- Positioning for procedures
- Femoral venipuncture
- Nurse places the child supine with the legs in a frog position to provide extensive exposure of the groin area.
- Infant’s legs can be controlled by the nurse’s forearms and hands.
- Only the side for venipuncture is uncovers so that the practitioner is protected if the child urinates.
- Apply pressure to the site to prevent oozing from the site.
- Extremity venipuncture or injection
- Most common sites for venipuncture are the veins of the extremities, especially the hands and arms.
- A convenient position is to place the child in the parent’s lap with the child facing towards the parent in a straddled position.
- Place the child’s venipuncture site on a firm surface, the nurse can partially stabilize the outstretched arm and the parent’s can hug the child
- Lumbar puncture
- A flexed sitting or side-lying position may be used, depending on the child’s ability to cooperate and whether sedation will be used
- The sitting position may interfere with chest expansion and diaphragm excursion, and in infants the soft, pliable trachea may collapse.
- Therefore, observe the child for difficulty with breathing.
- Take vital signs as ordered and observe the child for any changes in level of consciousness, motor activity, and other neurologic signs.
- Bone marrow aspiration or biopsy
- Position for a bone marrow aspiration or biopsy depends on the chosen site.
- In children, the posterior or anterior iliac crest is most frequently used, but in infants, the tibia may be selected because it is easy to access the site and hold the child.
- If posterior iliac crest is used, child should be laying prone.
- Femoral venipuncture
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