ATI Nur 223a Sect 4 Pediatrics Final Exam | Nurselytic

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Nurses Notes (0700hrs): Guardian reports infant has been forcefully vomiting after feedings. Guardian states the emesis is so forceful that it often lands 3 to 4 feet away. Infant is very fussy and rooting and sucks vigorously on a pacifier. Guardian mentions the vomiting started about a week ago and has progressively worsened. Infant has had fewer wet diapers over the past two days. Guardian reports the infant has been crying more than usual and seems uncomfortable. Infant's weight has decreased slightly since the last visit. Vital Signs (0700hrs): Temperature: 37.8°C (100°F), Heart Rate: 160 bpm, Respiratory Rate: 40 breaths per minute, Blood Pressure: 80/50 mmHg, Oxygen Saturation: 98% on room air. Medical History (0700hrs): Full-term infant, born via vaginal delivery. No known allergies. Up-to-date on vaccinations. No previous hospitalizations or surgeries. Family history of gastrointestinal issues. Diagnostic Results (0700hrs): Complete Blood Count (CBC): WBC: 10,000/mm³, Hemoglobin: 12 g/dL, Platelets: 300,000/mm³. Electrolytes: Sodium: 138 mEq/L, Potassium: 4.0 mEq/L, Chloride: 102 mEq/L, Bicarbonate: 22 mEq/L. Physical Examination Results (0700hrs): Abdomen is distended and firm to touch. Visible peristaltic waves observed. No signs of dehydration such as dry mucous membranes or sunken fontanelle. Infant appears irritable and cries during the examination. Bowel sounds are hyperactive. No palpable masses detected. Provider's Prescriptions (0700hrs): NPO (nothing by mouth) status. IV fluids: D5 0.45% NS at 20 mL/hr. Monitor intake and output. Abdominal ultrasound to be performed. Administer ondansetron 0.15 mg/kg IV every 8 hours as needed for vomiting.

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