Friday, April 24, 2009
Abe was switched to conventional oxygen today at 2 liters then the nurse switched him to 1 liter. I think he should be on 2 liters however the respiratory therapist on night shift was going to check with the nurse about this. I am not sure if this is a nursing judgement or a definite doctor's order. for the liter flow. The oxygen concentration was at room air 21% until when I held him during his 8PM feed. He had another A & B, heart rate 85 and oxygen saturation read 65%. I got very scared when the monitor showed further decrease so I pulled the curtain and started to get up out of the chair to give him blow by oxygen. Luckily the nurse came in so I did not have to give him blow by oxygen. She increased his oxygen concentration to 30%. He can not be transferred to the "floor", (regular peds unit) until the vessels in his eyes are more mature and he has less A's and B's. On the floor conventional oxygen concentration would be at 100% which is damaging to the developing eye blood vessels. ICU nurses have more autonomy than a "floor nurse" does. Since I was a hospital floor nurse and not in the ICU I am not sure. I do know that oxygen is considered a drug and requires a physician order (unless this has changed). I have not been a hospital nurse for 4 years. I thought his scrotum looked swollen however no doctor checked it while I was there. The fellow stopped by to talk to me about it however I was holding him and he was asleep. Also he received a phone call and never came back. I need to check on his in the morning. After everything he has been thou hope that nothing is going wrong with his boy parts. He has a new room mate because the other boy needed eye surgery. His mother stopped by today and she really wants to move back in the room with Abe however he might need surgery again so he will remain in a private room. He is next door in Abe's old room. The new family does not understand English so it's difficult to communicate with her. However the mother of the previous room mate stops by to translate. The mother and father that disagreed on the feeding tube placement surgery for their son came to an agreement today after the doctor called the father. The child will have the surgery done. This child has been in the hospital for 8 months. He had a major heart defect that was missed on the prenatal ultrasound. Shortly after he was born it was discovered and he has had many complications related to blood flow to his gut so some of the intestinal tissue died. He was born at 35 weeks gestation so almost a full term baby. Glenn and I have came up with some great ideas with the whole pumping thing. It started with a stop watch that I wear around my neck that way I can set it to monitor pumping time and see how long it's been since the last time I pumped since hospital clocks don't always work. I use a nursing cover when I pump at the hospital so that nurses and staff can take care of him if needed and I am completely covered. I also bought one of the dishwasher safe bins for bottles to rinse the pump parts at the hospital (this keeps them securely in one place so that I don't drop them in the yucky sink or worse the hospital floor). Night time ideas: I clipped a book light on the pump so at night I don't have to turn on full lights (turning on lights to use the bathroom at night or in this case pumping sends signals to your brain to wake up so dim light is recommended), I have 2 clean sets of pump parts before I go to bed that way I use one set it aside in pink hospital bin then use the other one then clean and sterile when I wake up for the day. Wow maybe I should get certified as a lactation consultant. I think I will share some of these ideas with the other mothers. Most of them are concerned that they are not successful in milk production. I am still debating on the milk bank donation however my heart is telling me that other NICU babies somewhere could use it. My baby certainly has done very well on it. Seattle Children's does not accept breast milk from the milk bank. Some California NICUs do and that is where the milk bank is. Apparently two ounces of breast milk is very expensive.
Posted by Karen Goddard