Thursday, March 12, 2009
The drain in his head was taken out today 3/12/09. He had a pretty tough day, no pre-medication prior to taking out the drain. He was given medication afterwards. I tried my best to pre-medicate my patients when I was surgical nurse. It did not always work but I advocated for physical therapy to come back after the pain medication was working. I was not there so I don't know what happened. Tylenol was not enough so he needed morphine. It would have been nice to pre-medicate him before the drain was taken out however I am not sure why this did not happen (neurosurgery just showed up or the nurse did not think he needed it). His thyroid medication was adjusted, lower dose. His oxygen level got down to 49 (very bad) today and it should be between 88-95%. He even turned a little gray in color. This concerns me because he was laying on the side where the drain was taken out. He was finally put on his belly and appeared to be more comfortable. I got to hold him for a few minutes. His breathing tube has an air leak and he was turning blue and gray around his lips (bad oxygen sign) so the nurse put him back to bed. The angle I was holding him was causing me some shoulder and neck pain. At least he got to be held for a little while. I did not ask about the CT scan results, in fact only neurosurgery talked to me today. Glenn is coming back, 4 days off from ship, so I figured it would be best to find out the results together. I have learned that no news sometimes means bad news and the doctors just don't always have time to discuss. They wait until they have more allotted time, which is good so that they can explain or answer questions. This is also a bad thing since we have to wait a day or two to get results. He may or may not need a permanent shunt placed. Neurosurgery is assessing him daily to determine. He needed blood yesterday and his urine output is on the low side today. Please pray that the CT scan showed improvement in brain structures, urine output increases and that he continues to tolerate his feeds. He is up to 2 mililiters of breast milk in his NG tube every 3 hours. This amount will be increased by 1 mililiter every 12 hours if he tolerates it. I still don't know about the enlarged gallbladder and green mucoid stool. I think I should start making a list of my questions and physically hand it to the nurse so that it can be passed on to the doctors. The NICU has been so busy. A twin boy passed away this week. His brother is still pulling along. The mother appears to have a lot of support from her husband and extended family. I talk to her a little bit; there is a slight language barrier. I talked to 2 mothers of special needs children. There are support groups out there however we don't know right now the prognosis. It seems like they spend a lot of the time in the hospital. Probably at least 3-4 times a year, if not more times. Surgeries that are routine for some children become an extensive time in the hospital for there children. I did not post the other day because I did some laundry instead. Got to bed at 2AM. It's after midnight so it's time to get some sleep.
Posted by Karen Goddard