Transcript PEDIATRIC VARIATIONS OF NURSING INTERVENTIONS

Pediatric Variations in the
Hospitalized Patient
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Reserved.
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Variations in Nursing Techniques with Children
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Pediatric medication administration is well covered on the
videos on reserve in the library. These are mandatory to be
viewed
Go to ReggieNet for websites where you can practice med
calculations and improve your competence in this area –
medication forms for clinical are also at this site
Use past textbooks and information – med calculation book
has chapter on Pediatrics; Health Assessment (Jarvis) has
great info and pictures on Peds assessment & variations
Use open hours at Lab to review clinical skills using the
information from your textbook to apply these to the Peds pt.
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Preparation for Procedures
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Psychological preparation
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Age-specific guidelines for preparation
• Drawings, puppets, dolls, etc
Based on developmental characteristics
Establish trust
Parental support
Explanation to the child
Always think “atraumatic care”
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Performing Procedures
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Special treatment room for procedures
Expect success
Distract the child; use play if appropriate
Conscious sedation may be used
Allow expression of feelings – during and
after procedure
Praise the child afterward and provide
positive reinforcement
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Therapeutic Hugging for Extremity
Vein Puncture
Positioning for Procedures
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Analgesia, sedation
Topical anesthetics (EMLA, numby)
Use appropriate restraints; excellent pictures
& descriptions on the Peds unit and in book
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Therapeutic hugging
Jacket restraints
Mummy or swaddle restraint
Limb restraints
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Mummy Restraint
Elbow Restraints
Nurse Maintains Hand Contact
Position for Lumbar Puncture
SPECIMEN COLLECTION
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Urine—sterile catheterization may be indicated or use of
a U-bag
Stool—if very loose diarrhea-like stools, may put U-bag
over anal opening to collect stool
Blood—use EMLA prn, may be capillary or venous
Sputum—often needed for children with Cystic Fibrosis
Gastric washings—in cases of poisonings
Nasal washings—especially for
RSV/bronchiolitis
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Application of a Urine Collection Bag
Alternative Feeding Techniques
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Gavage feedings
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NG
OG
Gastrostomy feedings
Jejunostomy feedings
May be continuous drip or intermittent (bolus)
feedings
G-button care
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Gavage Feeding
Healthy Granulation Tissue Around
Stoma
Skin-Level Gastrostomy Device
Improving Absorption of Feeds
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Use pacifier during alternative feeds
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Non-nutritive sucking improves digestion
Quiet, calm environment
Consistent feeding techniques by
caregivers/family members
Hold and nurture during feedings
Positioning is essential to foster gastric
emptying especially for children with GERD
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HOB  30 degrees ( infant seat helps with this,
but flat crib raised 30 degrees is better)
Right side promotes gastric emptying
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Devices for Delivering Medication to
Children
Administering Oral Medication
Holding Child for IM Injection
Instilling Nose Drops
There you have it!
You have a bird’s eye view of
some of the unique approaches
in working with children—what
we do, why we do it, and how to
do it atraumatically!!
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Reserved.
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