Question

Michael is a 7-week-old breastfed infant with a 2-day history of irritability and poor feeding.

Subjective Data

Mom states that her infant has been “fussy” for the last 2 days.

He feeds for only a “few” minutes at a time.

He is breathing heavily and fast for 2 days.

Objective Data

Weight: 4.8 kg

Vital signs: temp, 36.8º C; pulse, 250 bpm; resp, 65 breaths/min; blood pressure, 84/58 mm Hg

Breath sounds clear to auscultation

Oxygen saturation: 95%

Central capillary refill: 4 seconds

Questions:

1. What is the treatment for an unstable patient with supraventricular tachycardia (SVT)?
2. Decreased cardiac output from prolonged SVT would produce what complication?
3. In this clinical situation, what actions should the nurse take? Prioritize the actions.

Discussions

Discussion Topic# 1: What is a “shift to the left” in a CBC?

Discussion Topic# 2: A father brings in his 3-year-old son, James, who was initially running a fever. He was given Tylenol, and the fever went away for 2 days. Now, however, the fever is back, and he has noted dark spots on his body and a lump in his armpit. He has been lethargic and has not wanted to eat for the last 24 hours. The physician suspects acute lymphocytic leukemia and has ordered blood chemistry studies, immunophenotyping, and bone marrow aspiration and biopsy.

1. The father is upset and wants to know what is leukemia and how did his son catch it? How would the nurse address this question?

Answer 1

?treatment for unstable patient with SVT is synchronized cardio version. SVT is supra ventricular tachycardia,, which is a condition in which number if tachyarrthmia that originate above purkinje fibres. Voltage used in this type of patients are 50- 100J.

?Decreased cardiac output from prolonged SVT produce complications like, weaken heart. It can lead to complications like heart failure, stroke, and cardiac arrest.

?in this case the baby' have increased heart rate ( normal is 100 to 160b/ min), respiratory rate(30 to 60b/m), and delayed capillary refill 4sec . So here nurse should focus on respiratory distress, and capillary refill. Delayed Capillary refill may indicate dehydration . It can lead to shock or threatening condition. So nurse had to inform it to doctor. Heart rate should inform to doctor.

Nurse should first assess condition of patient. She should comfort position for baby and mother. Make him calm. Inform the situation and administration of medication as per doctor's order.

?shift to left is a term used in hematology, CBC. It is a phrase used, which means, presence increased young and immature WBC in blood. So by this result, it means, there is a presence of infection or inflammation in body , so bone marrow produces more WBC, and release them into blood without maturation.

?acute lymphocytic leukemua is a type of cancer, which affects blood and bone marrow. In this disease bone marrow produces more number of lymphocytes, a type of WBC. The exact risk factor for this disease unknown, but some studies shows that, changes in DNA in bone marrow cells, causes proliferation of leukemia cells. In childrens between 1 to 5 yrs this disease more happening. Make have more chance. But almost it is curable in childrens.