11 Jun Gabby is a 2-year old admitted from the Dr office
Question
Gabby is a 2-year old admitted from the Dr office with a four-day history of diarrhea, vomiting, lethargy and poor appetite. Her mother also reports that she has only urinated a small amount dark colored urine has had 6 light green watery stools today and she has been vomiting yellowish colored emesis x 3 today. Mom also reports that Emily has not been eating or drinking for some time.
On admit, Gabby’s vital signs are: Temp-38.4 ax HR-156 RR-30 BP-85/50 O2 sat -95%. She weighs 15 kg. Admit labs include Na+ 152, K+4.0, Cl-111, BUN 6,
Creatinine 2
Which Clinical Data is abnormal?
What are your concerns about the abnormal data?
Her initial assessment includes: General Appearance: slightly pale, listless, and irritable.
Airway: patent; Breathing: Unlabored, clear bilateral breath sounds; Circulation: CRT 3-4 seconds; pulses equal, regular HR. Abdomen: soft, non-distended; Skin: warm & dry, dry mucus membranes, mild tenting of skin turgor. Mom reports – small amount of dark colored urine, 6 light green watery stools, vomiting yellowish colored emesis X 3, refusing PO intake.
Which Assessment Data is abnormal?
What are your concerns about the abnormal data?
What additional information/data would you like to have about this patient? Why?
Looking at the clinical findings, what is the main problem?
How did you determine the cause of the problem with this patient?
What complications might you anticipate for this patient?
What other problems might cause this clinical presentation?
What orders do you anticipate from the physician? Why?
What other team members do you need to effectively manage this patient?
List and prioritize your nursing actions.
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