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

1, SVT can be stopped by vagal maneuvers that increases the slow down message to the heart by the brain and vagus nerves. it includes blowing on the thumb, bearing down as it passing a bowel movement, and doing a headstand. if vagal maneuver not working IV medications adenosine used to convert the heart rhythm to normal. radiofrequency ablation may be needed as a final option.
2, It leads to heart failure or cardiac arrest if cardiac output is too low due to prolonged SVT.
3, observe the child breathing pattern and monitor the ECG continuously. Administer oxygen by nasal cannula and start IV administration as per doctor orders. follow Valsalva manuer and try ice water face immersion. admisnter medication as per doctor instructions. support family members psychologically. assess the ECG pattern and heart rate and keep informing to the doctor. if SVT not resolved as per doctor advice electrical cardioversion can be performed.
1, Left shift or shift to the left in the WBC has high number of immature or premature neutrophils, it indicate there is infection or inflammation. it means stabs have increased that increase the infection progress. presence of immature nweutrophils in the bloods in the bone marrow.