wanderlost
New member
A friend of mine is a nursing student and has to do this case study for class, I told her i would help, but there are some things I don't know. If you know any of these answers and have the time to type them, I'd appreciate it! I already did a lot of it, but some of the transplant stuff I didn't know. But anything would help, as I will compare my answers to yours!
TIA!
<b>Client Profile: Erin is an 8-year-old girl who lives with her parents and two younger sisters, Rachel, who is 5 years old, and Samantha, who is 2 years old. They live in a Midwestern community where Erin's father is a bank manager and her mother is a part-time investment broker who works from home, which allows her to stay at home with the children. Both of Erin's parents are very attentive to the children and are very knowledgeable about Erin's cystic fibrosis, which was diagnosed when Erin was 3 months old. Neither of her sisters has the disease. Erin takes pancreatic enzymes with each meal and snack (six doses per day) and she performs breathing exercises twice a day. Her mother performs postural drainage 1 hour prior to breakfast, again when Erin returns from school in the afternoon, and finally each evening prior to Erin's going to bed.
Case Study: During late spring Erin's breathing has become increasing congested over the past week and her parents suspect that she has developed a respiratory infection when she becomes febrile with a temperature of 37.9 0 C (100.2 0 F). They phone her pediatrician, who recommends that she be admitted to the children's hospital 20 miles away.The pediatrician calls the hospital and informs the chief respiratory resident physician of Erin's history, chief complaints at present, and impending arrival. Sputum cultures, complete blood count, serum electrolyte panel, chest x-ray, and pulmonary function diagnostics are prescribed. Erin's last admission for pulmonary clean-out was 6 months ago. Erin is admitted and her diagnostic results include hemoglobin, 18g/dL; hematocrit, 51%; white blood cell count, 15,000 cells/mm3; platelets, 250,000 cells/mm3; red blood cell count, 5.1 million cells/mm3; serum glucose, 130mg/dL; potassium, 4.0 mmol/L; sodium, 130mmol/L; chloride, 90 mmol/L; blood urea nitrogen (BUN), 26mg/dL; and creatinine, 0.7 mg/dL. Her chest x-ray shows consolidation in her right lower and middle lobes, and her oxygen saturation is 89%. Erin's pulmonary function is determined to be 45% and as you are compiling Erin's history, her mother tells you that Erin has been on the lung transplant list for 9 months. Erin weighs 44 lb on admission.
Questions
1. Discuss your impressions about Erin's diagnostic values.
2. Discuss what risks Erin has for developing a pulmonary infection.
3. What pertinent information is missing?
4. Identify the common microorganisms that cause respiratory infections in a child with cystic fibrosis.
5. What is the relationship between Erin's condition and her oxygen saturation level?
6. The health care provider prescribes ceftazidime 1 g IV every 8 hours; gentamycin 50mg IV every 8 hours; and vancomycin 265 mg IV every 8 hours. Discuss why these drugs are prescribed for Erin.
7. Discuss the safety and efficacy of the doses of the antimicrobial agents prescribed for Erin.
8. What are the criteria established for lung transplant candidates?
9. Erin's condition worsens, and when no cadaver lungs are available, Erin's mother states that she wants to donate part or all of one of her lungs to Erin. After testing her mother for compatibility, the surgeon decides to proceed with the transplant the following day. Identify the priority client problems for Erin following the transplant.
10. Discuss the common immunosuppressant agents used to prevent organ rejection.
11. Erin receives a single lung transplant. Discuss what the risks are for her cystic fibrosis recurring in her transplant lung.
12. Erin and her mother recover from the surgery. Discuss the teaching priorities you will address with Erin and her parents prior to Erin's discharge.
13. What are the current statistics for successful lung transplants?</b>
TIA!
<b>Client Profile: Erin is an 8-year-old girl who lives with her parents and two younger sisters, Rachel, who is 5 years old, and Samantha, who is 2 years old. They live in a Midwestern community where Erin's father is a bank manager and her mother is a part-time investment broker who works from home, which allows her to stay at home with the children. Both of Erin's parents are very attentive to the children and are very knowledgeable about Erin's cystic fibrosis, which was diagnosed when Erin was 3 months old. Neither of her sisters has the disease. Erin takes pancreatic enzymes with each meal and snack (six doses per day) and she performs breathing exercises twice a day. Her mother performs postural drainage 1 hour prior to breakfast, again when Erin returns from school in the afternoon, and finally each evening prior to Erin's going to bed.
Case Study: During late spring Erin's breathing has become increasing congested over the past week and her parents suspect that she has developed a respiratory infection when she becomes febrile with a temperature of 37.9 0 C (100.2 0 F). They phone her pediatrician, who recommends that she be admitted to the children's hospital 20 miles away.The pediatrician calls the hospital and informs the chief respiratory resident physician of Erin's history, chief complaints at present, and impending arrival. Sputum cultures, complete blood count, serum electrolyte panel, chest x-ray, and pulmonary function diagnostics are prescribed. Erin's last admission for pulmonary clean-out was 6 months ago. Erin is admitted and her diagnostic results include hemoglobin, 18g/dL; hematocrit, 51%; white blood cell count, 15,000 cells/mm3; platelets, 250,000 cells/mm3; red blood cell count, 5.1 million cells/mm3; serum glucose, 130mg/dL; potassium, 4.0 mmol/L; sodium, 130mmol/L; chloride, 90 mmol/L; blood urea nitrogen (BUN), 26mg/dL; and creatinine, 0.7 mg/dL. Her chest x-ray shows consolidation in her right lower and middle lobes, and her oxygen saturation is 89%. Erin's pulmonary function is determined to be 45% and as you are compiling Erin's history, her mother tells you that Erin has been on the lung transplant list for 9 months. Erin weighs 44 lb on admission.
Questions
1. Discuss your impressions about Erin's diagnostic values.
2. Discuss what risks Erin has for developing a pulmonary infection.
3. What pertinent information is missing?
4. Identify the common microorganisms that cause respiratory infections in a child with cystic fibrosis.
5. What is the relationship between Erin's condition and her oxygen saturation level?
6. The health care provider prescribes ceftazidime 1 g IV every 8 hours; gentamycin 50mg IV every 8 hours; and vancomycin 265 mg IV every 8 hours. Discuss why these drugs are prescribed for Erin.
7. Discuss the safety and efficacy of the doses of the antimicrobial agents prescribed for Erin.
8. What are the criteria established for lung transplant candidates?
9. Erin's condition worsens, and when no cadaver lungs are available, Erin's mother states that she wants to donate part or all of one of her lungs to Erin. After testing her mother for compatibility, the surgeon decides to proceed with the transplant the following day. Identify the priority client problems for Erin following the transplant.
10. Discuss the common immunosuppressant agents used to prevent organ rejection.
11. Erin receives a single lung transplant. Discuss what the risks are for her cystic fibrosis recurring in her transplant lung.
12. Erin and her mother recover from the surgery. Discuss the teaching priorities you will address with Erin and her parents prior to Erin's discharge.
13. What are the current statistics for successful lung transplants?</b>