The Centers for Disease Control and Prevention, Division of Informatics and Surveillance website contains a number of resources nurses could innovatively incorporate in care delivery.

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The Centers for Disease Control and Prevention, Division of Informatics and Surveillance website contains a number of resources nurses could innovatively incorporate in care delivery. The CDC Wonder site could be utilized by nurses in a number of ways. https://wonder.cdc.gov/ (Links to an external site.)Links to an external site.

For this discussion you will:

  • Identify one of the resources at the CDC Wonder site above and describe how a nurse might use this information in practice.
  • How might nurses utilizing telehealth benefit from these resources?
  • Address what you find innovative about the link.
  • Feel free to share some of your nursing innovation ideas!

500 words

Textbook: American Nurses Association. (2015). Nursing: Scope and standards of practice. (3rd ed.). Silver Spring, MD: Author.

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What are 5 questions you would ask the mother next?

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What are 5 questions you would ask the mother next?

1. How high was the temperature and how was it taken (eg, rectal, temporal, axillary, or not taken at all, just by touch)?

 

2. Any home meds given for fever or is the patient taking any medication OTC or prescribed?

 

3. How much is the patient feeding and wetting diapers daily?

 

4. Any recent exposure to anyone sick or does patient attend daycare?

 

5. How many times did the patient have diarrhea in a day and describe stool for any blood and color?

 

What additional signs/symptoms would alert you that this infant may need to be transferred to the ER?

-Dehydration

 

– Failure to Thrive

 

-Continuous vomiting and labs as indicated

 

-Any child with fever and petechiae and who appears very ill.

 

According to Burns ,Dunn, Brady, Starr, Blosser, & Garzon (2017) symptoms that would prompt emergency care include: a change in or new rash, duskiness, cyanosis, or mottling of the skin. Coolness of the extremities, poor feeding or vomiting, irritability, cries with positional changes, difficulty in comforting or arousing, seizure activity and bulging anterior fontanelle.

 

What are your top 3 differential diagnoses

1. Rotavirus

 

2. Acute Gastroenteritis

 

3. Bacterial Gastroenteritis

 

Rotavirus has an acute onset of fever, vomiting and watery diarrhea occur 2 to 4 day later in children <5 years old, especially those between 3 to 24 months old (Burns et al., 2017).

 

Reference

 

Burns, C. E., Burns, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (2017). Pediatric primary care(6th ed.). St. Louis, MO: Elsevier.

Week 2 Discussion Question

Contains unread posts

Shana Henderson posted Mar 12, 2019 3:06 PMSubscribe

A 6 month old male patient presents to your clinic with his mother. The mother’s chief complaint is that the baby has had a fever and diarrhea for several days and is not nursing as much as usual. The infant is quiet and warm, lung sounds are clear, heart sounds normal. No medical history, born healthy at 39 weeks 5 days via uncomplicated vaginal delivery, he is exclusively breast fed and is up-to-date on his vaccinations.

 

5 questions to you would ask the mother?

 

1. How high was the temperature and what have you been giving to treat the temperature?

 

2. Anyone else in the family sick?

 

3. Does the child attend daycare?

 

4. How many episodes of diarrhea does the child have per day? Is there any blood in the diarrhea?

 

5. How many wet diapers per day are you changing?

 

What additional signs/symptoms would alert you that this infant may need to be transferred to the ED?

 

Additional signs and symptoms that would alert me that the infant may need to be transferred to the ED would include a high fever >39C, the infant is lethargic or difficult to arouse, the infant is not producing any tears/dry mucus membranes, persistent vomiting, tachycardia, increased or decreased respirations, decreased urine output, poor muscle tone, delayed capillary refill, pale cool skin, irritability, sunken eyes and sunken fontanelles.

 

Top 3 differential diagnosis:

 

1. Viral gastroenteritis

 

2. Bacterial gastroenteritis

 

3. Parasitic gastroenteritis

 

Gastroenteritis in children is a major cause of morbidity in the United States (Churgay, C., & Aftab, Z., 2012). It is defined as the onset of diarrhea in the absence of chronic disease, with or without fever or pain. It is common in children under the age of 5. The rotavirus is the number one cause of diarrhea and hospitalization in young children. After rotavirus, bacteria such as salmonella and shigella are also responsible for acute gastroenteritis in children under 5 years of age. A small percentage of gastroenteritis are caused by parasites such as Giardia intestinalis and Cryptosporidium. It is important that children who are suffering from acute diarrhea be treated as soon as possible to prevent dehydration. Oral rehydration should be the initial treatment if the child is mildly dehydrated. If oral hydration can be tolerated, commercially prepared oral hydration would be appropriate, as long as the child is not vomiting. The caregiver should start out by giving small amounts of liquid then increase as the child tolerates it. In cases where the child has severe dehydration, the infant should be taken to the ER where intravenous fluids can be administered and the child can be monitored for hemodynamic stability (Cochran, W., 2017). Prevention of gastroenteritis starts with proper hand washing. It is important to teach children and caregivers how to properly wash their hands and inform them to avoid improperly stored food as well as contaminated water.

 

Reference:

 

Gastroenteritis in Children – Children’s Health Issues. (n.d.). Retrieved from https://www.merckmanuals.com/home/children-s-health-issues/digestive-disorders-in-children/gastroenteritis-in-children

 

Gastroenteritis in Children: Part 1. Diagnosis. (n.d.). Retrieved from https://www.aafp.org/afp/2012/0601/p1059.pdf

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ACTIVE LEARNING TEMPLATES TherapeuTic procedure A7

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ACTIVE LEARNING TEMPLATES TherapeuTic procedure A7

Medication STUDENT NAME _____________________________________

MEDICATION __________________________________________________________________________ REVIEW MODULE CHAPTER ___________

CATEGORY CLASS ______________________________________________________________________

ACTIVE LEARNING TEMPLATE:

PURPOSE OF MEDICATION

Expected Pharmacological Action

Complications

Contraindications/Precautions

Interactions

Medication Administration

Evaluation of Medication Effectiveness

Therapeutic Use

Nursing Interventions

Client Education

 

  1. STUDENT NAME:
  2. MEDICATION: Atenolol
  3. REVIEW MODULE CHAPTER: PHARM Cht20
  4. CATEGORY CLASS: Anti Hypertensive Beta Adrenergic Blockers (Sympatholytics)
  5. Therapeutic Use: Hypertension, esp with aldosterone-mediated fluid retention Long term treatment of angina pectoris May be used to prevent reinfarction following an MI
  6. Complications: Hypotension Bradycardia Nausea /vomiting
  7. Contraindications/Precautions: Contraindicated: Sinus bradycardia; First degree Heart block; Cardiac Failure Shock Precaution: Hhistory of asthma
  8. Interactions: *Calcium channel blockers, Verapamil, and diltiazem intensify effects of beta blockers *Other antihypertensives can intensify hypotensive effects
  9. Evaluation of Medication Effectiveness: Absence of chest pain Absence of dysrhythmias Normotensive BP Control of heart failure s/s
  10. Expected Pharmacological Action: Decreased heart rate Decreased peripheral resistance Decreased BP
  11. Nursing Interventions: *Monitor HR before and after administration. Hold medication if HR is below 60 bpm and report. *Monitor BP before and after treatment Monitor for signs of heart failure
  12. Medication Administration: Tablets: give one dose per day IV: Administer slowly 1 mg/min
  13. Client Education: Do not discontinue without consulting physician. Avoid sudden changes in position. Do not crush or chew extended release tabs. Self monitor BP and HR

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Assume that after washing your hands you leave ten bacterial cells on a new bar of soap.

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Answer critical Thinking question #2 for chapter 6 on page 180. Answers should be submitted in word document with any associated references used

1 E.Coli was incubated with aeration in a nutrient medium containing two carbon sources, and the following growth curve was made from this culture

A) Explain what happened at the time marked x

B) Which substrate provided “better” growth condition for the bacteria? How can you tell?

2  Assume that after washing your hands you leave ten bacterial cells on a new bar of soap. You then decided to do a plate count of a soap after it was left in soap dish for 24 hours. You dilute one gram of the soap 1:106 and plate it on heterotrophic plate count agar. After 24 hours of incubation, there are 168 colonies. How many bacterial were on the soap? How did they get there?

3) Heat lamps are commonly used to maintain food at about 50 degree C for as long as 12 hours in cafeteria serving lines . The following experiment was conducted to determine whether this practice poses a potential health hazard.

Beef cubes were surface-inoculated with 500,000 bacterial cells and incubated at 43-53degree C to establish temperature limits for bacterial growth. The following results were obtained from heterotrophic plate counts performed on beef cubes at 6 and 12 hours after incubation.

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