1. What is the primary problem for my patient and what is the underlying
cause/pathophysiology of this problem?
- The priority problem for the patient is their ARIRWAY. This condition is induced by a viral
pathogen that subsequently triggers an acute inflammation of the bronchioles. It is
contracted through direct exposure to respiratory secretions or particles on objects that
are contaminated.
2. What are the anticipated clinical manifestations of that problem (what will my patient
look like/what are their symptoms?) Name at least three.
Low-grade fever
Clear Runny nose that can be profuse
Starts as a cough (1-3 days) followed by a wheeze.
3. Discuss my patient’s growth and development, include Erickson and Piaget stages.
Erickson: Trust versus mistrust. Tending to the infants needs provides a sense of security
and trust.PIAGET: sensory-motor- substage 3: secondary circular reactions 4-8 months
At 5 months the infant rolls from supine to prone and back again, Sits with back upright
when supported, grasps a rattle, the infant makes simple vowel sounds, laughs aloud,
performs, and vocalizes in response to voices.
Vital signs:
HR: 80-150
RR: 25-55
Respiratory system in Infants: The nasal passages are narrower, the chest wall are more
compliant, the bronchi and bronchioles are shorter and narrower, the larynx is more
funnel-shaped, the tongue is larger, and there are fewer alveoli.
4. Review the orders for the patient. Perform all medication calculations. Determine
minimum and maximum doses. Is this safe for the patient? Why is your patient getting
this medication? Discuss the pertinent information for each of these drugs (side effects,
nursing implications) and the mechanism of action for each.
Albuterol: bronchodilator- act on B2 to relax airway smooth muscle, resulting in
bronchodilation.
SAFE DOSE: CHILD LESS THAN 4- 2 PUFFS (180 MCG)
May cause nervousness, tachycardia, and jitteriness.
Determine airway status: pulse ox, rr, lung sounds,
Tylenol: antipyretic-blocks pain impulses.
Used for the fever and provide comfort.
Assess pain/ fever(FLACC scale.) LFT