Gastrostomy feedings / Nasoduodenal and nasojejunal tubes / Total Parenteral Nutrition / Family teaching and home care
Gastrostomy feedings Often used for children in whom passage of a tube through the mouth, pharynx, esophagus, and cardiac sphincter of the stomach is contraindicated or impossible. It is also used to avoid the constant irritation of an NG tube in children who require tube feeding over an extended period. A gastrostomy tube may be […]
Alternative feeding techniques : Gavage feedings
Alternative feeding techniques Gavage feedings Preparations A suitable tube selected according to the child’s size, the viscosity of the solution being fed, and anticipated duration of treatment A receptacle for the fluid; for small amounts, a 10- to 30-mL syringe barrel or Asepto syringe is satisfactory; for larger amounts, a 60-mL syringe with a catheter […]
Nasogastric, Orogastric, Or Gastrostomy administration
Nasogastric, Orogastric, Or Gastrostomy administration In children Use elixir or suspension (rather than tablet) preparations of medication whenever possible. Dilute viscous medication or syrup with a small amount of water if possible. If administering tablets, crush tablet to a fine powder and dissolve drug in a small amount of warm water. Never crush enteric-coated or […]
Aerosol Therapy
Aerosol Therapy Deposits medication directly into the airway Useful in avoiding systemic side effects Nebulized with oxygen Handheld nebulizers discharge a medicated mist into a small plastic mask, which the child holds over the nose and mouth. Metered-dose inhalers Self-contained, handheld device that allows for intermittent delivery of a specified amount of medication. To avoid […]
Optic, Otic, and Nasal administration
Optic, Otic, and Nasal administration The major difficulty is in gaining children’s cooperation. Older children need only an explanation and direction. Although the administration of optic, otic, and nasal medication is not painful, these drugs can cause unpleasant sensations, which can be eliminated with various techniques. Eyedrops and ointments Techniques One technique involves Place the […]
Maintaining fluid balance
Maintaining fluid balance Measurement of intake and output Fluids to be measured Nursing responsibility: To identify when fluids should be measured Receiving IV therapy Who underwent major surgery Receiving diuretic or corticosteroid therapy With severe thermal burns or injuries With renal disease or damage With congestive heart failure With dehydration With diabetes mellitus With oliguria […]
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 […]