Last night Kinley must have snuck in a coffee break when the nurses weren't watching because we were told that she was awake from 7:00 pm to 1:00 am. This is the longest period of time that we have ever seen or heard of Kinley being awake. We were also told that Kinley got a bath last night. I bet that is what finally put her to sleep.
During rounds today Dr. C decided to keep Kinley's continual feeds at 2 ccs per hour. Kinley's residuals from yesterday evening, last night and today have ranged from 1 to 5 ccs, all within the range to continue her feedings. The oxygen coming through Kinley's nasal cannula is still at 21% (room air), but Dr. C wants to back down the flow from 3 liters per minute to 2 liters per minute. Also, both Kinley's ativan and methadone doses will lowered slightly. The frequency of both doses will remain the same, every 6 hours, but the dosage amounts will be changed. The ativan dose will be moved from 0.07 mg per kilo to 0.06 mg per kilo and her methadone dose will be lowered from 0.2 mg per kilo to 0.18 mg per kilo. The idea and goal behind decreasing both the ativan and methadone doses is that Kinley will spend more time awake and the more time she spends awake the better her stomach and intestines will process.
Kinley has not had a poopy diaper since July 7th so Delores (nurse practitioner) has decided to give Kinley a glycerin suppository. Glycerin will not increase the motility in Kinley's gut and it is not a laxative, but it will help to move things through her intestinal tract.
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