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across the life span
nursing care across life
| Question | Answer |
|---|---|
| Informed consent does not mean blanket consent, parental consent is needed for ? | taking photos, removal from facility, postmortem exams, relaease of medical information |
| How does eligibility to give informed consent relate with parents? | Right to withdraw consent. In divorced families, the parent who has the legal custody is responsible. |
| who is responsible for explaining the procedure and obtaining consent? | primary provider. Verbal consent can be given if the parents are unavailable to sign the consent, but must be witnessed by two different people. Nurses can witness signatures on the consent form and may reiterate. |
| what is the mature minor's doctrine? | Permits minors to give consent even though they are not technically adults as long as they demonstrate the ability and maturity to understand the risks and benefits of the treatment. |
| During pregnancy, marriage, or military service a minor may have what? | A minor who is legally underage, but is recognized as having the legal capacity of an adult |
| What three conditions must be met for informed consent to be valid? | 1. Person must be over the age of majority (usually 18) and considered competent. 2. Person must receive all the information to make an informed decision. 3. Person must act voluntarily without force or coercion. |
| how does psychological and physical preparation help? | Decrease anxiety. Promotes cooperation. Supports their coping skills and may teach new ones. Facilitates a feeling of mastery in experiencing a potentially stressful event. |
| Psychological interventions consist of | systematic preparations, rehearsal of events and supportive during stressful times. Therapeutic play is appropriate at this time. |
| pre procedure care also includes? | Parents should be given the option to stay with the child. Prior to performing a procedure, children need explanations of what is to be done and what is expected of them. Pre-medicate as ordered. |
| how is the child reassured? | Develop a reward system. Reward systems such as earning stars, stickers or a badge of courage are appealing to children.Encourage constructive expression of feelings and provide feedback for improving preparatory strategies. |
| wha tis the most effective interventions post procedure | Therapeutic play is the most effective interventions post-procedure. |
| what is pre op care | Stress the admission process, blood tests, administration and preoperative medications if ordered, the period before and during transport and after when they return from the post-anesthesia care unit. |
| what is done to provide pre op care? | Offer the parents the opportunity to remain with child. Conduct surgical suite tours if allowed. to introduce caretakers and environment.Discuss the food/fluid restrictions. |
| 5 goals of giving oral drugs pre op care | Patient safety & welfare. Minimize discomfort and pain. Minimize negative psychological responses. Control behavior. Returning patients to a state in which safe discharge is possible. |
| what is done to decrease anxiety? | Disguise unpleasant odor of gases. Using a transparent mask. Allow child to sit up. Allow preoperative play. |
| post op care | Vital signs must be taken, recorded and compared. Manage pain. Auscultate lung sounds noting early signs of respiratory distress:Abnormal respiratory rate. Shallow depth. Cough. |
| What information do children need to have prior to performing a procedure? | Prior to performing a procedure, children need explanations of what is to be done and what is expected of them. This explanation should be short, simple and appropriate to the child’s level of comprehension. |
| What are the most important postoperative interventions a nurse should provide? | Vital signs, managing pain, assessing respiratory status. |
| Environmental safety measures | All environmental safety measures used for adults are also used for children. Child-sized furniture. Elevate crib rails and use cover when developmentally appropriate. Inspect all toys. NO balloons or blown up gloves. |
| Set Limits | Children must understand where they can go and what they can do. Educate their family on unit policies. Access to potentially harmful areas must be prevented. Supervision must be provided at all times. |
| how is the child or infant transported within the unit? | Infants in horizontal position with support or in football hold. Infants and toddlers can be held upright with the front of the body resting on the nurse’s chest. |
| transport Outside the unit: | Infants and toddlers can be transported in cribs or bassinets. Older children can be transported using strollers, wagons with high sides and wheelchairs with safety belts. |
| what is a restraint? | “any method, physical or mechanical, which restricts a person’s movement, physical activity, or normal access to his or her body” JCAHO, 2001. |
| Therapeutic hugging is the | use of a secure, comfortable, temporary holding position that provides close physical contact with the parent or caregiver. |
| A physician’s order must be presented before application of restraints. Must contain: | Start and stop time. Date. Reason for restraint. Type of restraint. Signature. |
| The nurse is initially responsible for assessing | whether or not restraints are needed. |
| Nursing Interventions among documenting and ongoing assessments includes: | Remove and reapply restraints periodically. Offer comfort measures. Raise HOB 30 degrees. Provide range of motion as needed. Offer food, fluids and toileting; give pacifier. Discuss criteria for removal. Provide distraction. |
| Types of Restraints | Jacket restraints. Mummy restraints. Arm and leg restraints. Elbow restraints.(for cleft lip/pallate, Head IV's) |
| The nurse is responsible for minimizing the child’s movement and discomfort with proper positioning. Different procedures for positioning include: | Jugular access. Femoral access.Extremity venipuncture. Lumbar puncture. Bone marrow aspiration. |
| When might elbow restraints be used? | Following repair of a cleft lip/palate or with a scalp vein IV. |
| What may be used to transport a young child? | A crib, wagon, wheelchair or stretcher with the side rails up and straps on. |
| Clean Catch specimens refers to | urine collected after the meatus is cleaned; process is the same as in adults. |
| Pediatric considerations among using special devices for non potty trained, and familiar terms when explaining to preschoolers and toddlers, include: | Older children and adolescents can use a bedpan, urinal or can be trusted to collect the specimen in the bathroom. School-age children will ask many questions. Preschoolers and toddlers can void on request after lots of liquids; |
| Bladder catheterization is used | when the specimen is needed urgently, when the child is unable to void or sample is inadequate; it is used to obtain a sterile urine specimen. |
| bladder cath... | Prepare the child. A sterile feeding tube may be used. Ensure sterile technique is maintained |
| When it is important to empty the bag as soon as the infant urinates, how is the collection bag attached for infants and small children? | Frequent removal and replacement of adhesive collection devices. A thin coating of sealant applied to the skin helps to protect it and aids in adhesion. |
| How is stool Collected in children to assess for parasites, GI function and occult blood? | For infants and toddlers wearing a diaper, stool specimen may be obtained by scraping the required amount from a diaper. Children can urinate, flush, defecate then collect. |
| what is the nurse's responsibility for blood speciments collection? | The nurse is responsible for making sure specimen is collected on time and with the proper equipment. |
| what is the Allen test? | For arterial samples, perform an Allen test first. |
| how is blood speciment taken for infants? | A method of obtaining a sample from an infant is via heelstick. Warm area with moist compress; clean heel; puncture. |
| what are some considerations for pediatric blood specimen collection? | Keep track of the amount of blood drawn and use pediatric blood tubes. Institute pain reduction techniques as needed. |
| why are Respiratory and Throat Specimens taken? | Collection is often needed to diagnose RSV.Gastric washings may be use to obtain specimen. Nasal washings are used to obtain specimens to help diagnose RSV. Nasopharyngeal swabs are often used for throat cultures. |
| what is a contraindication for Respiratory and Throat Specimens | DO NOT ATTEMPT IF ACUTE EPIGLOTTITIS IS EXPECTED |
| What needs to be used to obtain a urine specimen from an infant or toddler? | A special urine collection device must be used to obtain a urine specimen from an infant or toddler who are not potty trained. |
| Why is it important to keep track of the amount of blood drawn from a child? | It is important to keep track of the amount of blood drawn and discarded because frequent sampling can rapidly decrease a child’s blood volume. |
Created by:
redhawk101
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