• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Chapter 22 Power Point
 

Chapter 22 Power Point

on

  • 426 views

 

Statistics

Views

Total Views
426
Views on SlideShare
426
Embed Views
0

Actions

Likes
1
Downloads
7
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • Give an example of a situation in which informed consent is necessary and communicate the information to a child.
  • Discuss the importance of verifying ID bracelets on the child and the parent/guardian. Discuss safety measures while applying the bands and for discharge.
  • Give an example of a potentially dangerous situation if a child is not identified by an ID bracelet. Audience Response Question #1 The mother of a 2-month-old patient is changing his diaper with the crib rail in the down position. The nurse observes the mother walk away from the crib without raising the rail. The nurse should: 1. Realize the mother feels comfortable regarding the safety of her child. 2. Instruct the mother that crib rails must be returned to the upward position any time the child is unattended in the crib. 3. Notify social services and the pediatrician. 4. Document the occurrence in the medical record.
  • Give examples of how to minimize unsafe conditions within the hospital. What is an example of a cross-infection situation? Discuss precautions that should be instituted when administering oxygen.
  • Discuss these safety measures.
  • Discuss when it is and is not appropriate for a parent or caregiver to assist in a medical/nursing procedure.
  • What are some improper methods of transporting an infant?
  • Discuss Figure 22-4, A-D, on page 490.
  • Discuss why these organizational steps are important in the infant assessment process.
  • Give examples of situations in which the nurse must assess and observe growth and development.
  • Give an example of information gained during the history in which the nurse can teach the parents injury prevention. What is the rationale for the nurse obtaining eating, toileting, sleeping, and activity patterns?
  • Tachycardia is often the first sign of shock or body stress in infants and children. Hypotension could be a late sign of shock because of a compensatory mechanism that is activated early—this is an emergency! Mottled skin on the extremities is not unusual. Infants have a large body surface area and high metabolic rate that are prone to fluid loss and hypothermia as well as cold stress. Hydration status: Sunken fontanel could indicate dehydration. Bulging fontanels could indicate increased intracranial pressure (ICP). In an older child and adult, increased ICP is manifested by increased systolic BP, widening pulse pressure, irregular respirations, and bradycardia. In an infant, increased ICP might only be manifested by a decreased level of consciousness. Audience Response Question #2 A child's weight is 57 pounds upon admission. The nurse converts this to ________ kilograms. 1. 23 2. 26 3. 28.5 4. 114
  • Discuss the importance of obtaining an apical pulse for one full minute.
  • What methods are used to obtain a BP of the brachial, popliteal, or femoral arteries? Discuss the reason for inaccurate BP readings of children who are crying.
  • Discuss the pathophysiology regarding increased metabolic rate and fever and the increased demand on the heart and lungs.
  • Discuss the difference between fever and hyperthermia.
  • Discuss Skills 22-3 and 22-4 on page 496.
  • Describe where these temperatures are measured on the body. Audience Response Question #3 The nurse assesses the tympanic temperature of a 4-week-old as 95.9 º F. The nurse should: 1. document the temperature. 2. notify the physician. 3. have another nurse reassess. 4. take an axillary temperature.
  • Refer to Chapter 12 for pain in the newborn and Chapter 21 for pain in the child/adolescent.
  • Review techniques to use based on the age of the infant or child.
  • Discuss proper procedures to measure height of infants and children.
  • What is the importance of head circumference measurement?
  • What is the importance of proper documentation when obtaining and sending a specimen to the lab?
  • Review the techniques for obtaining specimens listed.
  • How might medications be absorbed differently when administered by these various routes? What factors need to be considered in the pediatric patient prior to administering any medications?
  • Discuss the pathophysiology regarding excretion of medications via the renal system.
  • Give an example of toxic symptoms the nurse might assess in a child. What are some examples of negative responses to medications?
  • Review the various techniques and safety measures for each method and for each age group.
  • Provide measurements and allow students to calculate medication using the dimensional analysis method.
  • Discuss why this is important to follow.
  • Give an example of a child’s situation that requires TPN. Discuss the pathophysiology regarding hyperglycemia, hypoglycemia, and electrolyte imbalances.
  • Discuss the importance of monitoring the child every hour.
  • Review nursing guidelines for IV therapy at various stages of development in Table 22-5, pages 510-514.
  • What is the proper technique when administering a gavage feeding?
  • Give examples of isotonic solutions. What is a potential complication when administering a tap-water enema? Fluid overload
  • Discuss Figure 22-18 on page 521.
  • Review the technique for correctly performing suctioning.
  • Discuss Figure 22-20 on page 524. Review safety considerations when administering oxygen.
  • Discuss the proper procedure for treating a child/infant with an airway obstruction.

Chapter 22 Power Point Chapter 22 Power Point Presentation Transcript

  • Chapter 22Chapter 22 Health Care Adaptations for theHealth Care Adaptations for the Child and FamilyChild and Family
  • ObjectivesObjectives • List five safety measures applicable to the care of the hospitalized child. • Illustrate techniques of transporting infants and children. • Plan the basic daily data collection for hospitalized infants and children. • Identify normal vital signs of infants and children at various ages. 2Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • ObjectivesObjectives (cont.)(cont.) • Devise a nursing care plan for a child with a fever. • Discuss the techniques of obtaining urine and stool specimens from infants. • Position an infant for a lumbar puncture. • Calculate the dosage of a medicine that is in liquid form. • Demonstrate techniques of administering oral, eye, and ear medications to infants and children. 3Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • ObjectivesObjectives (cont.)(cont.) • Compare the preferred sites for intramuscular injection for infants and adults. • Discuss two nursing responsibilities necessary when a child is receiving parenteral fluids and the rationale for each. • Demonstrate the appropriate technique for gastrostomy tube feeding. 4Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • ObjectivesObjectives (cont.)(cont.) • Summarize the care of a child receiving supplemental oxygen. • Recall the principles of tracheostomy care. • List the adaptations necessary when preparing a pediatric patient for surgery. 5Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Informed ConsentInformed Consent • Ensure the parent/guardian signing consent for any procedure understands the purpose and risks involved • Nurse acts as a patient advocate by ensuring the consent has been signed before the procedure • When possible, provide the patient with age- appropriate information 6Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • IdentificationIdentification • ID bracelet must be applied upon admission to the nursing unit • Parent/guardian is also given one to wear and the identification numbers must match what is on the child’s bracelet • ID bracelet must be verified before any medication, treatment, or procedure is provided 7Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Essential Safety Measures in theEssential Safety Measures in the Hospital Setting—the Do’sHospital Setting—the Do’s • Keep crib sides up at all times when the child is unattended in bed • Identify a child by ID bracelet and NOT by room or bed number • Use a bubble-top or plastic- top crib for infants and children capable of climbing over the crib rails 8Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Essential Safety Measures in theEssential Safety Measures in the Hospital Setting—the Do’sHospital Setting—the Do’s (cont.)(cont.) • Place cribs so that children cannot reach sockets or appliances • Inspect toys for sharp edges and removable parts • Keep medications and solutions out of reach of the child • Prevent cross-infection; do not borrow items such as toys from one child and give to another without cleaning the toy per hospital policy first • Take proper precautions whenever oxygen is being administered 9Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Essential Safety Measures in theEssential Safety Measures in the Hospital Setting—the Don’tsHospital Setting—the Don’ts • Do not allow ambulatory patients to use wheelchairs or stretchers as toys • Do not leave an active child in a baby swing, feeding table, or high chair unattended • Do not leave a small child unattended when out of the crib • Do not leave medications at the bedside • Do not prop nursing bottles or force-feed small children—risk of choking 10Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Preparation Steps forPreparation Steps for Performing ProceduresPerforming Procedures • Nursing actions prior to a procedure include – Verifying written order of health care provider – Gathering equipment – Identifying the patient – Explaining the procedure to the parent/child – Providing privacy – Performing hand hygiene – Utilizing standard/transmission-based precautions 11Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Transporting, Positioning, andTransporting, Positioning, and Restraining the InfantRestraining the Infant • Method depends on age, level of consciousness, and how far the child must travel • Older children are transported as adults are • Young children—cribs, wagons, pediatric-sized wheelchair, or gurney • Side rails are up • ID bracelet has been checked to ensure the correct child is being transported • The nurse documents time, method of transport, where child is transported, and who is accompanying child 12Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Transporting, Positioning, andTransporting, Positioning, and Restraining the InfantRestraining the Infant (cont.)(cont.) 13Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Verifying the Child AssessmentVerifying the Child Assessment • Children are different from adults. • Data collection is done to determine the level of wellness, the response to medication or treatment, or the need for referral. 14Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Organizing the Infant AssessmentOrganizing the Infant Assessment • Select a warm, non-stimulating room • Expose only areas of body to be examined • Observe without touching first, with minimal touching next, and with invasive touch last to assess reflexes and blood pressure • Talk softly • Utilize pacifier to comfort infant • Swaddle/hold after assessment complete • Utilize parent teaching opportunities • Document findings Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 15
  • Basic Data CollectionBasic Data Collection • Observation – How does the child look? • Growth and development – Are child’s size and actions age-appropriate? • Level of interaction between child and environment – Is child’s behavior withdrawn, normal for age and development, or inappropriate? • Is the child tipping his head or rubbing his ears? • Is child maintaining a rigid body posture in order to breathe? • Are there any obvious bruises (especially in various stages of healing) or cuts? • How clean is the child? 16Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • The History SurveyThe History Survey • Allows the nurse to teach parents about child’s needs as well as injury and illness prevention • Should include questions about complementary and alternative medicine, over-the-counter medications, and immunization history • Should also include – Child’s health and eating habits – Sleeping – Toileting – Activity patterns – Use of special words or gestures in order to communicate with others 17Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • The Physical SurveyThe Physical Survey • Head-to-toe review upon admission and then at least once per shift or clinic visit • Vital signs – Temperature – Weight – Blood pressure – Pulse – Respiration rate • Hydration status • Heart sounds • Lung sounds • Bowel sounds • Skin—rashes/lesions Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 18
  • Pulse RatePulse Rate • Apical pulse advised for children younger than 5 years of age • Radial pulse used for children older than 5 years of age • Pulse rate increases as temperature increases 19Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Blood Pressure (BP)Blood Pressure (BP) • The width of the cuff should be ⅔ of the upper arm • Electronic BP machines do not require auscultation with stethoscope • Normal BP is lower in children than in adults • Can secure BP cuff over brachial, popliteal, or femoral artery • A BP reading taken when an infant is crying may not be accurate 20Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Pathogenesis of Fever and thePathogenesis of Fever and the Use of AntipyreticsUse of Antipyretics • Infection stimulates immune substances to work along with prostaglandins to stimulate the hypothalamus to raise body temperature – Triggers vasoconstriction, shivering, and decreased peripheral perfusion – Decreases body heat loss while maintaining homeostasis • Antipyretic medications inhibit prostaglandin production • Fever increases metabolic demand on the heart and lungs Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 21
  • HyperthermiaHyperthermia • An increase in core body temperature occurs with central nervous system impairment • Prostaglandins are not involved – Homeostasis mechanism is bypassed • Treatment involves vigorous cooling measures 22Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Techniques to MeasureTechniques to Measure Body TemperatureBody Temperature 23Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Techniques to MeasureTechniques to Measure Body TemperatureBody Temperature (cont.)(cont.) • Usually done in one of five places – Oral – Axillary – Temporal artery – Tympanic – Core (not widely recommended due to increase risk of rectal mucosal tearing) 24Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • PainPain • The fifth vital sign • Must be addressed in the plan of care 25Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • WeightWeight • Provides a means of determining progress • Necessary to determine safe medication dosages 26Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • HeightHeight • Infants – Birth to 2 years • Measured lying on a flat surface • Children – 2 to 18 years • Measured in a standing position 27Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Head CircumferenceHead Circumference • Measured on all infants and toddlers • Place tape measure slightly above eyebrows, above ear, and around occipital prominence 28Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Collecting SpecimensCollecting Specimens • Verify physician order • Obtain lab requisitions, correct containers, and supplies • Collect specimen • Label clearly and attach proper forms • Send to laboratory according to hospital policy • Record in nurses’ notes and on intake and output record what specimens were obtained and, where appropriate, the amount of output Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 29
  • Examples of SpecimensExamples of Specimens • Urine • Stool • Blood • Cerebral spinal fluid • Wounds • Body fluids, such as peritoneal fluid or fluid from surgical drain • It is important to follow hospital protocols in the collection and handling of any laboratory specimen • Urine should not be collected from a disposable diaper as chemicals in the diaper will alter the results 30Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Physiological Responses toPhysiological Responses to Medications in Infants and ChildrenMedications in Infants and Children • Understanding the differences in drug absorption, distribution, metabolism, and excretion between children and adults is essential to provide safe pediatric medication administration • Age is the most important variable in predicting response to any drug therapy 31Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Absorption of Medications inAbsorption of Medications in Infants and ChildrenInfants and Children • Gastric influences • Intestinal influences • Topical medications (ointments) • Parenteral medications 32Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Metabolism of Medications inMetabolism of Medications in Infants and ChildrenInfants and Children • Most are metabolized in the liver • Drugs generally metabolize more slowly, especially because the liver and enzymes do not function at a mature level until 2 to 4 years of age 33Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Excretion of Medications inExcretion of Medications in Infants and ChildrenInfants and Children • Many medications depend on the kidney for excretion • If younger than 1 year of age, the immature kidney function prevents effective excretion of drugs from the body • Combination of – Slow stomach emptying – Rapid intestinal transmit time – Unpredictable liver function – Inability to effectively excrete medications via the kidney • Can result in altered responses and places the child at risk for toxicity 34Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Nursing ResponsibilitiesNursing Responsibilities • Observe for toxic symptoms whenever medications are administered • Document positive and negative responses • Every medication administered should have the safety of the dose prescribed calculated before administration 35Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Parent TeachingParent Teaching • Is essential to ensure compliance when the child is sent home with medications • Teaching should include – The importance of administering and completing the medications as prescribed – Techniques of measuring and administering each dose – Techniques for encouraging child compliance – Importance of writing and following a schedule for medication administration 36Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Methods of Drug AdministrationMethods of Drug Administration • Oral – Preferred route • Parenteral – Nosedrops, eardrops, eyedrops – Rectal – Subcutaneous and intramuscular injections – Intravenous – Long-term venous access devices • Saline lock • Peripheral • PICC – Central • Hickman, Groshong, and Broviac catheters • Implanted ports 37Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Calculating Drug DosesCalculating Drug Doses • Body surface area • Milligrams per kilogram (mg/kg) • Dimensional analysis 38Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Formula for Dimensional AnalysisFormula for Dimensional Analysis Unit × Dosage wanted Dosage on hand Unit to give 39Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Safety AlertSafety Alert • Maximum volume for IM administration – Infants—0.5 mL – Toddlers—1 mL – School-age/adolescent • Deltoid—1 mL • Vastus lateralis—2 mL 40Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Total Parenteral NutritionTotal Parenteral Nutrition • Also known as hyperalimentation • Provides nutritional needs to those who cannot use the gastrointestinal tract for nourishment for a prolonged period of time • Allows highly concentrated solutions of protein, glucose, and other nutrients to infuse into a large vessel • It is important for the nurse to monitor and report the following – Hypoglycemia – Hyperglycemia – Electrolyte imbalances 41Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Nursing Care of a Child ReceivingNursing Care of a Child Receiving Parenteral FluidsParenteral Fluids • Observe the child hourly for – Low volume in the bag or the need to refill the burette – The rate of flow of the solution – Pain, redness, or swelling at the needle insertion site – Moisture at or around the needle insertion site • Accurate I&O is kept for all children receiving IV fluids 42Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Nursing Care of a Child ReceivingNursing Care of a Child Receiving Parenteral FluidsParenteral Fluids (cont.)(cont.) • Key components to remember when providing intravenous therapies – The developmental level of the child – IV placement – Preparation of the child prior to insertion – Related nursing actions – Protection of the IV site – Mobility considerations – Safety needs 43Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Preventing Medication ErrorsPreventing Medication Errors • 6 Rights of Medication Administration – Patient – Drug – Dose – Time – Route – Documentation Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 44
  • Factors to Consider for Pediatric IVsFactors to Consider for Pediatric IVs • Developmental characteristics • Site where IV is to be inserted • Preparation of child • Family Involvement • Related nursing actions • Protection of IV site • Mobility Considerations • Safety needs Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 45
  • Avoiding Drug InteractionsAvoiding Drug Interactions • Selected drug-environment interactions – Phototoxicity • Selected drug-drug interactions – Phenytoin (Dilantin) and antacid • Selected drug-food interactions – Iron supplement and egg yolks 46Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Nutrition, Digestion, andNutrition, Digestion, and EliminationElimination • Gavage feeding – Given when infant cannot take food or fluids by mouth but the gastrointestinal tract is functioning – Places nutrients directly into the stomach so that natural digestion can occur 47Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Nutrition, Digestion, andNutrition, Digestion, and EliminationElimination (cont.)(cont.) • Gastrostomy – Tube surgically placed through the abdominal wall into the stomach – Used in infants or children who cannot have food by mouth because of anomalies or strictures of the esophagus, severe debilitation, or coma • Brown or green drainage may indicate that the tube has slipped from the stomach into the duodenum. This can cause an obstruction and is reported immediately. Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 48
  • Nutrition, Digestion, andNutrition, Digestion, and EliminationElimination (cont.)(cont.) • Enema – Administration is essentially the same as with adults – Modifications include • Type • Amount • Distance of insertion – Isotonic solutions – Tap water is contraindicated • Plain water is hypotonic to the blood and could cause a rapid fluid shift and overload if absorbed through the intestinal wall Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 49
  • RespirationRespiration • Tracheostomy – An artificial airway (a plastic tube) placed in the trachea through the neck – Nursing care is essential to the survival of the child – The tube can become plugged by mucus or other secretions and cause the child to suffocate – Tube prohibits vocalization 50Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • RespirationRespiration (cont.)(cont.) • Indications for suctioning – Noisy breathing – Bubbling of mucus – Moist cough or respirations • Complications – Tracheoesophageal fistula – Stenosis – Tracheal ischemia – Infection – Atelectasis – Cannula occlusion – Accidental extubation • Signs and symptoms to observe – Restlessness – Rising pulse rate – Fatigue – Apathy – Dyspnea – Sternal retractions – Pallor – Cyanosis – Inflammation or drainage around insertion site 51Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • General Considerations for the ChildGeneral Considerations for the Child Receiving Oxygen TherapyReceiving Oxygen Therapy • Signs of respiratory distress include increased pulse rate and respirations – Restlessness – Flaring nares – Intercostal an substernal retractions – Cyanosis – Children with dyspnea often vomit, which increases the danger of aspiration • Maintain clear airway by suctioning if needed • Organize nursing care to minimize interruptions • Observe children carefully because vision may be obstructed by mist and young children are unable to verbalize their needs Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 52
  • General Considerations for the ChildGeneral Considerations for the Child Receiving Oxygen TherapyReceiving Oxygen Therapy (cont.)(cont.) • Safety considerations • Infection prevention and control • Prolonged exposure to high concentrations • Therapy is terminated gradually 53Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Management of an AirwayManagement of an Airway ObstructionObstruction • Abdominal Thrusts – Works on the principle that forcing the diaphragm up causes residual air in the lungs to be forcefully expelled, resulting in popping the obstruction out of the airway 54Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Procedure for Clearing an AirwayProcedure for Clearing an Airway ObstructionObstruction 55Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Preoperative and PostoperativePreoperative and Postoperative CareCare • Preoperative – Children require both physical and psychological preparation at their level of understanding – Clarify any misunderstandings the child may have – Infants should not be maintained on NPO status for longer than 4 to 6 hours; provide a pacifier to assist in meeting developmental need for sucking • Postoperative – Nursing interventions are aimed at assisting the child to master a threatening situation and minimize physical and psychological complications Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 56
  • Body Art, Body Jewelry, TattoosBody Art, Body Jewelry, Tattoos • Most body jewelry designed to stay in place – Can cover with occlusive dressing – May need to remove if in area of surgery – Flexible plastic retainer may help keep holes open • Nipple rings removed for mammogram • MRI—most body jewelry is not ferromagnetic – Tattoos or permanent cosmetics at risk for developing edema or burning during MRI – Document presence of any tattoos 57Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.
  • Question for ReviewQuestion for Review • What is the nursing responsibility in the monitoring of IV therapy for the pediatric patient? 58Elsevier items and derived items © 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.