Competency
Prioritize nursing interventions when caring for pediatric clients with health disorders.
Scenario
A 5-year-old Gabriel is a multiracial male weighing 48 lbs with an allergy to penicillin arrives in the emergency room, no cultural considerations identified. You are handed the following notes on the patient that read:
He arrived in ER with his mother after falling out of bed after jerking movement activity as witnessed by his older brother while sleeping. Right-upper extremity appears with deformity. Mother and child speak English. Child has no significant medical history. Mother reports incontinent of urine during episode.
Your Assessment
Vital Signs: T 102.9, P 135, R 24, BP 118/60, O2 sat 100% RA
General Appearance: appears drowsy; face flushed, quiet
Neuro: oriented X3
Cardiovascular: unremarkable
Respiratory: lungs clear
Integumentary: very warm, dry
GI/GU: abdomen normal
Physician Orders
• Complete Blood Count (CBC)
• Complete Metabolic Panel (CMP)
• Urinalysis with culture and sensitivity (U/A C&S)
• Blood Cultures x 2
• X-rays kidneys,
• Influenza screening
• Acetaminophen 15 mg/kg PO now
• Ibuprofen 10 mg/kg PO now
• Pad side rails
• Suction at bedside with seizure precautions
• Radiographs of right arm
• Cast to right arm
• Start PO fluids and increase as tolerated
The physician discharges Gabriel from ER to home with a diagnosis of; Right ear infection, Acute Febrile Seizure and fracture of the right ulna.
Discharge orders include:
• Follow up with pediatrician in 7 days
• Follow up with pediatric orthopedics in 7-10 days
• Cefuroxime 30mg/kg PO BID for 10 days not to exceed 1,000mg daily. What is the recommended dosage if cefuroxime is supplied as an oral suspension 125mg/5ml or 250mg/5ml?
• Acetaminophen 15 mg/kg PO Q4 hours PRN fever or pain and ibuprofen 10 mg/kg PO Q6 hours PRN fever and pain for up to 3 days
• Acetaminophen is available as 160 mg/5 mL. Ibuprofen is available as 100 mg/ 5 mL.
• What is the amount of acetaminophen in mg and ml per dose? What is the amount of ibuprofen in mg and ml per dose?