friday 8/16/2013

12:00pm: Ava is having a good day. She spiked a temp of 102 due to the inflammatory response from surgery. It's coming down just fine with tylenol. She will get tylenol for 48 hours after surgery which is standard protocol. kinda funny side story here....Yesterday the admitting nurse was kind of running around with his head cut off trying to get everything done before the next shift got there. He was joking about having to give the "life saving tylenol" right then. He had what looked like a pill and some gel in a napkin. I finally figured out what he was doing when he opened up her diaper and started looking around. I said "uhhhhh, is that a suppository? She doesn't have an anus." And we all had a good laugh after that. The nurse was pretty embarrassed. So they decided to hold the tylenol rather than give it through the NG tube, where she could throw it up after anesthesia. So, that's probably why she spiked the temp. 

She will have one of her IVs taken out today, though we're having a little debate about which one. I think they should take out the old one, the one that is too small to give blood through, but the Dr.s ordered that the new/big one on the other side of the neck be taken out. I asked the nurse to talk to the NP about it again. We'll see. 

The fentanyl (narcotic) is stopped and she is just getting morphine and ativan now. She is breathing over the ventillator really well so they will probably extubate her this afternoon. 

We haven't seen any heart arrythmias either-yay. The heart likes it's new found freedom and pressures. 

8pm Ava is extubated. She can have her pacifier back but is too out-of-it to care. She is breathing on her own, though she is breathing pretty fast. She is on a high flow nasal cannula at 15 liters with just a little bit of oxygen. If she keeps working this hard to breathe they'll probably switch her to the CPAP tonight. They said that the right side of the lungs is having a harder time expanding-probably because of her previous sicknesses and chronic lung disease. She is getting ativan and morphine for pain now, as well as the tylenol to keep the temperature down. Her blood pressure is on the high side but they are thinking the morphine may help that. we'll see. If not they'll bump up one of the heart meds. One of the neck IVs has been removed as well as the arterial line that went bad. Her drainage output from the chest tubes is low so those will probably get pulled out tomorrow. Thank goodness because one of the drains is the size of a slurpee straw! and they say the drains are probably more painful than the chest incision. We'll probably see several lines get pulled tomorrow.