Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Maternal-Child Nursing Care Optimizing Outcomes for Mothers, Children, & Families Susan Ward Shelton Hisley Susan Ward Shelton Hisley Chapter 21 Caring for the Child in the Hospital and in the Community

Gathering the Child’s Health History  Establish a relationship  Asking questions  OLD CAT  SODA

Comprehensive Health History  Family medical and social history  Past medical history  Immunizations  Developmental milestones

Comprehensive Health History  Patterns of daily activities  Sleep  Nutrition  Play, activities, and schoolwork

Review of Systems  General  Skin  Head, eyes, ears, nose, and throat  Neck  Chest  Cardiovascular  Gastrointestinal  Genitourinary  Musculoskeletal  Neurological  Endocrine

Health Assessment  Anthropometric measurements  Length  Weight  Body mass index  Head circumference  Skinfold thickness

Vital Signs  Temperature  Pulse  Respirations  Blood pressure

Physical Assessment  General impression  Skin assessment  Head assessment  Neck assessment

Physical Assessment  Eye assessment  Ocular alignment  Color blindness  Ear assessment  Hearing screening  Nose/sinus assessment

Physical Assessment  Throat/mouth assessment  Chest assessment  Lung assessment  Breath sounds  Cardiac assessment  Abdominal assessment

Physical Assessment  Genitourinary and perineal assessment  Female genitalia  Male genitalia  Anal examination  Musculoskeletal assessment  Neurological assessment

Routine Health Screening  Lead poisoning  Iron-deficiency anemia  Cholesterol screening  Tuberculosis screening

General Care Measures  Bathing  Feeding  Rest  Safety  Infection control  Fever-reducing measures  Emotional and spiritual support

Common Procedures: Hospital or Clinic Setting  Explain procedures  Use developmentally appropriate words  Educate parents as it diminishes anxiety and fearfulness  Use informed consent  Insert intravenous lines  Measure intake and output

Common Procedures: Hospital or Clinic Setting  X-ray exams  Specimen collection  Urine sample  Stool sample  Blood sample  Throat culture  Cerebrospinal fluid

Common Procedures: Hospital or Clinic Setting  Enteral tube feedings  Orogastric feeding tube  Nasogastric feeding tube  Gastrostomy tube  Ostomies

Restraining the Child  Physical restraint  Elbow restraint  Mummy restraint  Pharmacological restraint  Chloral hydrate (Aquachloral)

The Child in Pain  Pain assessment and management  Appropriate pain scale  Mild, moderate, severe  Acute, chronic  Myths about pain management  Pain management strategies

The Child with Disabilities  Emotional concerns  Developmental concerns  Physical concerns  Caregiver fatigue  Resiliency