2. Because of Nathan\'s symptoms, the pediatrician prescribes arterial blood gas
ID: 247683 • Letter: 2
Question
2. Because of Nathan's symptoms, the pediatrician prescribes arterial blood gases (ABGs) be drawn. What is the purpose of this prescription and what nursing implications are appropriate prior to drawing Nathan's ABGs?
3. Nathan's ABG results are: pH. 7.30, Poo, 30 mm Hg; PO2, 90 mm Hg; oxygen saturation, 94%; and bicarbonate (HCO,), 22 mEq/L. Compare his values to the normal values for a child Nathan's age.
4. Discuss Nathan blood gas values considering his present condition and clinical manifestation.
10. What are the teaching priorities you should discuss with Nathan’s mother prior to discharge?
HW LTHE DIGESTIVE AND URINARY SYSTEMS Nathan is a Gyear-old first grader who lives with his mother and older brother, 8yearold piratory infections. His mother diligently kept up with his immanizations and all of his pediatric checkups. He started first grade 2 weeks ago and is ahays eager to go to school. His level of grouth and development is appropriate for his age and he quickly developed friendships with his classmates Client Profile l Micah. Nathan has been a healthy child with only oecasional upper res. Case Study Yesterday afternoon when he came home from school, Nathan began having episodes of abdominal pain and diarrhea. His stools have been intermittent, foul smelling, watery, and, according to Nathan's mother, "float in the toilet. He refused to eat or drink atrician. At the pediatrician's office Nathan is listless, his skin is varm and dry, and he complains that his "ummy hurts. His urine specific gravity is 1.040, his heart rate is 120 beats/minute, his respirations are 50 breaths/minute, and his blood pressure is 78/46. His stool is negative for blood and his complete blood count results are as follows: anything since that time so Nathan's mother calls the pedi- Hematocrit: 50% Hemoglobin: 165 g/dL Platelets: 455,000 cells/mm Red blood cell count: 5.2 million cells/mm White blood cell count: 11,300 cells/mm Because he continues to refase to eat or drink, the pediatrician recommends he be hospitalized for further diagnostic testing. Questions 1. Discuss your impressions about the above situation 2. Because of Nathan's 6. What additional data would be helpful in confirming Nathan's diagnosis? 7 Nathan is diagnosed with giardiasis and is pre scribed nitazoxanide. What is this agen you question it being prescribed for Nathan? the t and would prescribes arterial blood gases (ABGs) be drawn. purpose of this prescription and what What is the nursing implications are appropriate prior to dra 8. What are the nursing priorities for Nathans ing Nathan's ABGs? 3. Nathan's ARG resuls are: pH. 7.30, Poo,30mm9. Nathan begins to respond to therapy and is Hg; Por 90 mm Hg; oxygen saturation, 94%; and bicarbonate (HCO), 22 mEq/L Conpare his val- would be appropriate ues to the normal values for a child Nathan's 4. Discuss Nathan's blood gas values considering 10. What are the teaching priorities you should is present condition and clinical manifestations. 5. What is the significance of Nathan's case? beginning to eat and drink. What play activities for Nathan while he is age.hospitalized? discuss with Nathan's mother prior to his cal test results and his urine specific gravity?Explanation / Answer
1. By the above scenario , we can understand that child Nathan is having diarrhea and abdominal discomfort.
2. Diarrhea leads to metabolic acidosis. In order to detect metabolic acidosis , paediatrician advised for ABG. By the given scenario , we can understand that child is having dehydration also. In diarrhea , child loses fluids. And moreover child Nathan is also refusing to eat or drink. His haematocrit valve is increased. So obviously child is having dehydration. Before taking ABG , nurse should grab all the items needed to take an ABG sample. Heparinised syringe is important to take ABG blood sample. Assess the patent artery and draw the sample. Immediately send to lab before it gets clotted.
3. Normal pH is 7.35 - 7.45. But the child is having pH 7.3. Therefore it is acidosis. Other values are comparitively normal.
4. Diarrhea leads to loss of alkaine fluids from intestine. So it will develop acidosis. His heart rate is increased due to dehydration. Child is having abdominal pain also. He might get gastro intestinal infection from the school.
5. Child Nathan is having urine specific gravity of 1.040. It indicates dehydration. Dehydration leads to increased haematocrit value. Child's platelets and WBC is increased. It is clear sign of infection.
6. Child complains of abdominal pain. So to confirm any diagnosis and for additional information , paediatrician may ask for USG abdomen.
7. Giardiasis is an intestinal infection caused by parasite. Nitazoxamide is an antiparasite agent used to treat parasitic infection.
8. The most important nursing action is to maintain strict hand hygiene. This type of infection may spread to others by feco-oral route. So take all measures to prevent contamination and avoid spreading of infection.
9. When the child begins to respond treatment , we can allow him to play in a play area alloted by hospital. Whenever child plays , make sure to avoid the spreading of infection.
10. Advise the mother to make practice the child , a good hand washing before and after food. Even in school also teach the child about importance of hand washing to avoid gastro intestinal infection. Provide clean and we'll balanced diet. Maintain a neat and tidy environment. Visit paediatrician whenever required without delay.
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