Question

A three week old is brought to the emergency room with a history of poor feeding for the past few days.   Mom states she usually takes 1 ½ ounce every 3 hours. As of late she has been refusing to take her usual amount. Today she started to spit up every feeding, which is the reason why mom brought her to the emergency room.

Data Obtained From Nursing Assessment

Child’s vital signs are:

Temp 97.2 Rectally

heart rate is 160

Respiratory rate is 64.

Bp 60/30

O2 sat 93-95%

Total Bili level is 18 mg/dl

Mother has been well since the delivery but has a cold sore on her mouth which she gets when she is stressed. The mother is surprised that the emergency room physician wants to admit the child and obtain some lab tests. The mother is very nervous and would like you to explain what lab work they will be obtaining and why?

The physician said he will probably start the child on three different types of medications while they wait to get the results of the lab work. The medications he is looking to start on the child is acyclovir, gentamycin and ampicillin. The mother wants to know why the physician wants to use all three of these medications and are there any adverse effects to these medications.

CONSIDER THE CORE DRUG KNOWLEDGE FOR EACH OF THESE DRUGS

Discuss the reason and use for three different medications.

Discuss what lab data the physician is obtaining.

Compare and contrast what different precautions, there are for the various drugs.

Explain what patient teaching would be reviewed with the client’s mother.

CONSIDER THE CORE PATIENT VARIABLES FOR EACH OF THESE DRUGS

What patient variables are most important to consider for a newborn when assessing her drug therapy?

Are there any aspects of core drug knowledge that are especially relevant to consider because they may interact with the core patient variables?

Which of the findings from the nursing assessment demonstrate effectiveness of drug therapy?

Which of the findings from the nursing assessment demonstrate possible adverse effects from drug therapy?

CONSIDER THE NURSING MANAGEMENT NEEDED WITH THESE DRUG THERAPies

What actions are indicated to maximize therapeutic effects?

What actions are indicated to minimize adverse effects?

What teaching is required for this newborn? Do you need any additional data to determine appropriate teaching?

Answer 1

Three different drugs used for treating infection and minimize the metabolic effects in the liver

Blood culture, reticulocyte count, complete blood count, coombs test..

Precautions should be taken while using different kinds of medication like rashes, fever, baby alertness, pain, fever, respiratory rate, urine output, urine colour etc..

Explain to mother that baby total bilirubin level is high so it should be ruleout for different complications like hyperbilirubinemia, sepsis and other potential causes for jaundice..

Advice mother about drug therapy , side effects..

Advice mother to continue breast feeding..

Advice if mother note with the infant anything abnormal should be informed..

We need dose adjustment.bacause infants under 2years need more doses because they metabolize the drugs too quickly..baby age and growth affect the core drug variable in drug therapy..

Check infant weight and physical assessment before drug therapy

Infants have less acidic gastrointestinal tracks..it affect absorption of some drugs ..erratic blood flow as per immature peripheral vascular system,it can alter the absorption from the IM and SC route infection this may result in adverse effects than children above 2years..

Checking baby age, weight,height,head circumference, chest and abdomen circumference, allergic reaction,physical activity important before drug therapy..