Pediatric Multi-trauma 5-year- old female child transported to the emergency department (ED) by ambu. Question
Answered step-by-step
Asked by ProfOryxMaster139
Pediatric Multi-trauma
5-year- old female child transported to the emergency department (ED) by ambulance following a (multi-car) MVC on I-10.
EMT Report: 7-year-old child unconscious at scene, restrained in car seat on side of impact. Regained consciousness in route began vomiting x 5-6. Child is crying for mother who is severely injured and air transport to Lafayette. Multiple forehead, facial and neck bruising and lacerations to left face. BS clear, HR regular, PERLA, Abd soft, MAE except right leg, which is immobilized in traction splint, C-spine immobilized. VS: T[1]97.4ax, P – 130, RR – 24, B/P – 100/64, O2 Sat 91% on 10L O2 NRB mask. IV NS @ 60cc/hr infusing to rt. antecubital. State Police attempting to contact family through the mother’s out-of-state driver’s license.
Initial M.D. orders: Neuro checks IV D5 1/2NS @ 70 cc/hr CT scan of head and spine X-ray left leg & facial series IVP, KUB Lab: U/A, BUN, Creatinine, CBC, type and cross[1]match NG tube after facial trauma evaluation Foley to gravity drainage O2 10-15L NRB
Morphine Sulfate 1.25 mg IV q 4 hours prn pain
Nursing Assessment: VS: Temp 96.5ax, P – 126, RR – 26, B/P – 98/66, O2 Sats – 90% on 10L O2 NRB mask. Weight: 80 lbs. Allergies: Unknown, Immunization status: Unknown. Crying and screaming mommy, uncooperative. Facial and forehead swelling around lacerations and bruises. PERLA, GCS – 13, Breath sounds equal and clear. Heart tones normal without murmur, regular rhythm. Abdomen firm, flat with diminished bowel sounds x 4 quad, swelling and bruising over left flank. Closed deformity to left femur, left leg immobilized in traction splint. Left foot cool, pale, +1 left dorsalis pedis pulse, Cap. Refill > 2 sec. to left ft. Skin cool, clothes, hair, skin wet from rain, good turgor. IV D512NS hung and infusing at 70cc/hr. IV site stable without redness or swelling. 10Fr foley to gravity drainage with gross hematuria and 45 cc urine output. Father and grandmother are on their way.
Initial Report: CT scan of head and spine – negative.
45 minutes after arrival to the ED, the father and grandmother arrive and are insistent that they are allowed to be in the room with the child. They are forcefully told they have to remain in the family waiting room for now and that someone would be coming to speak to them. They ask, “Why family cannot be present in the trauma resuscitation room?
· Components of critical thinking identify
assumptions
data inconsistencies in the case
Cluster related data according to either a) body systems or b) Gordon’s Functional Health Patterns
missing data
conclusions
· Most significant pathological process identify
Etiology
Pathology
Clinical manifestations
Diagnostic tests
Provide rationales for abnormal lab data
· Identify 5 priority nursing/collaborative diagnoses with expected outcome (goal statement)
Nursing diagnostic statements must be written correctly
Outcome (goal) statements must be measurable, realistic, and include a time frame
· Identify priority interventions for each diagnosis
Include the rationale for each intervention (identify why this intervention is necessary for the care of this patient)
SCIENCE
HEALTH SCIENCE
NURSING
NURN 400
Pediatric Multi-trauma 5-year- old female child transported to the emergency department (ED) by ambu
