Final answer:
Concerning assessment findings for a child on mechanical ventilation include hypoxemia, indicated by a pulse oximeter reading below 90%, sinus tachycardia, and greater breath sounds on one side of the chest, which may suggest partial lung collapse or obstruction.
Step-by-step explanation:
For a child who is intubated and on mechanical ventilation, certain assessment findings would be concerning to a nurse. Specific findings of concern include:
- The child's pulse oximeter reading ranges from 85% to 90%. While individual target saturation levels can vary depending on the patient's condition and treatment goals, a consistent pulse oximetry reading below 90% can be indicative of hypoxemia, or a lower-than-normal level of oxygen in the blood. This could suggest that the mechanical ventilation is not adequately supporting the child's oxygenation needs.
- The child's heart rhythm showing sinus tachycardia could be a response to hypoxemia, distress, fever, pain, or other stimuli. Persistent or severe tachycardia may necessitate further evaluation and intervention.
- Differences in breath sounds between the sides of the chest, such as greater sounds on one side, may indicate partial lung collapse, a mucus plug, or another issue obstructing airflow to parts of the lungs.
While other findings, such as the chest rising with each breath of the ventilator or the child's nail beds being pink with capillary refill, can be reassuring signs of adequate perfusion and ventilation, the above concerning signs warrant immediate attention to ensure proper mechanical ventilation and to address any underlying issues.