Care Plan for Pediatric Patient

Care Plan for Pediatric Patient. Attached is the Scenario, Medications used and Templates. Just need it filled out properly and for it to make sense. **PLEASE FILL OUT A DRUG CARD FOR EACH MEDICATION ** PLEASE FILL OUT EVERYTHING HIGHLIGHTED.

Scenario for care plan:

Use the info for the care plan

T.B. was a 21-month-old male child who presented to a community ED through triage with his mother. The mother stated that she was concerned that her son “had the flu.” The mother stated that he had a fever that she noticed that morning and had not been eating well since the previous night. She indicated that her son vomited green fluid once that morning and was complaining of abdominal pain. The mother explained that she had responsibility for T.B. from Monday to Friday, and the grandparents watched him on the weekends. It was Saturday morning. The mother reported that she and T.B. had been “staying at the casino for the last four days, he was running around and playing the whole time until last night.” The mother appeared detached from T.B. and said that she “only came because my father told me to.”

​Initial vital signs were as follows: Temperature: 39.2 [degrees]C (102.6 [degrees]F); rectal heart rate (HR): 190; apical respiratory rate (RR): 35; pulse oximetry: 98% at room air, which was within normal limits; blood pressure: 101/54 mmHg; weight: 15.4 kg/33 lb 15 oz (greater than 90th percentile); and capillary refill less than 2 s.

The triage nurse administered ibuprofen 154 mg orally (10 mg/kg) for the fever per the hospital policy. When obtaining vital signs, the triage nurse noticed that the child had not made any verbal sounds and asked the mother whether the child speaks. The mother stated, “You know, it is the weirdest thing … usually he doesn’t stop talking but for the last two days he hasn’t said a word.” The triage nurse recognized this as a possible indication of lethargy, and the patient was promptly brought to an ED treatment room for immediate attention by the health care team.

Upon completing the triage information, T.B. was given an Emergency Severity Index score of 2, as the triage nurse recognized that this was a high-risk patient with an altered mental status manifesting as lethargy and aphasia that required immediate interventions (Gilboy, Tanabe, Travers, & Rosenau, 2012). The physical examination was completed by the primary ED nurse while T.B. was being undressed in the treatment room. A pediatric crash cart was also brought to the treatment room upon recognition of the severity of this child’s illness. The pediatric crash cart equipment was organized according to weight and correlated with recommendations of a length-based weight resuscitation tape (Broselow & Hinkle, 1993).

A pulse oximeter, a heart monitor, and a blood pressure cuff were placed upon disrobing the patient. A 22-gauge PIV catheter was placed in the left antecubital area, blood was drawn for laboratory analysis, and the site was secured with an arm board. Urinary catheterization was carried out with 6 ml of urine initially collected. A nasal swab for rapid influenza/respiratory syncytial virus testing was also collected. The bedside glucose result was 109 mmol/L. A complete blood cell count, complete metabolic panel, blood type and screen, blood cultures, and a urine toxicology panel to rule out possible drug ingestion as the cause of lethargy and altered mental status were ordered STAT. Fluid resuscitation with 0.9% normal saline was initiated at 20-ml/kg rapid infusion (300-ml intravenous bolus). Antibiotic treatment was begun immediately following collection of blood culture specimens. As bacterial meningitis, antibiotic-resistant infection strains, and septicemia were not yet ruled out, ceftriaxone 1.5 gm intravenously (over 30 min) and vancomycin 150 mg intravenously (more than 90 min) were ordered. These antibiotics were used as broad-spectrum, empirical coverage for gram-positive (vancomycin) and gram-negative (ceftriaxone) organisms. Acetaminophen 230 mg orally (15 mg/kg) was also administered for further fever reduction.​

Medications:

ibuprofen (10 mg/kg)

Ketamine (1.5mg/kg)

vancomycin (15mg/kg)​

here is scenario for care plan:

use the info for your care plan – let me know if you have any questions

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