Nursing Care of a Child with Life-Threatening Conditions Emergency Situations (Acute & Chronic) Flashcards
BCLS
Basic Cardiac Life Support
is performed to support the patient’s circulation and respiration through the use of cardiopulmonary resuscitation (CPR) until advanced life support arrives
Basic Life Support (BLS)
CPR
Cardiopulmonary Resuscitation
is a lifesaving technique. It aims to keep blood and oxygen flowing through the body when a person’s heart and breathing have stopped
Cardiopulmonary Resuscitation (CPR)
DoctoRS ABCD
D-danger
R-response
S-send for help
A-airway
B-breathing
C-CPR
D-defibrillator
(2) Types of CPR
- Hands-only CPR
- Traditional CPR with breaths
Involves calling for help and then pushing on the chest in a rapid motion in chest compressions. This CPR can prevent a delay in getting blood
moving through the body.
Hands-only CPR
(8) Rules for achieving effective chest compressions:
- 100 – 120 compressions per minute (for all ages)
- Push down firmly on the sternum to 1/3 of the depth of the chest
- Push in a regular rhythm, for example counting ‘1, 2, 3’
- Compression/relaxation ratio should be 50:50 with complete recoil of chest between each compression
- Frequent rotation of personnel should be taken after approximately 200 compressions or approximately every two (2) minutes
- Avoid compression below lower limits of sternum as may cause regurgitation and/or damage to liver/spleen/stomach
- Interruptions to chest compressions should be minimized
- Avoid compressions applied too high as ineffective depth is achieved
- After each 30 compressions there is an interruption in chest compressions for two (2) rescue breaths (optional).
Rules for achieving effective chest compressions:
___-___ compressions per minute
100 – 120 compressions per minute
Rules for achieving effective chest compressions:
Push down firmly on the sternum to ____ of the depth of the chest
1/3 of the depth of the chest
Rules for achieving effective chest compressions:
Compression/relaxation ratio should be __:__ with complete recoil of chest between each compression
50:50 with complete recoil of chest between each compression
Rules for achieving effective chest compressions:
Frequent rotation of personnel should be taken after approximately ____compressions or approximately every ____minutes
200 compressions or approximately every two (2) minutes
Rules for achieving effective chest compressions:
Avoid compression __________ as may cause regurgitation and/or damage to liver/spleen/stomach
lower limits of sternum
Rules for achieving effective chest compressions:
After each ___ compressions there is an interruption in chest compressions for _______rescue breaths (optional).
30 compressions there is an interruption in chest compressions for two (2) rescue breaths (optional).
Also called CPR with breaths, this alternates chest compressions with mouth-to-mouth breaths. This type of CPR can give the body more oxygen in the critical moments before help arrives.
Traditional CPR with breaths
CPR with breaths: Steps for adults and teens (4 steps)
- Perform chest compressions.: Checking the scene for safety then place the person on a firm, flat surface, perform 30 chest compressions.
- Open the airway: Put the palm of your hand on the person’s forehead and tilt your head back. Gently lift their chin forward with your other hand.
- Give rescue breaths: With the airway open, pinch the nostrils shut, and cover the person’s mouth with a CPR face mask to make a seal. For infants, cover both mouth and nose with the mask. If a mask isn’t available, cover the person’s mouth with yours. Give two rescue breaths, each lasting about 1 second. Watch for their chest to rise with each breath. If it doesn’t, reposition the face mask and try again.
- Alternate rescue breathing with chest compressions: Continue alternating 30 compressions with two rescue breaths until the person begins to breathe or until medical help arrives. If the person begins to breathe, have him or her lie on their side quietly until medical assistance is on the scene
SAFE Approach
SHOUT for help
APPROACH with care, check if the area is
FREE from danger, and then
EVALUATE the patient using ABC
EVALUATE the patient using ABC
AIRWAY
BREATHING
CIRCULATION
This maneuver is to ensure an open airway is referred to as _______?
Its purpose is to prevent the tongue obstructing the upper airway.
head tilt-chin lift
Once the child or infant’s airway is open the rescuer should look, listen and feel for signs of _________ by placing their face close to the child/infant’s chest and looking down the chest.
BREATHING
(3) Rescue breaths in children are delivered by:
(a) pinching the soft part of the nose closed
(b) taking a breath
(c) placing the lips around the child’s mouth
Infants have underdeveloped diaphragmatic muscles, which results in the increased use of abdominal muscles to breathe. Therefore, the rescuer should?
observe both chest and abdominal movement when assessing breathing.
Once the rescuer has delivered five rescue breaths, they should assess for signs of life for no longer than 10 seconds
CIRCULATION
In rescuers who are trained to check for a pulse, this can be done through
feeling for a________ in children and a _________ in infants for 10 seconds.
(a) carotid pulse in children
(b) brachial pulse in infants
If there are no signs of life or the pulse is below 60 beats per minute then the rescuer will commence chest compressions at a rate of _______ beats per minute
100-120 beats per minute
If a rescuer is alone and no help has arrived following their shout, they should undertake 1 minute or 5 cycles of BLS before seeking further help.
CONTINUING RESUSCITATION
It may be possible for them to carry them to get help, in order to minimize the delay in delivering BLS. Continue to deliver BLS at the __:__ ratio until the child shows signs of life, qualified help arrives or the
rescuers become exhausted
15:2 ratio
refers to a set of clinical guidelines for the urgent and emergent treatment of life-threatening cardiovascular conditions that will cause or have caused cardiac arrest, using advanced medical procedures,
medications, and techniques
ADVANCED CARDIAC LIFE SUPPORT (ACLS)
Due to the rapidity and complexity of ACLS care, as well as the recommendation that it be performed in a standardized fashion, providers must usually hold ________in ACLS care.
certifications
is a testament to a provider’s education on ACLS guidelines.
ACLS certification
The certification does not superseded a
provider’s __________ as determined by state
law or employer protocols; and does not, itself,
provide any _______to practice.
(a) scope of practice
(b) license
(6) CLIENT EDUCATION
Ø If your baby is sent home with oxygen, follow your doctor’s directions for giving the oxygen.
Ø Learn how to do rescue breathing. It is important to know this in case your baby stops breathing. Talk to your doctor or take a class to learn how to do rescue breathing and infant CPR.
Ø Follow instructions on using a breathing monitor at home if your doctor tells you to use one.
Ø Do not smoke or allow anyone else to smoke in your house. Smoking increases the chance of sudden infant death syndrome (SIDS), ear infections, asthma, colds, and pneumonia.
Ø Wash your hands well before holding your baby. Keep your baby away from crowds and people who are sick.
Ø Make sure your baby gets all recommended vaccines. Also, make sure anyone who comes near your baby has had all of the recommended vaccines.
Following your doctor’s advice and taking good care of yourself and your baby during pregnancy can often prevent problems that lead to?
MAS
________during pregnancy can raise the chances of having a baby with MAS
SMOKING
(5) How to reduce the chances of having an MAS Baby?
- Talk to your doctor early to make sure you get good prenatal care.
- Eat a healthy diet.
- Avoid tobacco.
- Avoid cocaine use.
- Avoid alcohol
(5) How to reduce the chances of having an NEONATAL SEPSIS Baby?
Ø Practice good hygiene. Poor hand hygiene and disinfection practices often lead to infections that cause sepsis.
Ø See your healthcare provider regularly. Neonatal sepsis treatment needs to begin immediately, your baby will get antibiotics right away, even before test results are available.
Ø Get your recommended vaccines. vaccination can reduce mortality from neonatal sepsis in human newborns
Ø Know the signs of sepsis. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.
Ø Get care fast if you think you or your baby have sepsis.
By using the nursing intervention to reduce the incidence and severity of neonatal respiratory distress syndrome utilizing:
Prenatal corticosteroid
By using the nursing intervention to reduce the incidence and severity of neonatal respiratory distress syndrome utilizing: Prenatal corticosteroid
(3) followed by optimal management?
- Breathing support
- Surfactant therapy
- General care of the premature infant
IDENTIFY THE MEDICAL CONDITION using the given EVALUATION OF CARE:
At the end of nursing intervention, the patient has maintained adequate breathing with respiratory rate and oxygen saturation within the normal range and the newborn airway will remain patent and will not develop any signs or symptoms of respiratory disorders. By assisting with the respiratory status of the patient their rate, effort of breathing, oxygen saturation, and auscultation rates can result in varying degrees of respiratory distress to the patient.
Meconium Aspiration Syndrome
IDENTIFY THE MEDICAL CONDITION using the given EVALUATION OF CARE:
The patient will maintain normal body temperature and avoid developing cold and stress and their vital signs and Apgar score is already normal. Ensure that the area around the cord is dry and free of erythema.
Administer supplemental oxygen as prescribed. Increasing inspired oxygen may be necessary for the setting of neonatal septic shock to maximize tissue oxygen delivery.
Neonatal Sepsis
DOCUMENTATION:
Meconium is a newborn’s _______ poop. This sticky, thick, dark green poop is made up of cells, protein, fats, and intestinal secretions, like bile.
Babies typically pass meconium in the first few hours and days after birth but some babies pass meconium while still in the womb during late pregnancy.
first poop
DOCUMENTATION:
(3) Meconium aspiration syndrome (MAS) happens when a newborn has trouble breathing because meconium got into the lungs. Meconium can make it harder to breathe because it can:
- clog the airways
- irritate the airways and injure lung tissue
- block surfactant, a fatty substance that helps open the lungs after birth
occurs in babies born early (premature) whose lungs are not fully developed. The earlier the infant is born, the more likely it is for them to have this and need extra oxygen and help breathing
Infant Respiratory Distress Syndrome
is caused by the baby not having enough surfactant in the lungs. Surfactant is a liquid made in the lungs at about 26 weeks of pregnancy. As the fetus grows, the lungs make more surfactant.
Respiratory Distress Syndrome (RDS)
Also take note that Surfactant is made about 26 weeks of pregnancy
RDS:
__________ coats the tiny air sacs in the lungs and to help keep them from collapsing. The air sacs must be open to allow oxygen to enter the blood from the lungs and carbon dioxide to be released from the
blood into the lungs. While RDS is most common in babies born early, other newborns can get it.
Surfactant
(7) Those at greater risk for RDS are:
- siblings that had RDS
- twin or multiple births
- C-section (cesarean) delivery
- mother that has diabetes
- infection
- baby that is sick at the time of delivery
- cold, stress, or hypothermia. Baby cannot
keep body temperature warm at birth.
Is a blood infection that occurs in an infant younger than 90 days old.
Neonatal Sepsis
Early-onset sepsis is seen in the first week of life. Late onset sepsis occurs
after _ week through _ months of age
1 week through 3 months of age
can be caused by bacteria such as Escherichia coli (E coli), Listeria, and some strains of streptococcus.
Neonatal Sepsis
_____________ has been a major cause of neonatal sepsis. However, this problem has become less common because women are screened during pregnancy.
Group B streptococcus (GBS)
Neonatal Sepsis:
The _______________ can also cause a severe infection in a newborn baby. This happens most often when the mother is newly infected.
herpes simplex virus (HSV)
Early-onset neonatal sepsis most often appears within _____to____ hours of birth. The baby gets the infection from the mother before or during delivery.
24 to 48 hours
(4) The following increase an infant’s risk of EARLY-ONSET bacterial sepsis:
- GBS colonization during pregnancy
- Preterm delivery
- Water breaking (rupture of membranes) longer than 18 hours before birth
- Infection of the placenta tissues and amniotic fluid (chorioamnionitis)
(2) Babies with LATE-ONSET neonatal sepsis are infected after delivery. The following increase an infant’s risk for sepsis after delivery:
- Having a catheter in a blood vessel for a long time
- Staying in the hospital for an extended period of time
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