You are an RN working the 7a-730p

You are an RN working the 7a-730p shift on a 22 bed, Renal/GI Pediatric Unit in a community hospital. The day staff consists of a Nurse Manager, 6 RNs, 4 PCTs (Patient Care Technicians), a Child Life Specialist, and a Unit Clerk. Patient rounds with the pediatricians, nurse practitioners, physician specialists, and charge nurse occur daily at 0800. After rounds, the charge nurse and nurse practitioner meet with the Nutritionist, PT and OT, Child Life, Certified Teacher, Nurse Case Manager and Social Work to discuss each patient’s daily plan of care. A satellite Pharmacist is assigned to the pediatric unit. You arrive and receive report from the RN on night shift: Charity Williams Age: 9 yo Weight: 110 lbs Admitting Dx: Gastroesophageal Reflux Disease (GERD), R/O aspiration PMH: pneumonia 2x within last year, Cerebral Palsy, developmental delay CXR: hazy infiltrate RML Current medications: Nexium 10mg PO once a day Diet: bland thickened liquid feedings in upright position 02 Sats 96% on 2 L 02 via NC Hgb 11.4, Hct 36.4 No emesis last night Abd soft BM x2 yesterday IV Saline lock OOB to wheelchair as tolerated Mother primary caregiver and is overwhelmed with Charity’s care. Consults: Surgery to evaluate for Nissen Fundoplication and GT insertion Dietary to evaluate caloric needs and feeding frequency Identify probable discharge day (hospital day #) or indicate the length of stay (LOS) and place. Include at least two scholarly sources (within 5 years)

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