Exam 4 Transition - RSV/Bronchiolitis

Question 1

Normal BP for infants

Answer 1

under one - 64/41
one to two - 95/58

Our 5 month old has 130/72

Question 2

Normal RR for infants

Answer 2

30 - 60

Ours is 83

Question 3

Normal HR for infant

Answer 3

100 - 150 for 5 month old

Ours is 188

Question 4

Based on signs and symptoms what will be ordered

Answer 4

ABGs
BNP
Not necessarily a CBC - because RSV is viral

Question 5

Where to put IV in infants

Answer 5

Arm

Very little: scalp

Question 6

Why not feed a baby when respiratory rate is higher than

Answer 6

Obligate nose breather
Aspiration risk
Can increase respiratory distress
How to feed? NG tube

Mom can pump for baby food

Question 7

When the baby’s respiratory rate decreases, what should parents know

Answer 7

When respiratory rate is less than 60, it is safe to feed

Suction prior to eating

Small or short feedings to reduce respiratory distress

Suction PRN, but not too often, cause it can cause airway edema

Question 8

What is a questionable provider order in this scenario

Answer 8

Amoxicillin

any kind of antibiotics

It’s a virus - that won’t work

Question 9

How long does RSV infection often last?

Answer 9

7 - 10 days

Question 10

New S&S of our case study baby

Answer 10

RR decreased to 23
O2 is 89%
She’s listless and doesn’t cry to stimulation

Why?

She’s tired - she’s wearing out

Question 11

Interpret these ABGs

Answer 11

pH - 7.31
PaCO2 - 73
HCO3 - 29
PaO2 - 57 mmHg

Partially compensated respiratory acidosis

Question 12

What resources to seek for the case study baby’s parents during this unanticipated change

Answer 12

Child life specialist
Chaplain
Lactation consultant

Question 13

Recommendations for parents

Answer 13

No aspirin
Saline drops and suction before food
Ensure she is drinking enough
No over-the-counter cough suppressants

Question 14

What measures to help parents deal with anxiety and fear

Answer 14

Parent’s presence calms infant
Parents do not need to put baby’s need a head of own
Parental anxiety can certainly be recognized by infant
Provide not overly detailed technical information to them as that might stress the mout

Question 15

Fluid rescucitation

Answer 15

4 - 2 - 1
100 - 50 - 20

First 10 = x4
Second 10 = x2
everything else = x1
(Hourly rate)

first 10 = x100
second 10 = x50
everything else = x20
(Total volume)

Question 16

42 kg baby fluid rescucitation

Answer 16

10 x 100 = 1000
+
10 x 50 = 500
+
22 x 20 = 440
=
1940
(1940/24 = 80.83)

10 x 4 = 40
+
10 x 2 = 20
+
22 x 1 = 22
=
82
(82 x 24 = 1968)