The nurse is caring for an intubated infant with botulism in the pediatric intensive care unit. Which health care provider prescriptions should the nurse clarify with the health care provider before implementing?
a. Administer 250 mg botulism immune globulin intravenously (BIG-IV) one time.
b. Provide total parenteral nutrition (TPN) at 25 ml/hr intravenously.
c. Titrate oxygen to keep pulse oximetry saturations greater than 92.
d. Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback every 12 hours.
ANS: D
The nurse should clarify the administration of an aminoglycoside antibiotic. Antibiotic therapy is not part of the management of infant botulism because the botulinum toxin is an intracellular molecule, and antibiotics would not be effective; aminoglycosides in particular should not be administered because they may potentiate the blocking effects of the neurotoxin. Treatment consists of immediate administration of botulism immune globulin intravenously (BIG-IV) without delaying for laboratory diagnosis. Early administration of BIG-IV neutralizes the toxin and stops the progression of the disease. The human-derived botulism antitoxin (BIG-IV) has been evaluated and is now available nationwide for use only in infant botulism. Approximately 50% of affected infants require intubation and mechanical ventilation; therefore, respiratory support is crucial, as is nutritional support because these infants are unable to feed.
You might also like to view...
The tool the clinical nurse specialist uses to organize data about three-generational relationships
within a client's family system is a. play. b. genogram. c. word association. d. projective story-telling cards.
The nurse is caring for a client who received an electrical shock. What is the most appropriate initial action for the nurse?
a. Immediately start CPR. b. Turn off or remove the electrical source. c. Assess the client's pulse and respiration. d. Notify the physician.
A patient with peripheral arterial disease (PAD) is a smoker. The nurse has established a nursing diagnosis of Deficient Knowledge of Self-Care Needs and Treatment Plan related to tobacco use
Which intervention should the nurse choose to implement? 1. Encourage the patient to use medications to stop smoking. 2. Discuss with the patient a smoking cessation plan. 3. Instruct the patient in increasing exercise. 4. Discuss the patient's use of herbal therapies for smoking cessation.
Convert 0.567 to a fraction: __________
Fill in the blank(s) with correct word