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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers
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22 - Pediatric Nursing Interventions and Skills

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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Registered Nurse (RN) School Study Aid

22 - Pediatric Nursing Interventions and Skills
22 Picmonics to Learn | 43 mins
Preoperative Care
Preop Education
Surgical Procedure
NPO
Turn, Cough, Deep Breathe, Incentive Spirometer
Lower Extremity Exercises
Compression Stockings or SCD's
Pain Management
Safety
Informed Consent
Physical Preparation
Preop Checklist
Handoff to Surgery
Universal Precautions
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2 mins
Postoperative Care
Head to Toe Assessment
Complications
Hemorrhage
Clotting
Pain
Dehiscence or Evisceration
Respiratory Complications
Paralytic Ileus
Infection
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2 mins
Pressure Ulcers
Risk Factors
Prolonged Immobilization
Neurologic Disease
Decreased Level of Consciousness
Classification
Stage 1: Intact Skin with Non-blanchable Erythema
Stage 2: Partial Thickness Skin Loss
Stage 3: Full-thickness Skin Loss without Fascial Involvement
Stage 4: Full-thickness Skin Loss with Fascial Involvement
Management
Wound Care
Surgery
Considerations
Septicemia
Osteomyelitis
Prevention
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3 mins
Interventions for Impaired Skin Integrity
Assessment
Signs of Skin Breakdown
Pain
Redness
Decreased Skin Turgor
Bleeding
Bony Prominences
Intervention
Reposition Q2H
Pressure Relief
Maintain Clean and Dry Skin
Adequate Nutrition and Hydration
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2 mins
Fever
Flushed skin, warm to touch
Chills
Sweating
Change in LOC
Provide adequate fluids
Monitor Electrolytes and Fluid
Monitor vital signs, esp temperature
Remove excess clothing and blankets
Sponge bath with tepid water
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2 mins
Aspirin (Acetylsalicylic Acid)
Mechanism
Inhibits Platelet Aggregation
NSAID
Indications
Thrombotic Event Prevention
General Pain
Inflammatory Conditions
Fever
Side Effects
Pancytopenia
GI Ulcers
Bleeding
Considerations
Withhold Before Surgery 7-10 Days
Reye's Syndrome
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2 mins
Prevention of Falls
Risk Factors
Physical Aging
Polypharmacy
Environmental
Hospital / Facility Prevention
Call Light within Reach
Assistive Devices Available
Bed Alarms
Home Prevention
Improve Lighting
Remove Home Hazards
Priority Nursing Interventions
Promote Exercise
Fall Risk Assessment
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2 mins
Standard Precautions
Hand Hygiene
Wash In / Wash Out
Alcohol-Based Hand Rub
Hand Washing
Personal Protective Equipment (PPE)
Gown
Face Mask
Goggles/Face Shield
Gloves
Donning and Removing PPE
Discard Sharps in Puncture-Resistant Container
Cough Etiquette
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2 mins
Droplet-Airborne Precautions
Private Room
Droplet
Droplets Larger than 5 Microns
Being Within 3 Feet of Patient
Surgical Mask with Face Shield
Type of Infection or Condition
Airborne
Airborne Infection Isolation Room (AIIR)
Droplets Smaller than 5 Microns
N95 Respirator
Type of Infection or Condition
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2 mins
Contact Precautions
Private Room
Wash In / Wash Out
Personal Protective Equipment (PPE)
Gloves
Gown
Limit Time Patient Leaves Room
Leave Equipment In Room
Special Linen Handling
Same Pathogen, Same Room
History of Contact Isolation
Preventative Education
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2 mins
Use of Restraints
Use Guidelines
During Emergency
Protecting From Harm
For Limited Time
Considerations
Last Resort
May Further Agitation
Frequent Observation
Obtain Order Within 1 Hour
Quick-Release Tie
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2 mins
Lumbar Puncture
Indications
CSF Sample
CSF Pressure
Considerations
Empty Bladder
Side-lying Position
Between 3rd and 4th Lumbar Vertebrae
Number Tubes
Supine Position After Procedure
Contraindications
Increased ICP (Intracranial Pressure)
Infection at Puncture Site
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2 mins
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
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1 min
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
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2 mins
Intramuscular Medication (IM) Administration
Risks
Injury to Nerves, Bone, and Blood Vessels
Sites
Deltoid
Vastus Lateralis
Ventrogluteal
Nursing Considerations
Selection of Needle Length
Aseptic Technique for Drawing Up
Z-Track
90 Degree Angle
Max Amount (2-5 mL Adult, 1 mL Child)
Techniques to Reduce Pain
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2 mins
Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
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2 mins
Eye Medication Administration
Procedure
Supine with Neck Hyperextended
Wash Away Crusts
Cotton Ball on Cheekbone
For Ophthalmic Drops
Instill Drops into Conjunctival Sac
Repeat if Missed or Patient Blinks
5 Minutes Before 2nd Medication
For Ophthalmic Ointment
Thin Stream Along Inner Edge
Inner Canthus to Outer Canthus
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2 mins
Ear Drops Medication Administration
Indications
Earwax Buildup
Ear Infections
Pulling The Pinna
Child - Back and Downward
Adult - Back and Upward
Procedure
Side-Lying with Ear Up
Instill Medication
Stay for 2-3 Minutes
Nursing Considerations
Room Temperature
May Massage Tragus
Perforated Eardrum
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2 mins
Enema Administration
Types
Tap Water/Soapsuds
Normal Saline
Hypertonic Solution
Medication
Oil Retention
Administration
Procedure Education
Wear PPE
Put Patient in Sims Position
Insert Tip
Start Flow Slowly
Stop With Discomfort
Potential for Vagus Response
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2 mins
Total Parenteral Nutrition (TPN)
Mechanism
Nutrition Given Outside GI
Side Effects
Hyperglycemia
Hyperlipidemia
Refeeding Syndrome
Nausea and Vomiting
Considerations
Slow IV Infusion
Use Large Central Vein
No Added Meds to TPN Line
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2 mins
Ileostomy Care
Antibiotics
Monitor Skin Breakdown
Drains Continuously
Fluid and Electrolyte Imbalance
Low Fiber Diet
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2 mins
Colostomy Care
Wash with Warm Water
Cut 1/8 inch Around Stoma
Decreases Skin Irritation
Empty When 1/3 to 1/2 Full
Change 3-7 Days
Considerations
Avoid Odor Causing Foods
Irrigate at Same Time
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2 mins

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