HESI CASE STUDY Pediatric, Respiratory Syncytial Virus (RSV) Bronchiolutis

What action should the nurse take
continue respiratory assessment
what techniques should the nurse use to assess for respiratory distress?
-Inspect on chest wall for symmetry and retractions
-Count the infants pulse/respiratory rates
-place pulse ox on big toe of infant
Which assessment finding exhibited by Grace warrents Immediate intervention by nurse?
minimal response to stimuli
What action should the nurse take?
Suction nose agian
How many ml/hr will nurse set IV pump for??
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What should the nurse do next to best promote atramatic care…
Infant sucrose solution (sweet Ease) on a nipple to suck on during procedure.
what action should the nurse take?
Apply @ 1/2 liter nasel cannula as prescribed
Which med should the nurse question?
Diphenhydramine (Benadryl)
what nursing dx has the highest priority?
Ineffective airway clearance
which staff member should Charge nurse assign to Grace for the day?
RN, w/ 9m old (pneumonia)
which staff will transport child to peds unit?
experienced Ped RN, floated to ER for day.
what statement by the nurse reflects the philosophy of family centered care
while you hold Grace, we can talk about her diagnosis and care
What action should nurse take?
-Rapid response
-reposition
-notify the HCP
What type of precautions should PICU nurse initiate while Grace receives ribavirin
restrict pregnant care givers
what type of toy should nurse recommend
musical mobile
After gathering exam gloves and bulb syringe, the nurse should include
Nasal Saline Drops
How should the nurse respond?
the amount of mucous is not as important as how she acts after the treatment
How should the nurse respond?
use proper hand hygiene and stay away from the sick
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