1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 37 Nursing Care of a Family When a Child Needs Diagnostic or Therapeutic Modalities

2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Diagnostic or Therapeutic Procedures Assessment Nursing diagnosis Outcome identification, planning Implementation Outcome evaluation

3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities Informed consent Explaining procedures Scheduling Preparing child, family Accompanying child Providing support

4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities (cont’d) Modifying procedures –Infant –Toddler, preschooler –School age, adolescent

5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities (cont’d) Promoting safety –Restraints Care after procedures

6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities (cont’d)

7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Measurement of Vital Signs Temperature Pulse rate Respiratory rate Blood pressure

8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Common Diagnostic Procedures Electrical impulse studies X-ray studies –Flat-plate –Dye contrast –Computed tomography Magnetic resonance imaging

9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Common Diagnostic Procedures (cont’d) Ultrasound Nuclear medicine studies Direct visualization procedures –Endoscopy –Bronchoscopy –Colonoscopy Aspiration studies

10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Specimen Collection Blood specimens –Venipuncture –Capillary puncture

11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Specimen Collection (cont’d) Urine specimens –Routine –Age appropriate –24 hour –Clean-catch –Suprapubic aspiration –Catheterization

12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Specimen Collection (cont’d) Stool specimens

13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nutritional Care Intake, output Enteral feedings Gastrostomy tube feedings Total parental nutrition (TPN)

14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nutritional Care (cont’d)

15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nutritional Care (cont’d)

16. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Elimination Enemas Ostomy care

17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question The best option for measuring a pulse on an infant would be A.radial pulse for one full minute. B.apical pulse for one full minute. C.anterior fontanelle for one full minute. D.brachial pulse for one full minute.

18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer B. Apical pulse for one full minute Rationale: Peripheral pulses may be weaker and difficult to palpate effectively for one full minute. Counting for one full minute will give the most accurate data in young children.

19. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Question When preparing to perform routine physical assessments on several children, which of the following children would you expect to obtain blood pressure? A.A 6-month-old infant B.A 13-month-old infant C.A 2½-year-old toddler D.A 3½-year-old preschooler

20. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer D. A 3½-year-old preschooler Rationale: Typically blood pressure is obtained on routine physical examinations for children over 3 years of age.