Your patient is:Molly, is a 8 month

Your patient is:Molly, is a 8 month female infant that weighs 8 kg. She has increased work of breathing, is irritable and pale, and has a barking cough and nasal flaring. Her VS are T 037C, HP 165, RR 50, BP 80/40, SPO2 87% on Room Air, CRT is 2 sec and heart rhythm is sinus rhythm.The Primary Assessment shows; Nasal congestion, barking cough Deep suprasternal retractions and nasal flaring Pulses normal Irritable, blood glucose value; 67 mg/dl Secondary Assessment shows; Increased RR 65 Born 6 weeks premature; intubated for the first 7 days of life Increased nasal congestion and increased barking cough. Case consideration; Your client has a upper airway obstruction that is a common occurrence in infants and children and can occur at the level of the nose, pharynx, larynx, or trachea. A frequently observed cause of upper airway obstruction is a viral injection that leads to swelling of the tissues lining the upper airway. Thick secretions may also obstruct the nasal passages, causing upper airway obstruction. A consideration for Molly is that she was a premature neonate and was intubated at birth. Expected Interventions for Molly; evaluate appearance, breathing, and circulation by following a Pediatric Assessment Grid. Identify signs and symptoms of respiratory distress in an infant. Evaluate airway patency and how would you position the infant. Give 100% oxygen by mask (remember that infants are nose breathers only). Apply relevant cardiac and respiratory monitoring. Administer nebulized epinephrine per physician order, administer corticosteroids, teach parents care of a infant with croup. Create the patient including all their data. Include all steps of the nursing process and label each step. Include: Assess; Patient and learner the parent. Be sure to describe your patient and include assessment data. Include age, learning style, educational level and any other data that describes your patient. (review mini-lecture if needed) Diagnosis: Choose the nursing diagnosis; problems to focus on – upper airway obstruction, gas exchange in an infant, education for the learner the parent. Plan: Choose a goal, and then set specific and measurable objectives of the infant and any learning goals for the parent (what will you be able to observe with the patient and any objectives you set for the parent) Interventions: List what you will do to reach the objectives, what will you teach and how? Be thorough with complete directions. Evaluation: How will you evaluate if your patient care and teaching has been successful and the objectives are met? Include a section on Learning Needs that include: Learning style Learning Need (e.g. respiratory care for the infant) Describe the setting for the teaching session and how it will contribute to learning. Identify in your teaching plan where/how your teaching addresses the cognitive, psycho motor and affective domains. SCIENCE HEALTH SCIENCE NURSING NURS 242

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