolonged intubation vs. premature extubation, and what healthcare professionals can do to assess a patients readiness to begin the weaning process. A patient care scenario will be given and an explanation of how nursing practice can evolve with the knowledge from this study will be shown. The accountability of the nursing professional in regards to mechanical ventilation will be visited as well.

Lung development takes place while a child is in their mother’s womb. A baby’s lungs take twenty-three weeks to fully expand. At this point in the baby’s life, he is ready to start breathing air when he or she is born. Some children are born with developed lungs but others are not. Scientists believe that there is a molecule in vegetables such as broccoli that helps with lung development.

The project aim was to propose the adaptation of a humidification device to offer comfort to patients who are on high flow oxygen therapy; and to provide in-service trainings to clinical staff. Fisher & Paykel humidifiers were chosen in the proposal as the company provides excellent support for staff; and my past experience has assured me that the equipment is reliable and simple to use for nurses.

The main priority for all the pediatric patient was to make sure they are getting enough air. They needed an open airway. Without an open airway nothing else matters. To help with the patients airways we monitored their O2 sats and if they were low we made sure to apply oxygen, and continue to monitor their sats. Once oxygen was applied we worked on

I have personally seen how fast the symptoms progressed in a 10-month old child whose symptoms started as a regular cough. Next day his body temperature went up to 104 for and kept coming back constantly for couple of days. Cough became painful and started sounding more like wheezing and child could not eat or drink anything. Two separate trips to emergency room resulted in bringing toddler’s fever down, but even with chest x-rays and physical examinations, they were unsuccessful in detecting pneumonia until 911 was called and paramedics detected low oxygen and severe dehydration. I was informed by the admitting hospital physician that without prompt fluids, oxygen and antibiotic treatments, this cold complication may result in child’s

38. American Journal of Respiratory care and critical care Medicine, Volume 175, issue 7, pages 698 – 704

Karen Meunier, is the education consult for New Orleans’s Childrens Hospital Ventilator Assisted Care Program (VACP). Mrs. Meunier educated the audience on the history of ventilators. Next, Mrs. Meunier stated the criteria for the children who are enrolled in the Ventilator Assisted Care Program. Overall, these children either have a neuromuscular, brain and/or spinal cord injury, and/or birth related diagnosis. The children in the program live at home in Louisiana, under the age of 26, Medicaid eligible, and require daily mechanical support of respiratory efforts. Lastly, Mrs. Meunier informs the audience about each member in the VACP staff. The VACP staff includes an education consultant, respiratory therapist trainer, two case managers,

Impaired gas exchange should still be kept in the plan of care for the resident as they have not meet the expected outcome of oxygen saturation of 95 % in 24 hours. One intervention I would add to this diagnosis would be for the nurse to assist and instruct the patient to deep breathe and perform

J., Cormier, S., & Meyer, T. (2012). Reduction in the Incidence of Ventilator Associated Pneumonia: A Multidisciplinary Approach. Respiratory Care, 57(5). 688-696. DOI: 10.4187/respcare.01392

On admission to ICU, the patient should be positioned in fowler 's position, vital signs checked, oxygen is very important since her saturation is 82%. A non-rebreather mask is advisable at this time. Reassurance is very important to calm the patient and the plan of care explained to allay anxiety, calm the patient and ease breathing. Cardiac activities should be monitored continuously in every 10 to 15 minutes with pulse oxymeter, IV assess initiated, medications Beta blockers (Lopressor), Angiotensin-converting enzyme (ACE) inhibitors (Vasotec), diuretics (Lasix), and Morphine Sulphate giving. Laboratory work should be done such as levels of electrolyte, serum creatinine levels, weight and fluid balance. Other serum tests such as BNP, liver function, D-dimer, and CBC should also be done. Telemetry monitoring maintained continued for 24-48 hours after entrance into ICU. Signs and symptoms of congestion should also be monitored daily, intake and output, weight, if there is fluid restriction it should be adhered to, and diet should be according to dietician order such as 2g sodium and no added salt, turn and repositioned to avoid tissue breakdown, exercise according to patient tolerance.

The ventilator bundle is having the head of the bed above 30 degrees, strict oral care every 2-4 hours to help prevent infection, sedation verification charting for neurological purposes, and having a H2 blocker scheduled to prevent reflex and risk of aspiration. My patient was not on a ventilator so none of these were included in their plan of care.

ation that I will be discussing is Airway Pressure Release Ventilation (APRV). I have not had an opportunity to use this mode, so I thought I would research it for this assignment. “The degree of ventilator support with APRV is determined by the duration of the two CPAP levels and the mechanically delivered tidal volume. Depends mainly on respiratory compliance and the difference between the CPAP levels. By design, changes in ventilatory demand do not alter the level of mechanical support during APRV. When spontaneous breathing is absent, APRV is not different from conventional pressure-controlled, time-cycled mechanical ventilation”( Putensen, C. )APRV is a form of improved pressure ventilation allowing unrestricted spontaneous breath at an

You have a patient who has been on a ventilator for 3 weeks. What should be you highest assessment priority that needs to be obtained before beginning the weaning process?

The first assessment I performed for my patient, C.P., was during a day shift on February 23, 2016. Upon receiving her into my care at approximately 0730hrs, I noticed that she was extremely difficult to rouse awake as she was drowsy and could not seem to keep her eyes open. On top of this, she was exhibiting unusually slow respirations while laying supine on her bed, with many blankets around her. For the purpose of this paper, I will be focusing on my respiratory assessment. During this event, performing a thorough respiratory assessment was challenging because C.P. was unable to fully participate due to her current cognitive state.

Blood gas analysis may be performed to determine if high concentration oxygen therapy is needed (Bush & Thomson, 2007). The management of fever would be a part of care plan when the infant is febrile due to infection (Axton & Fugate 2009).