I get to spend the day and night with the little man again. I have only been in for a couple hours a day lately and I have really missed him. Rob has been here for the last couple days and from what he tells me Charlie hasn't been behaving very well. Per Rob, Charlie was fussy all day yesterday and only slept a total of two hours (some of which must have been during therapy-see previous post pictures). Then, he had an average night of sleeping from around 2am to 6 or 8. Because he was so relaxed (low blood pressure) at 6:00am he didn't get his morning dose of clonadine. He has been fussy, sweating high heart rate (180's) and moaning all morning. The nurses have orders to vent his tube to get all the air out of his stomach every two hours. When they vent, air doesn't come out but instead his feedings do because there is so much pressure. The doctors have said if there are more than 35cc of residual (food in his stomach) they are supposed to turn off the feeds for 30 min and give him time to digest. He has also been put on 3/4 formula and 1/4 pedialite to help with the digetion. When Rob asked the doctors about changing formulas they said he is already on the easiest to digest so they wouldn't know what to switch to. There is still a little bit of fresh blood in his residuals but nothing like the disgusting picture that Rob posted a couple days ago. (Sorry about that.) Still thought to be drainage from his ear surgery and nothing to worry about. Charlie has been given Motrin and Tylenol this morning to see if that would change anything. It didn't. We decided to not give the Ativan until after his clonadine dose at noon because we didn't want to chance his blood pressure being too low again and then not being able to get it for another 6 hours.
His PICC line was taken out yesterday because it was loose and when they did an X-ray to check placement it was "no where near where it should be"(pulled out to the brachial plexus instead of right above the heart). So now we are not able to give morphine or IV fluids because he doesn't have a port. This may become an issue today because he hasn't had a wet diaper since last night. If he doesn't calm down and have a wet diaper soon the nurse is going to page the resident and get some feedback. I think the non-stop sweating may be dehydrating him or it may be related to the fact that he isn't digesting the feedings. The nurse just did an ultrasound of his bladder to see if he is retaining urine and there is some but not a lot. As I am writing this he seems to be calming down 28 minutes after receiving the clonadine. Yipee!
I get to spend the day and night with the little man again. I have only been in for a couple hours a day lately and I have really missed him. Rob has been here for the last couple days and from what he tells me Charlie hasn't been behaving very well. Per Rob, Charlie was fussy all day yesterday and only slept a total of two hours (some of which must have been during therapy-see previous post pictures). Then, he had an average night of sleeping from around 2am to 6 or 8. Because he was so relaxed (low blood pressure) at 6:00am he didn't get his morning dose of clonadine. He has been fussy, sweating high heart rate (180's) and moaning all morning. The nurses have orders to vent his tube to get all the air out of his stomach every two hours. When they vent, air doesn't come out but instead his feedings do because there is so much pressure. The doctors have said if there are more than 35cc of residual (food in his stomach) they are supposed to turn off the feeds for 30 min and give him time to digest. He has also been put on 3/4 formula and 1/4 pedialite to help with the digetion. When Rob asked the doctors about changing formulas they said he is already on the easiest to digest so they wouldn't know what to switch to. There is still a little bit of fresh blood in his residuals but nothing like the disgusting picture that Rob posted a couple days ago. (Sorry about that.) Still thought to be drainage from his ear surgery and nothing to worry about. Charlie has been given Motrin and Tylenol this morning to see if that would change anything. It didn't. We decided to not give the Ativan until after his clonadine dose at noon because we didn't want to chance his blood pressure being too low again and then not being able to get it for another 6 hours.
4 comments:
I hope the day gets better, I think he is just as frustrated as the staff. Is that his g/ng tube above his belly? When will they be able to place a new PICC line?
The tube coming out of his belly is his g-tube and is where we put all of his food and medications. The nurse just came back with orders to have the IV team put a new IV in but they won't do a PICC line because it is just for fluids. The PICC line was originally put in when he was in the ICU and they were monitoring his blood pressure through it. They are going to do a bolus of fluids and take a urine sample to test for an infection. He has been asleep for over 30 minutes so far. Yea!
I don't think I explained very well. Charlie is only in need of fluids and the easiest way to do that is to just do a regular IV not a PICC line.
Thanks for the update. Love, Allie :)
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