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Pediatric Nursing Procedure Manual
A Padmaja
1:
Pediatric History Taking and Physical Examination
PROFILE OF THE CHILD
IMMUNIZATION HISTORY
PHYSICAL EXAMINATION
A. Head to Foot Assessment
B. Basic Physiological Data
Anthropometric Measurements
C. Summary of Physical Examination
Investigations
Drug Regimen
List out Nursing Diagnoses: (As per NANDA)
Nursing Process: (As per priority)
2:
Newborn Assessment
3:
Anthropometry Measurements
INTRODUCTION
DEFINITIONS
ANTHROPOMETRIC MEASUREMENTS
Physical Growth Parameters
1. Weight
2. Length and Height
3. Head Circumference
4. Chest Circumference
5. Abdominal Circumferences
6. Mid-Arm Circumference
7. Skin Foldings
8. Examination of Fontanelles
9. Dentition
SUMMARY
4:
Developmental Assessment
DEVELOPMENT
ASSESSMENT OF DEVELOPMENT
DEVELOPMENT OF NEWBORN
REFLEXES OF NEWBORN
Rooting Reflex
Sucking and Swallowing Reflex
Moro Reflex
Grasp Reflex
Crossed Extension Reflex
Glabellar Reflex or Tape
Tonic Neck Reflex
Stepping Reflex
Plantar (Babinski) Reflex
IMPORTANT MILESTONES AT GLANCE
LANGUAGE DEVELOPMENT
Speech Development of the Child
DEVELOPMENTAL SCREENING TEST
Development
Goal
Purpose
General Instructions
Apparatus and Equipments
Setting
LABORATORY BASED
Steps
5:
Kangaroo Mother Care
INTRODUCTION
DEFINITION
COMPONENTS OF KMC
1. Skin-to-Skin contact
2. Exclusive Breastfeeding
Pre-requisites of KMC
Eligibility Criteria for KMC
Preparation for KMC
KMC Procedure
Monitoring during KMC
Time of Initiation of KMC
Duration of KMC
Can the Mother continue KMC during Sleep and Resting?
Discharging Criteria
Discontinuation of KMC
6:
Methods of Feeding
INTRODUCTION
PRINCIPLES OF FEEDING CHILDREN
BREASTFEEDING
Procedure
BOTTLE FEEDING
Purpose
Equipment
Procedure
Nursing Alert
Replacement of Equipment
SPOON/PALADI/KATORI (CUP) FEEDING
Purpose
Indication
Equipment
Procedure
Replacement of equipment
GAVAGE FEEDING
Purpose
Indications
Types of Tube-Feeding
Equipment
Procedure
Nursing alert
Replacement of equipment
GASTROSTOMY FEEDING
Purpose
Equipment
Procedure
GASTROJEJUNAL FEEDING
Precautions
CONCLUSION
7:
Drug Administration
ORAL ADMINISTRATION OF MEDICATIONS TO CHILDREN
Safety Measures
Possible errors in Drug Administration
Oral Route
Purposes
Points to Remember
Administration of Medicine by mouth
For infants
For Toddlers
Pre-school Age Children
Equipments
Steps of Procedure
Prepare drug
Prepare Liquids
Administrating Medication
After care of Equipment
Calculation for Administration of Medication
INTRAMUSCULAR DRUG ADMINISTRATION
Definition
Purpose
Selection of Sites
Intramuscular Injection Sites
Equipment
Procedure
Care of equipment and child
FLUID CALCULATION FOR IV INFUSION
Introduction
Maintenance therapy
Body Fluids
Hypotonic Solutions
Isotonic Solutions
Hypertonic Solutions
Management of Dehydration
Dehydration
Electrolyte imbalance
Management
Hypernatremia
Management
Hypokalemia
Management
Hyperkalemia
Management
Burns management
Purpose
EXCHANGE TRANSFUSION
Introduction
Aim
Points to Remember
Indications for Exchange Transfusion
Exchange Transfusion Formulae
Pre-exchange Requirements
Staffing
Ordering Blood
Consent
Monitoring Equipment
Resuscitation Equipment
Nursing Management
Initial Steps
Exchange Transfusion Equipment Box
Additional Equipment Required
Exchange Transfusion Methods
1. Push–pull Method
Steps
2. Isovolumetric Method
Key Points to Consider with Exchange Transfusions
Post Exchange Care
Complications, Prevention and Management
TOTAL PARENTERAL NUTRITION
Definition
Goal
Purposes
Indications
Contraindications
Instructions
Equipment
Preparation of Articles
A Tray Containing
Procedure
Steps of Procedure
Solutions Used
After Care of the Equipment
Complications
8:
Urine Collection
DEFINITION
Purpose
GENERAL PRINCIPLES
Precautions
Types of Urine Specimen
First Morning Specimen
Single Random Specimen
Timed specimen
A 24-hour Urine Specimen
Bladder catheterization
Clean-Catch Urine Specimen
IN ELDER CHILDREN
For Male Child
For Female Child
IN AN INFANT
Complications
NURSING RESPONSIBILITY
9:
Restraints
DEFINITION
Purposes
Precautions
TYPES OF RESTRAINTS
Jacket Restraint
Mummy Restraint
Procedure
Modified Mummy Restraint
Elbow Restraint
Purpose
Equipment
Procedure
Extremity Restraint
Equipment
Procedure
Abdominal Restraint
Mitts
HAZARDS OF RESTRAINTS
10:
Play Needs for Different Age Groups
INTRODUCTION
Importance of Play
FUNCTIONS OF PLAY
DEVELOPMENT ROLE OF PLAY
TYPES OF PLAY ACCORDING TO SOCIALIZATION
I. Onlooker play
II. Parallel play
III. Solitary play
Associative play
Cooperative play
TOY SAFETY
Selection
Supervision
Maintenance
Storage
SELECTION OF PLAY MATERIALS FOR DIFFERENT AGE GROUPS
Infancy
Play Magnifies Infant's Visual, Auditory, Tactile and Kinetic Stimulation
Birth to 6 Months
6–12 Months
Toddler
Preschooler
School-Age Child
THERAPEUTIC PLAY DURING BEDSIDE CARE
SUMMARY
CONCLUSION
11:
Care of Child with Phototherapy
12:
Care of the Child in Incubator
THERMOREGULATION
Introduction
Incubator Indications
Purpose
Maintenance of temperature
Incubators (Isolettes)
THE NEUTRAL THERMAL ENVIRONMENT (NTE)
Neutral Thermal Environment by infant age
NTE under 1200 grams
NTE 1200–1500 grams
NTE 1500–2500 grams
NTE over 2500 grams
Disadvantages
Humidification
Incubator Child Care Activities
Fluid Requirement for Low Birth Weight Babies
General Guidelines for Fluid Therapy
Nurses responsibilities
13:
Care of the Child in Radiant Warmer
14:
Ostomy Care
COLOSTOMY CARE AND IRRIGATION
Definition
Purpose
Indications
Older Children
Types of Colostomies
Temporary Colostomy
Permanent Colostomy
Wet Colostomy
Double Barrel Colostomy
Types of Pouches used for Colostomies
Types of Colostomy Pouches: (Open Ended Pouch)
Closed Ended Pouch
One Piece
Two Piece
Precut or cut to Fit Pouches
Stoma Covers and Caps
Preparation
Change of Pouch
Equipment
Procedure
Nursing management
Colostomy Irrigation
Preliminary Assessment
Equipment
Preparation of the patient and the environment
Postoperative Care
Procedure
After care of the patient and the articles
UROSTOMY CARE
Definition
Indication
Purposes
Equipment
GASTROSTOMY CARE
Purposes
Indications
Sites of Tube Insertion
Types of Tubes
Equipment
Procedure
Gastrostomy or Jejunostomy care
Community and Home Care Considerations
15:
Care of Surgical Wounds, Dressing and Suture Removal
DEFINITION
PURPOSES OF DRESSINGS
TYPES OF DRESSINGS USED
Types of Dressing Used Depends on
Guaze
Types of dressings
Wet dressing
Non-Adherent Dressing
Self-adhesive Dressing
Hydrocolloid (HCD) and Hydrogel dressings
Pressure dressing
Equipment
Preparatory Phase
Steps of Procedure
Removal of Sutures
16:
Catheterization in Children
INTRODUCTION
Aims of Urethral Catheterization
Indications for Urethral Catheterization
Factors to Consider Prior to catheterization
Documentation
Catheter Selection
Duration of catheter
Catheter size
Length of catheter
Balloon size
PROCEDURE FOR PEDIATRIC URINARY CATHETERIZATION GENERAL GUIDELINES
Female Urethral Catheterization
Male Urethral Catheterization
In Both Female and Male
Catheter Care/Urinary Drainage Equipment
When Removing the Catheter
17:
Oxygen Administration in Children
INTRODUCTION
OXYGEN THERAPY
Additional Benefits of Oxygen Therapy
Long-Term Benefits of Oxygen Therapy
INDICATIONS
Indications for Oxygen Therapy
Types of Oxygen Therapy
High Concentration Oxygen Therapy
Low Concentration Oxygen Therapy (Controlled Oxygen Therapy)
Long-term Oxygen Therapy (LTOT)
METHODS OF OXYGEN THERAPY
A. Face Mask
Types of Face Masks
Procedure
B. Nasal Cannula
Equipment
Procedure
C. Oxygen Tent
Advantages
Disadvantages
D. Hood
E. Incubator
F. T-Piece Circuit
G. Transtracheal Oxygen Delivery
General Instructions for giving Oxygen Inhalation
Nurses responsibility in administration of Oxygen
After Care of the Patient
Complications
18:
Cardiopulmonary Resuscitation
INTRODUCTION
OBJECTIVES
PURPOSES
INDICATIONS
Antepartum Factors
Intrapartum Factors
PREPARATION FOR RESUSCITATION
EQUIPMENT REQUIRED
THE TABC OF RESUSCITATION
SIGNS TO EVALUATE FOR RESUSCITATION
INITIAL STEPS OF RESUSCITATION
Provision of Warmth
Position
Clearance of the Airway
If no Meconium
Tactile Stimulation
Administration of Oxygen
POSITIVE PRESSURE VENTILATION BAG AND MASK
Indications
TECHNIQUE OF POSITIVE PRESSURE VENTILATION
CHEST COMPRESSION
TECHNIQUE OF CHEST COMPRESSION
19:
Endotracheal Intubation
INDICATION
TECHNIQUE OF INTUBATION
PROCEDURE OF ENDOTRACHEAL INTUBATION
OROTRACHEAL INTUBATION
MEDICATIONS
20:
Care of Child on Ventilator
INTRODUCTION
INDICATIONS
DEFINITIONS
TYPES OF VENTILATORY SUPPORT
Indications
Technique
Complications
Mechanical ventilation
Principle
Indications
Advantages
Disadvantages
CARE OF INFANTS ON VENTILATOR
Management
VENTILATOR SIGHS
ENDOTRACHEAL TUBE SUCTION
General Principles
Signs of Excessive Secretions and blocked ETT
Equipment
Technique
Precautions
COMPLICATIONS DURING VENTILATION
BRADYCARDIA DURING VENTILATION
EXTUBATION
21:
Intravenous Therapy
INDICATIONS FOR IV THERAPY
COMMON IV SOLUTIONS
COMMON IV ADDITIVES
EQUIPMENTS
PREPARATIONS
HINTS FOR PROLONGED IV INFUSIONS
Potential Hazards of Infiltration of Fluid Administration
Nursing Care
22:
Blood-Drawing Techniques in the Neonate
HEEL PUNCTURE
Purpose
Limits
BLOOD-DRAWING TECHNIQUES IN THE NEONATE
Procedure
COMPLICATIONS
Prevention of Complications
Antecubital Venous Stick
Methods
Complications
Prevention of Complications
ARTERIAL PUNCTURE
Methods
Follow-up after Puncture
Complications
Prevention of Complications
23:
Central Venous Catheters (CVC) and Long Lines
DEFINITIONS
Care of Lines
Changing Connection Dressing
Requirements
Procedure
PROCEDURE IF INTRALIPID IS USED
Procedures
To Administer Medications through These Lines
Removal of Lines
Procedure for Changing CVC Dressing
Requirements
Procedures
24:
Umbilical Arterial Catheterization
INDICATIONS
Equipment
Techniques
COMPLICATIONS
Precautions
Removal of Arterial Catheter
25:
Umbilical Vein Catheterization
ARTERIAL/VENOUS CATHETER INSERTION: UMBILICAL
Policy
Equipment Required
Procedure
DOCUMENTATION
In NICU Central Catheters Registry
In Registered Nurses’ Notes
In Flow sheet
26:
Umbilical Cord Blood Collection or Analysis
AT BIRTH
BACKGROUND INFORMATION
POST-BIRTH SPECIMEN COLLECTION/EXAMINATION
Equipment Required
Procedure
NORMAL CORD BLOOD GAS AND PH (DURING AND POST-LABOR)
Umbilical Artery:
Umbilical Vein:
27:
Thoracic Drainage for Tension Pneumothorax
INDICATIONS
Equipment
Procedures
Preparation of Skin
Insertion of Thoracostomy Tube
Drainage with Continuous Negative Suction (Fig. 27.2)
Secure Thoracostomy Tube
Check Position of Thoracostomy Tube
Precautions
Removal of Thoracostomy Tube
THE NURSE'S ROLE IN MANAGING UNPLANNED CHEST DRAIN EVENTS
Bibliography
INDEX
TOC
Index
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