Medication 84 Mcg / Puff Is Too Much For A Child

His skin was mottled with an increasing capillary refill time. Schmidt and Mandel (2008) suggest this is a sign of hypoperfusion as the skin is vasoconstricting due to the redirection of blood flow to the core organs.

tells you that he began feeling changes in his heart rhythm about 10 days ago. He has hypertension

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

Pulse oximeter used to check his oxygen saturation level, which was 98% on air with no central or peripheral cyanosis. Since Mr Devi, does not seem to have any sign of abnormal respiration. The next assessment is circulation, where there are many physical signs to look for. The colour of the hand and digits, are they blue, pink, pale or mottled. Also need to measure for capillary refill time (CRT) by applying cutaneous pressure for 5 Sec on a fingertip held at heart level of Mr. Devi. The normal value of CRT is usually less than 2 second prolonged CRT suggests poor peripheral perfusion. Measure his Blood Pressure (B/P), count pulse rate by listening to the heart with a stethoscope or palpate peripheral and central pulses, assessing for the presence, rate, quality, regularity and equality. All of this assessment indicates the cardiovascular system in the patient is within the normal range or is there any emergency measures should take (Resus.org.uk 2016). However, Mr Devi’s circulation is a concern because his HR was 110bpm which is higher than normal range, the normal heart beat for adults ranges from 60-100bpm. Also his BP was 190/99mmhg with mean arterial pressure (MAP) of

As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.

R.J. is a 15-year-old boy with a history of asthma diagnosed at age 8. His asthma episodes are triggered by exposure to cats and various plant pollens. He has been using his albuterol inhaler 10 to 12 times per day over the last 3 days and is continuing to wheeze. He normally needs his inhaler only occasionally (2 or 3 times per week). He takes no other medications and has no other known medical conditions. Physical examination reveals moderate respiratory distress with a respiratory rate of 32, oximetry 90%, peak expiratory flow rate (PEFR) 60% of predicted, and expiratory wheezing.

hypotensive with a blood pressure of 82/44 mm Hg. His respiratory rate is 28 breaths/min

PHYSICAL EXAM: Temperature 98.6, Blood pressure 140/90. Pulse 110. Respirations 26. Her lungs are clear, showing mild signs of distress. Heart sounds are normal, irregular rhythm and bradycardia noted. No edema noted in extremities. Patient skin is cool to touch, slightly clammy. EEG shows prolonged QRS wave, with ischemic ST changes and PVCs. Chest radiograph clear.

Pulse rate is at 72. The blood pressure was 140 / 95,which is suggestive of high blood pressure and related to his medical history. No heart murmur was noted, and no other abnormalities were noted.

Also he’s oxygen diffusion rate has increased due to the more oxygen which is absorbed by the alveoli and then circulated around the body.

All persons who administer medications should have adequate access to patient information, as close to the point of use as possible, including medical history, known allergies, prognosis, and treatment plan, to assess the appropriateness of administering the medication. (National Coordinating Council for Medication Error Reporting and Prevention).

Wte today 254, which in Dec was 292 lbs. O2 sat 97% on 1 liter oxygen. He states he is trying to save his O2 in his tank. Informed vet that he can get a oxygen tank from Pulmonary when he is in the clinic.

As stated earlier, my three children also have asthma, which is in no doubt genetically linked to my father— their grandfather. Fortunately, they have mild symptoms, and inhalers are only needed during cold and flu season as a preventative measure. However, they are at higher risk of developing pneumonia or bronchitis due to their asthmatic predisposition, and unfortunately, there has been previous winters when this has happened. Because of this, as soon as any of the children have signs of a cold, they are immediately treated with their inhalers.

During inspection of the heart assessment observe abnormal finding. Inspect the jugular vein and the carotid artery. Note pallor or cyanotic skin color, temperature, turgor, texture, and clubbing of finger. Observe for swelling, edema and ulceration. Clubbing is a sign of chronic hypoxia caused by a lengthy cardiovascular or respiratory. Poor cardiac output and tissue perfusion is noted by cyanosis and pallor. For dark-skinned, inspect his mucous membranes for pallor. Decreases or absent of pulse with cool, pale, and shiny skin, and hair loss to the area, and the patient may have pain in the legs and feet may indicate arterial insufficiency. Ulcerations typically occur in the area around the toes, and the foot usually turns deep red when dependent

and low oxygen level in the blood, and a chest X ray can show the fluid accumulation in