Case Study # 3

UNRS 314 Name ______Number

Asthma

6 year old admitted to the unit with asthma. According to the mother she noted that the child was wheezing and having difficulty breathing. His temp is 101 and he has been complaining of an earache. He has a history of an asthma attack one year ago. The current illness started as a cold and cough 1 week prior to admission. He is admitted to the unit from the ER with a diagnosis of asthma and ROM (right otitis media). You admitted him and are giving him the medications as ordered.

Weight 47 pounds: weight in kg ______

Calculate maintenance IV fluids ______

Calculate 1 ½ times maintenance for IV fluids ______

Physician Orders:

·  IV Dextrose 5% in 0.45 Normal Saline @ 80 mL / hour

·  Oxygen to keep oxygen sats at 96 to 100%

·  CPT every 4 hours prn

·  Xopenex via nebulizer q 2-4 hours prn for wheezing

·  Methylprednisolone IV 20 mg q 6 hours

·  Tagamet 80 mg IV q 6 hours

·  Azithromycin 200 mg po first dose and 100 mg po x 1 daily x 4 days

How provided:

·  Methylprednisolone 40 mg / mL

·  Tagamet 300 mg / 2 mL

·  Azithromycin suspension 200 mg / 5 mL

Methylprednisolone (Solu-medrol) 20 mg IV

Dosing: 1 to 2 mg mg / kg as loading dose and maintenance 0.5 to 1 mg/kg every 6 hours

Medication
Classification / Action:
Labs: / mg/kg calculations
How fast can drug be administered IV? / Nursing Responsibilities
Why this drug?

Tagamet 80 mg IV

Dosing per drug book: 20 – 40 mg / kg / day

Medication
Classification / Action:
Labs: / mg/kg calculations
How fast can drug be administered IV? / Nursing Responsibilities
Why this drug?

Azithromycin 60 mg po

Dosing: 10 mg / kg x 2 doses on first day and 5 mg / kg one daily x 4 days

Medication
Classification / Action:
Labs: / mg/kg calculations
How fast can drug be administered IV? / Nursing Responsibilities
Why this drug?

Xopenex to be administered per respiratory therapist

Classification:

Action:

Indication and uses:

Contraindications:

Side effect:

Nursing implications

Critical Thinking: The mother asks you what the IV medications are for. How would you explain the medications to her.