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July 2006, Volume 36 Number 7 , p 72 - 72


  • Ellen M. Chiocca RN,C, APN, CPNP, MSN


Chiocca, Ellen M. RN,C, APN, CPNP, MSN

Assistant Professor of Clinical Nursing, Loyola University, Niehoff School of Nursing, Chicago, Ill.

MARY WATSON ARRIVES in the ED with her 9-week-old daughter, Selma, who just had an episode of “turning blue” while coughing. Earlier she was coughing so hard, she vomited. The baby is pale, slightly dusky, and appears slightly dehydrated—she has no tears and her mucous membranes are dry. Her vital signs are: BP, 78/40; temperature, 99° F (37.2° C); apical pulse, 140; respirations, 60 and slightly labored; and Spo 2 , 91%. As you assess Selma, she begins to cry, which triggers a severe coughing spell that ends in vomiting.

What's the situation?

Ms. Watson states that for about 2 weeks Selma has had a runny nose, sneezing, and a mild cough, but no fever. She says neither she nor her 3-year-old son has been sick, but her teenage babysitter has been coughing for weeks. Selma has had no other recent illnesses, and received all scheduled vaccines at her ...

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