Childrens+log

Childrens Hospital West Campus April 2012
Maxine Arnett unit supervisor 80 hours, 20 JACO policy review, 60 pt care

derm rash 4 yo not eating 6 mo gi abd pain 7 yo ? ears 3 yo fussy closed head injury 11 yo laceration hand 7 yo derm rash 4 yo MT injury lacorss ball hit hand 10 yo resp cough 5 yo fever rsp ear 18 mo uti 3 yo cath fever red eyes 10 mo asthma 6 yo
 * 4/7/8-4**
 * Mentor Lu Stewart**

stye staple removal minor trauma fall resp fever cough earache lac hand fever reap cough diarrhea vom reap breathign diff sore throat Fx scapula asthma pathway vs pas pediatric astham score keep O2 >90
 * 4/11/ 3-11**
 * Mentor Lu**

resp cough eent eye resp cough shoulder pain gi vomiting finger nalal cong fever sore throat crying resp diff breathing orientation to charge position duties, role
 * 4/15 8-4 Lu**

abe pain gi resp fever cong lac scalp eent resp barky couth fever gi ibs neur dizzy fever
 * 4/18 3-11 Kathy VG**

echo coarc repair check /teaching 12 lead ekg turners syndrome / teaching 12 lead ekg /teaching
 * 4/20 2-5 Arianna Cardiac**

gi vomiting lac scalp mt other wrist sore throat fever gu other fussy fever oral sores neuro dizzy fever mnor trauma elbow gi/ abd pain resp barky cough
 * 4/21 8-4 Mamta**

head injury vomiting fall shoulder injury vomiting vomiting no urine urine cx migraine ts to main stronger meds, migraine coctail Knee injury xray splint temp dehydr cough UA, fluid rehydration
 * 4/23 3-11 Mamta**


 * 4/25 11-7 Arianna adol health**

baby neb alp anxious nausea today weak headahce restlsee loos fo consious, seizure activity rad U asthma actoni plan check value sucks on spacer older 1 breath hold 1-3 breaths in, spacer holds meds, doesn't get lost in mouth MDi have counters check puffs delvered, started on controller keeps okay baseline take every day

better often use steroid bursts to help clear but nto fast acting

\septic 3 year old, iv start, bolus, vs, pt support tsf to chidlresn for sepsic workup back pain meds adm triage

tordal benedryl zantac or zofran with iv fluids
 * migrane coctail,**

mar meds stop

TBT orintation to uint review floor protocl manual quick reference for urgetn care pt care meds strep cx processing, discharge charting on EPIC system,

triage 3 hours, vs assessmetn,

spinal tap 5 week old, assist, 4 sticks air life to childrens septic work up review tyl/ibpurofen protocol for nurse orders

review exposure worksheet, pertussion sp previous pt withpositive pertussis

brohciolitis clinical care guidelines

social work, red flag sexual assault, referals urgent care Orientation to unit rooms, open triage names on boards med count

web sites pediatric advantage, look up medconsult.com

Immunization info

vacine/immunization cdc.gov ccis colorado immunization for informed consent for immunizations tdaa

medical handouts with discharge look up on lexicomp

Standing protocols from RN manual

Bronchiolitis clinical care guidelines

social work ref flags


 * Triage**
 * chief complaint**
 * allergies**
 * past med hx**
 * pain goal**
 * motrin tyl today?**
 * immunizations utd**
 * ex pt contagous disease like strep or pertussis**
 * seen PCP in last 2 weeks**
 * chronic med problems**
 * daily meds**

LET, feht fingers toes, ear, nowe penis


 * reviewed CMT CA competencies for role delegation of tasks**
 * onlien policies Plante TCH undre CHEX system**
 * pain scales bier alien faces**
 * FLACC face lege activity cry consolability for babies to evaluate pain**
 * verbal 1-10 scale parents can also give this**


 * DKA**
 * insuline**
 * perls rapid short long acting**

Charge Role, leadership unit checklist of duties check staff, assignments check meds, names on boards Check emergency supplies Check lab results Check unit communication book Check unit O2 Check rooms supplies are stocked Patrient signup Breaks special projects for down time
 * diabetic treatmetn rsource binder**

Med administration, check out of Omni Cell Double check dose for proper level for childs weight Scan bar code scan pt name band, double check pt name/birthday with pt or parent give med chart reactions -decreased pain...bs better

PT care Discharge planning and instructions, teaching, care information sheets 4 yo asthmatic asthatic, cxr Neb x 3, prednisone, evaluate resp status pre adn post nebs Thera PEP for increase (possitive exp pressure) exhalation, set at one to start, dial up for increased effort once get use to it, 4 adn older helps encourage cough seal lips, chest level hold 2-3 seconds 10-20 repeats each session after encoure 2-3 huff coughs deep breath, fractured elbow xray, splinted ibuporfen for pain fractured scapula soccergame long term asthma, prednisone nasal suction straigth cath call back on meds AAPED asthma plan MDI spacer for asthma inhailer 4/20 Cardiac 12 lead ecg lead placemtn for <12 year old, murmer (innocent per cardiologist) family history of heart porblems, borther, pulm stenosis, moms dad murmer high cholesteral, no, no surgeries, Turners syndrome sports, no symptoms, check feomral pulse, murmer between lub/dub, sluggish sound innocentmurmer surgical no family hx, echo observation could see valves, adn flow ? MD pacers at school look for cyanosis, blue incidents, fainting, dizzy pass out usually not cardiac, dehydration,low blood sugar no weight lifting for cardiac kids in high school, also football training can be hard on heart kids care plan, do need to exercise,paretns often watn them exempted fromPE, they need this when the are increased fatique is probablywhen they need surgical intervention. dec o2 levels
 * HIKE FIRST AID, IF FALL, CUT**

**4/21 Momta**
count ER equipment, check cart

observe med count

check lab results

diabetic new dx, increase urination, thirsty, labs, IV insulin to lower blood sugar Also increase with illness Followed at Barbara Davis Center Look up insulin pumps, diabetic levels for doses, reveiw care plans

will also see in cardac for chest pain,usually musc skeletal or gerd coudl also be blocked coronary arteries reflux, ekg, for any adhd med adm for baseline or any amphetimine admin watch energy drinks, pop and coffee, can cause palpitations, stress caused palpitations,high stress kids shcool settings, refer to psych

2 year old fall down stairs, eval md, feed before d/c Soccer injury, back hurt, hard to move, muscle relaxant,

herpies eye, culture adn herpies, varicella, bacterial, sent to main childrens, danger eye involvment

ort oral replacement therapy, zofran, then 5 cc q 5 minutes for while. helps get past iv need sometimes

head staples, let to hea then statples, and antibiotic cream

situaiton, assesemtn background, recommenation

evidence based practice

[] good resources adn books for families

positive pertussis from child with cough, call back