COVİD-19 ve MIS-C Tanılı Çocuk Hastanın Hemşirelik Bakımı: Olgu Sunumu

Year 2023, Volume: 4 Issue: 2, 140 - 149, 23.10.2023

Nalan Karaoğlan , Aslı Çatıkoğlu , Hatice Yıldırım Sarı , İlker Devrim

Abstract

Bu olgu sunumu çocuklarda ateş, öksürük, nefes darlığı ve solunum güçlüğü ile kendini gösterebilen ve zatürreye, akut solunum yetmezliğine, böbrek yetmezliğine ve hatta ölüme neden olabilen COVID-19 enfeksiyonuna sekonder MIS-C (Multisistem İnflamatuar Sendrom) tanılı bir çocuğun hemşirelik bakımının açıklanması amacıyla hazırlanmıştır. 6 yaşındaki erkek hasta üçüncü düzey çocuk hastanesinin acil servisine ateş, karın ağrısı ve el ve ayakta döküntüler nedeniyle başvurmuş, COVID-19 hızlı antikor testi pozitif saptanmış ve intaniye servisine yatışı yapılmıştır. COVID-19 kliniğinde 4 gün izlenen hasta klinik tablosunun ağırlaşmasının ardından yoğun bakımda 4 gün süreyle izlendikten sonra tekrar COVİD-19 kliniğine yatırılmıştır. Yatış fizik muayenesinde lenfadenopati ve peroral lezyon, tonsillerde hiperemi, çilek dili, gözlerde kızarıklık, bilateral avuç içleri ve bilateral ayak tabanı ile lateral kısımda eritemli döküntüler saptanmıştır. Sonrakigünlerde diyare, kusma, sinüs taşikardisi, hipotansiyon gelişen hastaya İVİG, dopamin infüzyonu ve furosemid infüzyonu ve diğer ilaçlar uygulanmıştır. Olgu hipertermi, doku perfüzyonunda bozulma, sıvı volüm eksikliği, aktivite intoleransı, diyare, beslenmede dengesizlik: vücut gereksiniminden az beslenme/riski, enfeksiyon bulaştırma riski ve sekonder enfeksiyon gelişme riski, öz bakım eksikliği, anksiyete ve sosyal etiketlenme hemşirelik tanıları ile izlenmiştir. Bilinci açık, vital bulguları stabil olan, ek şikâyeti olmayan, kültürlerinde üreme olmayan ve klinik bulgularında gerielme gözlenen hasta önerilerle taburcu edilmiştir.

Keywords

COVID-19, çocuk, hemşirelik bakımı, MİS-C

Nursing Care Of A Pediatric Patient Diagnosed With COVID-19 And MIS-C: A Case Report

Abstract

This case report was prepared to explain the nursing care of a child diagnosed with MIS-C (Multisystem Inflammatory Syndrome in Children) secondary to COVID-19 infection, which can present with fever, cough, shortness of breath and difficulty breathing in children and can cause pneumonia, acute respiratory failure, renal failure and even death. A 6-year-old boy was broughtto the emergency department of a tertiary pediatric hospital due to complaints such as fever, abdominal pain and rashes on the hands and feet. Following his COVID-19 rapid antibody test, which came positive, he was admitted to the infectious diseases clinic of the hospital. The child was initially observedin the COVID-19 clinic for 4 daysand later was transferred to the pediatric intensive care unit (PICU) due to his clinical picture worsening. After the observation of his treatmentin the PICU for 4 days, he was retransferred to the COVID-19 clinic. On his physical examination at admission, lymphadenopathy, perioral lesion, hyperemia of the tonsils, strawberry tongue, redness of the eyes, and erythematous rashes on the bilateral palms, bilateral soles and lateral parts weredetected. In the following days, intravenous immunoglobulin (IVIG), dopamine infusion and furosemide infusion and other drugs were administered to the patient because he developed diarrhea, vomiting, sinus tachycardia, and hypotension symptoms. The patient was treated in accordance with the diagnoses of hyperthermia, impaired tissue perfusion, fluid volume deficiency, activity intolerance, diarrhea, fluid volume deficiency, nutritional imbalance: undernutrition/risk of body requirement, risk of transmission of infection and risk of developing secondary infection, lack of self-care, anxiety and social labelling. The patient who was conscious, had no additional complaints and had no growth in his blood cultures, whose vital signs were stable and clinical findings showed improvement was discharged with recommendations.

Keywords

COVID-19, child, nursing care, MIS-C

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