04 February 2013

Admitted for RSV: Monday Morning

Luke rested well overnight, sleeping from midnight until, well he's still sleeping. He was up once at 3:50 to eat and respiratory was in at least twice to suction out his nose. If they were in more than that they were awful quiet because they didn't wake me up.

Luke seems be be getting a little worse.... His coughs are more disruptive and when combined with his congestion, kept him from eating easily at his 11 pm feeding last night. It was a chore for me to get him to eat although we eventually got through the feeding and he did well at his next feeding at 3:50. His vitals have included his heart rate generally ranging from 130 to 160 and for the most part his oxygen saturation has been above 90, although they did have to increase his oxygen flow from .10 liters to .25 liters because his respiration rate had been ranging from 80 to 90 breaths per minute, higher than the guideline of 60 breaths per minute. Now that they've increased his oxygen flow, his respiration rate is back down between 40 and 50 breaths per minute.

Last night we should have begun the infamous "Day 3" that we keep hearing is when the symptoms and distress from the virus generally peak. Apparently between now and "Day 5" is when this is supposed to be the worst and he should begin to improve after that if he follows the typical trend with the virus.

If he isn't able to maintain a normal respiration rate with the oxygen flow they have here in the general pediatric unit, which is up to 1 liter (and now he is on .25 liters) we will have to be moved to the pediatric icu, so please pray that his respiration rate doesn't exceed the capabilities here which would mean that his condition is worsening. I had our nurse teach me how to take his respiration rate (it's pretty easy... I'm [almost] embarrassed that I didn't know how to do it other than the fact that I've never had to think about tracking it on someone). I plan to monitor his respiration rate on my own so I can make sure I'm taking an active role in consulting on his need for oxygen with the nurses and folks from the respiratory unit.

One of the residents was just in to complete a general exam of Luke. His lungs still sound clear, although she mentioned that she can hear his nasal congestion all the way down in his lungs and his belly too. I've been hot and heavy on the staff here to consult with his cardiology team to make sure his heart isn't at risk because of how hard he's working in response to the virus and she shared that they did talk with cardiology yesterday and they aren't concerned unless he's turning blue and having other clinical symptoms, although she didn't share what else they have indicated as red flags. I think I'm still going to stay on top of that today just because I feel uneasy about him needing to work so hard.

Rounds are supposed to be around 9:30, I'll update later once I have time to sit down after they're in to talk about Luke.

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