So 7N again... whoo-wee!
So for this shift, I picked up one of the kids I had before. Miss beautiful Jay-cee. So you see this lil' cute 21m yo and see the pacer wires and blake drain... and feel so bad for this girlie. Luckily during this day, she was getting them all off. And boy, did she make a fuss about ANYONE touching her. I don't blame her. And I don't blame her screaming her lil' mouth off at the sight of me. Yea, I didn't think I was that scary... but it's really sad that no matter how I cute I talked to her -- she felt everything I did was to hurt her. Even the lil' EKG "stickers" I had to place on her body, were enough to make her go crazy. But that child was absolutely gorgeous... her whole family was there visiting -- I mean, everyone. They all are a good-looking fam too. But yea, as much as her experiences were traumatic -- I was very disappointed that I could be one of those "scary" nurses.
- PAVR repair aka PAPVR (partial anomalous pulmonary venous return) =
- replant vertical vein (drain to left atrium)
- LULV -> RA anastomosis
Pt. #2
- T&A removal
- went home with amoxicillin and ciprofloxan-dexamethasone otic
Pt. #3
Miracle kid, Caitlyn. She's been through a lot -- and I've learned most about heart stuff from her. Here's a short list of her PMHx:
- Bell palsy =
- TOF (Tetralogy of Fallot) =
- MAPLA =
- CHARLIE abscess =
- Pulmonary atresia =
- Tracheomalacia =
- Eczema =
- Esotropia =
- Macular Degeneration =
- had RV -> PA conduct surgery =
- CHARGE syndrome!!! >> common is the symmetry of the face, problems with trachea
Admitted for leg pain R/T who-knows-what?! Possible differential dx:
- muscle injury (positional from op), radialopathy, avascular necrosis, synovitis
Will get lumbar puncture on Tues =
MEDS:
- calcium carbonate (TUMS) = for possible JRA R/T leg pain
- Diazepam
- Dig = make heart more forceful, harder contractions, less frequency of contractions to push max amount of blood flow
- Erythromycin = antibiotic, but with pt is used for stomach motility and help empty stomach (so mom did not give in AM b/c she didn't take breakfast)
- Pepcid before meal and meds to help stomach
- IVIG = (will get only monthly to help boost immune system since immunosuppressed)
Random notes:
- Children tend to resp arrest before cardiac arrest and adults tend to cardiac arrest before respiratory arrest
- Sudafed helps drippy cough... otherwise use Robitussin
- Chest tubes:
1. change q4
2. change with knock drainage system over -- need correct measurements
3. chest tube change not sterile on floor
4. to change, put sterile water in water collection chamber >> see H2O turn blue. Clamp pt tubing, connect pt tubing to drainage, unclamp, then put suction -- REMEMBER watch for bubbles in the water chamber
- I and D = Incision and drainage?
- ECHMO?
- Amitrix (new) vs. Relapex for migraines
- PAVR repair aka PAPVR (partial anomalous pulmonary venous return) =
- replant vertical vein (drain to left atrium)
- LULV -> RA anastomosis
Pt. #2
- T&A removal
- went home with amoxicillin and ciprofloxan-dexamethasone otic
Pt. #3
Miracle kid, Caitlyn. She's been through a lot -- and I've learned most about heart stuff from her. Here's a short list of her PMHx:
- Bell palsy =
- TOF (Tetralogy of Fallot) =
- MAPLA =
- CHARLIE abscess =
- Pulmonary atresia =
- Tracheomalacia =
- Eczema =
- Esotropia =
- Macular Degeneration =
- had RV -> PA conduct surgery =
- CHARGE syndrome!!! >> common is the symmetry of the face, problems with trachea
Admitted for leg pain R/T who-knows-what?! Possible differential dx:
- muscle injury (positional from op), radialopathy, avascular necrosis, synovitis
Will get lumbar puncture on Tues =
MEDS:
- calcium carbonate (TUMS) = for possible JRA R/T leg pain
- Diazepam
- Dig = make heart more forceful, harder contractions, less frequency of contractions to push max amount of blood flow
- Erythromycin = antibiotic, but with pt is used for stomach motility and help empty stomach (so mom did not give in AM b/c she didn't take breakfast)
- Pepcid before meal and meds to help stomach
- IVIG = (will get only monthly to help boost immune system since immunosuppressed)
Random notes:
- Children tend to resp arrest before cardiac arrest and adults tend to cardiac arrest before respiratory arrest
- Sudafed helps drippy cough... otherwise use Robitussin
- Chest tubes:
1. change q4
2. change with knock drainage system over -- need correct measurements
3. chest tube change not sterile on floor
4. to change, put sterile water in water collection chamber >> see H2O turn blue. Clamp pt tubing, connect pt tubing to drainage, unclamp, then put suction -- REMEMBER watch for bubbles in the water chamber
- I and D = Incision and drainage?
- ECHMO?
- Amitrix (new) vs. Relapex for migraines