CHECK YOUR UNDERSTANDING 4.

Scenario E.M,

Scenario E.M,

Scenario E.M, Get help at

Scenario E.M, a 5-month-old girl, is brought to the emergency department (ED) with respiratory distress, hypoxia, and fever. Her parents state that she has had mild cold symptoms for a few days. She has breastfed poorly over the last few days, with a decreased number of wet diapers. You take her vital signs and complete an initial assessment. Chart View Vital Signs 130/72 mm Hg 83 breaths/min 188 beats/min 38.4° C (101.1° F) Get help at Blood pressure Respiratory rate Heart rate Temperature Spo, Weight 88% on room air 8 kg Initial Assessment Alert, fussy; consoles briefly; anterior fontanel soft and slightly depressed Tachycardia; Scenario E.M, capillary refill less than 3 seconds Upper airway congestion; coarse cough; tachypnea, transient bilateral wheezing; coarse rhonchi and slightly decreased breath sounds at bases; mild intercostal retractions Positive bowel sounds; last bowel movement yesterday Decreased urine output (per history); Scenario E.M, Neurologic Cardiovascular Respiratory Gastrointestinal Genitourinary no urine output in last 4 hours No rashes; slightly flushed Mucous membranes “sticky”; decreased tearing Skin Other Emergency Department Orders Acetaminophen (Tylenol) 80 mg PO for feverx 1 dose Start IV and administer normal saline (NS) bolus 20 mL/kg IV bolus over 30 minutes Oxygen to keep saturation greater than 93 % Nebulizer trial of albuterol (Proventil) 2.5 mg STAT 1 dose

 
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