Question

1. John is a 10-week-old male who was born at 28 weeks gestation and weighed

0.8 kg (1 pounds, 12.2 ounces) at birth. His Neonatal ICU stay was essentially uneventful. John has an older sister, Jane, who just started preschool. Last week Jane was ill with a respiratory infection, and now John is starting to seem ill as well. He initially became ill with a runny nose, sneezing, coughing, and wheezing, and he has not been breastfeeding well. He has since been admitted to the pediatric floor with worsening respiratory symptoms that include consistent tachypnea, moderate retractions, circumoral cyanosis, and periods of apnea. Based on John’s medical history and clinical manifestations, the nurse suspects that his most likely medical diagnosis is:

2. How is this illness diagnosed?

3. John now weighs 6 pounds. The provider orders D10 1/2 NS maintenance fluids. Using the “4-2-1 Rule,” what is the correct hourly infusion rate?

4. As John’s nurse, what are some interventions that you would expect may be included in his plan of care?

5. What type of isolation do you expect that John will be placed in? What personal protective equipment (PPE) should be used when entering his room?

6. What medication therapy do you expect John to receive if his illness becomes very severe (i.e. he requires intubation)? Who should not handle this medication?

7. What product is given to certain infants in the NICU prior to discharge to prevent contraction of this illness? What are the criteria that makes an infant eligible to receive this product?

Answer 1

1) diagnosis is pneumonia.

2) This illness is diagnosed because the baby was preterm and low birth weight baby. So, the baby's immunity is very low, so he becomes infected from his elder sister. The baby is suffering from tachypnea, cyanosis, unable to feed, moderate retraction is indicated that baby is suffering from pneumonia.

3)John is now 6pound= (6×0.454)= 2.72kg= 3kg.

Therefore infusion rate, according to 4-2-1 rule is = (4×3)=12mL/hr.

4)• Respiratory rate should be assessed.

•Oxygen saturation should be maintained.

•Airway should be cleared by suctioning.

•Oxygen should be administered.

•propped up position should be given to the baby.

•Iv fluid should be administered.

• Sign of dehydration should be assessed.

• Nebulisation should be given.

NOTE: as per check guidelines, I am only supposed to answer1st 4 questions. Kindly post the other questions separately, if you want the answer.