Intraosseous infusion & Feeding a sick child
Intraosseous infusion Temporary route of administration for use in an emergent situation in which venous access cannot be obtained Use an intraosseous or large bore needle that is inserted into the tibia. Monitor site for infection, leakage of fluid Monitor distal pulses, temperature of leg, and color frequently Risk for compartment syndrome Feeding a sick […]
Description & Benefits & Care Considerations
Description Benefits Care Considerations Tunneled Catheter (e.g., Hickman or Broviac Catheter) Silicone, radiopaque, flexible catheter with open ends or VitaCuffs (biosynthetic material impregnated with silver ions) on catheter(s) enhances tissue ingrowth May have more than one lumen Reduced risk for bacterial migration after tissue adheres to cuff Easy to use for self-administered infusions Removal requires […]
Subcutaneous and intradermal administration / Intravenous administration
Subcutaneous and intradermal administration Give anywhere there is adequate subcutaneous tissue. Common sites are the lateral aspect of the upper arm, abdomen, and anterior thigh Inject volumes of less than 0.5 ml Use a 1ml syringe with a 26-to-30- gauge needle Insert at a 90° and 45° angle for thin children Intravenous administration Used for […]
Intramuscular injection sites in children
Intramuscular injection sites in children Vastus Lateralis Location Palpate to find greater trochanter and knee joints; divide vertical distance between these two landmarks into thirds; inject into middle third Needle insertion and size Insert needle perpendicular to knee in infants and young children or perpendicular to thigh or slightly angled toward anterior thigh 22 to […]
Administration of medication
Administration of medication Determination of drug dosage Few standardized doses ranges Body surface area Checking dosage Identification Two identifiers Preparing the parents Preparing the child Oral administration Preparation administration Intramuscular administration Apply EMLA (a eutectic mix of lidocaine and prilocaine) or LMX cream (lidocaine) topically over site if time permits. Prepare medication Selecting the syringe […]
Collection of Specimens : Blood Specimens
Blood specimens Guidelines for skin and vessel punctures To reduce the pain associated with heel, finger, venous, or arterial punctures: Apply EMLA topically over the site if time permits (>60 minutes). LMX cream also may be used and requires a shorter application time (30 minutes). To remove the transparent dressing atraumatically, grasp opposite sides of […]
Collection of specimens : Urine & Stools
Urine Urine collection bags For infants and toddlers who are not toilet trained, special urine collection bags with self-adhering material around the opening at the point of attachment may be used. To prepare the infant, the genitalia, perineum, and surrounding skin are washed and dried thoroughly because the adhesive will not stick to a moist, […]
Collection of specimens : Emergency Room Procedures
Collection of specimens Fundamental steps common to all procedures Assemble the necessary equipment. Identify the child using two patient identifiers (e.g., patient name and medical record or birth date; neither can be a room number). Compare the same two identifiers with the specimen container and order. Perform hand hygiene, maintain aseptic technique, and follow Standard […]
Restraining methods : Nursing
Restraining methods Alternative methods: Consider first Diversional activities Parental participation Therapeutic holding Use least restrictive Behavioral restraints Used when significant risk present Determine cause of behavior first Mummy restraint or swaddle Jacket restraint Arm and leg restraints Elbow restraint
Infection control
Infection control Role of Centers for Disease Control and Prevention Standard Precautions Involve the use of barrier protection, such as gloves, goggles, gown, or mask, to prevent contamination from Blood All body fluids Secretions and excretions except sweat, regardless of whether they contain visible blood Nonintact skin Mucous membrane Transmission-based precautions Airborne, droplet, and contact […]