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Picu Observation

1. The document summarizes the author's observation of nurses on the pediatric intensive care unit (PICU) at Akron Children's hospital. 2. During the observation, the author witnessed various nursing care and interventions for the children on the unit. This included observing nurse Laura care for a 3-year-old patient with asthma exacerbation who was following the PICU Asthma Pathway protocol. 3. The author also observed nurse Deanna care for a 11-year-old patient with diabetic ketoacidosis (DKA) who was receiving IV fluids and insulin and being educated for transition back to subcutaneous injections.

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161 views4 pages

Picu Observation

1. The document summarizes the author's observation of nurses on the pediatric intensive care unit (PICU) at Akron Children's hospital. 2. During the observation, the author witnessed various nursing care and interventions for the children on the unit. This included observing nurse Laura care for a 3-year-old patient with asthma exacerbation who was following the PICU Asthma Pathway protocol. 3. The author also observed nurse Deanna care for a 11-year-old patient with diabetic ketoacidosis (DKA) who was receiving IV fluids and insulin and being educated for transition back to subcutaneous injections.

Uploaded by

api-663643642
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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PICU Observation

Madison Kimes

NURS 4832L

Instructor Roberts

September 27, 2022


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This week I had opportunity to observe the nurses on the pediatric intensive care unit

at Akron Children’s hospital. During my time observing, I was able to witness a variety of

nursing care and interventions provided to the children on that floor. By the end of my

observation, I could identify multiple physical and psychological needs met for each child

taken care of by my nurse.

In the first half of my observation, I was introduced Laura, who is a float nurse at

Akron Children’s. Laura explained to me that she works on multiple units at the hospital

which included the NICU, PICU, and Burn unit. Laura had two patients during this shift,

which included a child diagnosed with asthma exacerbation. Patient “AS” was diagnosed

with asthma exacerbation while at the hospital. She is currently 3 years old and was

diagnosed with asthma a little over a month ago. When arriving to the emergency

department, AS was experiencing SOB, wheezing and fatigue. She was also dealing with

rhino entero, which Laura explained are viruses that typically lead to upper respiratory

infections. She also stated that rhino entero is the cause of many children’s admission during

this time of the year. While the patient’s airways and oxygen saturation seemed to stabilized

in the first few hours of admission, the next step in her treatment was following the “PICU

Asthma Pathway.”

The Asthma Pathway is a step-by-step sheet on how to treat a PICU asthma patient. It

is a protocol designed by Akron on determining the next steps in treating a child with

asthma. This child was on level 1 of treatment which meant she was receiving albuterol

medication and beginning to ween off the vapo-therm mask. Laura would also rate the

child’s breathing and oxygen levels using the Pediatric Asthma Score. The Pediatric Asthma

Score is another one of Akron’s guidelines to us when treating a patient with asthma. The
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patient is scored on their oxygen requirement, retraction of muscle, signs of dyspnea, and

auscultation. At that time Laura scored her at a moderate level, meaning that the child still

needed a vapo-therm mask and further assessment. Teaching is very important with newly

diagnosed asthma patients, and Laura explained that would be her main focus in her care

plan. Since she was diagnosed with asthma so recently her parents had difficulties adjusting

to their new lifestyle. Laura also had suspicions that hospitalization could have been

prevented if the parents had been more educated in knowing how, and knowing when to

administer the inhaler in times of need.

During Laura’s lunch break, I then observed nurse Deanna in her care and

interventions for her patients. She had three patients during her shift, one being a patient with

DKA. The patient was 11 years old and having SOB and fatigue in her admission to the ED.

When the initially took her blood sugar it was well over 500 so they started her on a

continuous infusion of fluids and insulin. While on the IV infusion she was ordered an NPO

diet. After several hours of monitoring her lab values, she was eventually able to come off

the continuous insulin and Deanna helped transition her back to sub-q injections. During the

patient care I was able to witness Deanna give several educational points to the patient’s

mother and the next steps towards her recovery.

Overall, I really enjoyed my time on the PICU unit. The nurses I observed were very

thoughtful and used critical thinking skills when performing care to their patients. I became

aware that each patient is unique in their treatments and diagnosis, and the nurse must make

appropriate and rational judgement to treat their medical diagnosis.


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