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 […]
Safety : Risk factors for hospitalized children
Safety Environmental factors Electrical equipment Furniture Strangulation Toys Preventing falls Risk factors for hospitalized children Medication effects: Postanesthesia or sedation; analgesics or narcotics, especially in those who have never had narcotics in the past and in whom effects are unknown Altered mental status: Secondary to seizures, brain tumors, or medications Altered or limited mobility: Reduced […]
The child with fever
The child with fever Call Office Immediately If: Your child is younger than 2 months of age. The fever is over 40.6° C (105° F). Your child looks or acts very sick, including a stiff neck, persistent vomiting, purplish spots on the skin, confusion, trouble breathing after you have cleansed his or her nose, or […]
Managing pain : Respiratory tract infection
Managing pain Respiratory tract infection Patient education Discharge instructions Postoperative Care Ensure that preparations are made to receive child: Bed or crib is ready. Intravenous (IV) pumps and poles, suction apparatus, and oxygen flow meter are at bedside. Obtain baseline information: Take vital signs, including blood pressure; keep blood pressure cuff in place and deflated […]
Surgical Procedures
Surgical Procedures Preoperative care Parental presence Preoperative sedation Postoperative care Continuous monitoring Vital signs assessment Potential causes of Postoperative vital sign alterations in children Alteration Potential Cause Comments Heart rate Increase Decreased perfusion (shock) Heart rate may increase to maintain cardiac output. Elevated temperature Pain Respiratory distress (early) Medications (atropine, morphine, epinephrine) Decrease Hypoxia Bradycardia […]
Preparing the family
Preparing the family General principles of family education Establish a rapport with the family. Avoid using any specialized terms or jargon. Clarify all terms with the family. When possible, allow family members to decide how they want to be taught (e.g., all at once or over 1 or 2 days). This gives the family a […]
Postprocedural support
Postprocedural support Encourage expression of feelings Playing with medical objects provides children with the opportunity to play out fears and concerns with supervision by a nurse or child life specialist Positive reinforcement Children need to hear from adults that they did the best they could in the situation—no matter how they behaved. It is important […]
Performance of the procedure
Performance of the procedure Expect success Approach children with confidence and convey the impression that you expect to be successful Involve the child Permitting choices gives them some measure of control. But don’t state “Do you want to take your medicine now?” leads them to believe they have an option and provides them the opportunity […]