Pediatric Variations of Nursing interventions

Pediatric Variations of Nursing interventions

• General concept related to pediatric procedures
  • Informed consent
    • The person must be capable of giving consent: Age at majority (usually age 18)
    • The person must receive the information needed to make an intelligent decision
    • The person must act voluntarily when exercising freedom of choice
  • Requirements for obtaining informed consent
    • Separate informed permissions must be obtained for each surgical or diagnostic procedure, including
      • Major surgery
      • Minor surgery (e.g., cutdown, biopsy, dental extraction, suturing a laceration [especially one that may have a cosmetic effect], removal of a cyst, closed reduction of a fracture)
      • Diagnostic tests with an element of risk (e.g., bronchoscopy, angiography, lumbar puncture, cardiac catheterization, bone marrow aspiration)
      • Medical treatments with an element of risk (e.g., blood transfusion, thoracentesis or paracentesis, radiotherapy)
    • Other situations that require patient or parental consent include the following:
      • Photographs for medical, educational, or public use
      • Removal of the child from the health care institution against medical advice
      • Postmortem examination, except in unexplained deaths, such as sudden infant death, violent death, or suspected suicide
      • Release of medical information
    • Assent should include:
      • Helping the patient achieve a developmentally appropriate awareness of the nature of his or her condition
      • Telling the patient what he or she can expect
      • Making a clinical assessment of the patient’s understanding
      • Soliciting an expression of the patient’s willingness to accept the proposed procedure
    • Parents have full responsibility for rearing of their minor children, including legal control over them.
    • If children are minors, their parents or legal guardians are required to give informed consent before medical treatment is rendered or any procedure is pre-formed. 
    • If the parents are married to each other, consent from only one parent is require in nonurgent pediatric care. 
    • If parents are divorced, consent goes to who has legal custody.