Question

Please help answer these questions case study

You are working in the emergency department when a father

comes through the doors, crying, carrying his 1-month-old infant.

The infant is awake and very irritable. The father reports that the

infant has not been feeding well for the past 6 hours, and the father

has noticed sweating (diaphoresis) with attempted feeds. No

history of fever is noted. Further assessment reveals a diaphoretic,

crying infant with a respiratory rate of 60 breaths/min, blood

pressure of 60/40 mm Hg, and heart rate that is too fast to count by

auscultation. When the infant is attached to the cardiorespiratory

monitor, the heart rate is 220 beats/min, nonvariable, with an

oxygen saturation of 97%. Capillary refill time is slightly prolonged

at 3 seconds, and femoral pulses are palpable but weak.

Questions

1. Evidence: Is there sufficient evidence to draw conclusions about

this infant?

2. Assumptions: Describe an underlying assumption about each of

the following:

a. Symptoms associated with heart failure

b. An infant younger than 3 months of age with poor

feeding

c. Tachyarrhythmias in infants

3. What priorities for nursing care should be established?

4. Does the evidence support your nursing interventions?

Answer 1

1. Evidence that is given in this case are increased heart rate, prolonged capillary refill time, absence of fever, increased sweating, crying and poor feeding. Further information about the child's behavior, pain, pallor, syncope, cyanosis are required to make a conclusion.

2. Assumptions:

a. Symptoms associated with heart failure

• Rapid breathing
• Poor feeding
• Rapid and irregular heart rate
• swelling of feet and ankles

b. An infant younger than 3 months of age with poor feeding

• Traumatic injuries
• Neurological disorders
• Low birth weight
• Immaturity
• Respiratory problems
• Heart disease.

C. Tachyarrythmias in infants:

• Secondary to anemia
• dehydration
• dysrhythmias
• Decreased cardiac output

3. Priorities for nursing care:

• Note the skin color and temperature.
• Calm the child and avoid prolong crying.
• Use soft nipples to improve feeding.
• Monitor ECG.
• Auscultate heart sounds.
• Maintain fluid balance.
• Administer digoxin to reduce heart rate.

4. Yes. Proper nursing intervention are implemented for poor feeding, crying, Rapid heart rate, and breathing. The child is evaluated and necessary action are taken.