LP 10 Diagnostic Tests, Meds, & Other Therapy
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- Slows Rate to Improve Quality, which improves Oxygen exchange
- Don't administer if child already has slow respirations
- Loosens Mucous
- Given After Bronchodialators
- May be used before Corticosteroids
- Class: Glucocorticoid
- Given For: Given to clients in preterm labor (↓34 weeks) to hasten fetal lung maturity to ensure surfactant production
- Action: Takes up to 24 hours to have positive effect. Effect lasts for 7 days. Repeated if infant is not born within first 7 days. Decreases Inflamation & Suppresses the Immune Response
- Adverse Reactions: Euporia, Insomnia, Seizures, Heart Failure, Thromboembolism
- Nursing Implications:
- Give IM injection deep and rotate sites
- If client is Diabetic they may need an insulin dose adjustment
- Measure/Record I/O & Daily Weight
- Recommended Dosage: 12mg daily for 2-3 days prior to delivery
Racemic Epinephrine By Arosol
Ribavirin (RSV Treatment)
Specifically used to treat severe cases of RSV where the patient would not otherwise survive such as infants with complicated CONGENITAL HEART DISEASE or are IMMUNOCOMPROMISED
NO CAREGIVERS WHO ARE IN CHILDBEARING AGE SHOULD TAKE CARE OF CHILD RECEIVING RIBOVARIN!
- Expensive with Marginal benefits
- Treatments are given over 3-7 days and given over 12-18 hours in a Cruepet.
- Anyone who goes into the room of a client receiving Ribovarin MUST WEAR A MASK!
CBC (Total) Vs. CBC W/Diff
Elevated in bacterial infections. Elevated for first 12 hours in Viral Infections, lowers after first 12 hours (WBCs dying fighting the infection)
- CBC W/Differential:
- Neutrophils=40-50%(↑= L shift (bacterial infection), ↓= R shift)
- Monocytes=0-10%(↑in a rapid or chronic infection)
- Eosinophils=0-2%(↑in allergic reactions or parasitic infections)
- Positive: Indicates Recent Strep Infection
- Negative: Indicates No Recent Strep Infection
Types Of Retractions
- The More Areas of Retraction a child has, The greater severerity of their respiratory distress
X-Ray Of Lateral View Of The Neck
- LTB- Narrowing
- Epiglottitis- Bulging (Shadowy Spot On X-Ray)
Peak Flow Meter
Used as an indicator for need of Inhalor for Children with Sports Enduced Asthma.
Green Means GO, Yellow inhail to keep mellow, Red put the inhalor to your head
Cruepet (AKA: Oxygen Tent)
- Used as a supplimental Oxygen source in treating respiratory distress.
- Has two holes in the back, one is for room air and the other is to humidify the environment (liquefies the lungs to loosen mucus)
- AVOID STATIC DISCHARGE! Do not let patient bring TV Remote or other static producing things into the tent due to risk for explosion! DO NOT USE PLASTIC SHEETS IN A CROUPET.Change Bath Blanket Every Hour and avoid cotton sheet/pillow case due to moisture(Risk for Hypothermia)
- Lessen Anxiety(Decreases Need/Rate of Oxygen Consumption)
- Room Air is 21% Oxygen, Croupet provides 2-3% higher concentration for every liter of supplemental oxygen.
- Try to avoid opening the croupet as much as possible due to a temporary decrease in SpO2
- If you must open the Cruepet (Models without a side access zipper) The RN should increase Oxygen to 5L until SpO2 levels are WDL at 95-100%
- You may not leave the room until SpO2 is WDL
- You may raise the head of the bed while the child is in the croupet to provide additional respiratory relief
Percussion & Postural Drainage (P&PD)
- Used to break up and drain mucous collection in the lungs.
- Very Time consuming (1 hour each up to 4 times a day)
- May need Pulmonary Cleansing once a year
- For Cystic Fibrosis
Done as much as once a year to supplement the effectiveness of Mucus drainage not otherwise achieved through Percussion and Postural Drainage (Cystic Fibrosis)
The Chief Diagnostic Test for Cystic Fibrosis
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