CONGENITAL HEART DISEASE HESI RN EXIT CASE STUDY WITH NGN QUESTIONS AND ANSWERS LATEST;(2024) /100% CORRECT

CONGENITAL HEART DISEASE HESI RN EXIT CASE STUDY WITH NGN QUESTIONS AND ANSWERS LATEST;(2024) /100% CORRECT Page 1 1. Clinical Manifestations Page 2 1. Diagnostic Tests Page 3 1. Nursing Diagnoses and Interventions Page 4 1. Negotiating Feeding Options Page 5 1. Billy's SaO2 level drops to 90% when breastfed using a supplemental feeding device and when using the nipple with the enlarged hole. Flow-by oxygen increases the SaO2 to 95%. Billy does seem to have more choking episodes with the nipple. The nurse, lactation consultant, and Billy's parents discuss feeding options again. They decide that Teresa will pump breastmilk before each feeding, and breastmilk fortifier will be added to increase Billy's caloric intake. Teresa recognizes that pumping will also allow the milk to "let-down" so Billy will not have to expend extra sucking effort to start the milk flow. Teresa will use the supplemental feeder as she breastfeeds. If Teresa is unavailable, Aaron or the nurse can feed Billy fortified breastmilk using the bottle with the enlarged hole in the nipple. Page 6 1. The Infant Receiving Digoxin The cardiologist confirms that Billy has ventricular septal defect (VSD) and is experiencing an acute exacerbation of congestive heart failure (CHF), which often occurs with untreated VSD. The cardiologist prescribes the cardiac glycoside digoxin elixir (Lanoxin) and the loop diuretic furosemide (Lasix) for Billy. Page 7 1. A Complication Occurs Growth and Development Billy is stabilized. His oxygen saturation level is 96% on room air. He tolerates his next feeding without complications. The next day the nurse is assessing Billy's growth and development. Teresa and Aaron are loving parents, and they are very interested in the care Billy is receiving. Teresa asks the nurse, "Is Billy growing all right?" The nurse responds that Billy seems to be right on target for a 4-month-old. Page 8 1. Therapeutic Communication The nurse walks into Billy's room to complete the shift assessment and finds him sleeping soundly in his crib and Teresa crying quietly and staring out the window. Page 9 1. Alternative Therapies Page 10 1. Legal Considerations Page 11 1. Management Considerations The nurse is caring for four clients on the pediatric unit, including Billy. Billy is sleeping in the crib, and Teresa is sitting in the room Page 12 1. Discharge Preparation Prior to discharge, Billy's parents must learn cardiopulmonary resuscitation (CPR) for infants. The American Heart Association's CPR technique is being taught to Aaron and Teresa. Page 13 1. Surgery: Preoperative Nursing Care When Billy is 1 year old, he is readmitted to the pediatric cardiac unit and scheduled for open heart surgery to repair the ventricular septal defect. Teresa and Aaron are at Billy's bedside and appear very frightened about the upcoming surgery. Page 14 1. Postoperative Care Billy's surgery is successful, and Teresa and Aaron are allowed to visit him in the intensive care unit. The nurse is completing Billy's shift assessment. His weight is 22 lbs and his length is 28 inches. Page 15 1. Client Teaching Billy has been improving daily and is due to be discharged. The nurse is completing the discharge teaching Page 16 1. Case Outcome Aaron and Teresa take their beautiful son, Billy, home. Billy is not taking any medications, and he is developmentally on target for a 1-year-old. Billy's parents appear to be confident in their ability to care for him at home. They have written discharge instructions and a list of phone numbers to be used in case of emergency. ..................Download and get the full test 100% correct