ATI Proctored Nursing Care of Children

death and dying: therapeutic communication chapter 11 allow an opportunity for anticipatory grieving. consistency among nursing personnel. encourage parents to remain with client. communicate with the client honestly and respectfully. encourage independence. provide and clarify information and explainations. encourage physical contact: address feelings, and show concern empathy and support. health promotion of adolescents (12-20 years): informed consent chapter 7 Parents do not need to give consent for adolescents to get tested for STD 01:03 01:24 infection control: teaching about methicillin-resistant staphylococcus aureus chapter 11 fundamental Treat with vancomycin and linezolid. Obtain specimen for culture and sensitivity for antimicrobial therapy. Monitor to make sure therapeutic levels are maintained. Complete full course of antibioitics. Avoid overuse immunizations: recommended schedule for preschool-age child chapter 35 4-6 years: DTaP, MMR, IPV 3-6 years: Flue vaccine immunizations: schedule for infant immunizations chapter 35 Birth: Hep B 2 months: DTaP, RV, IPV, Hib, PCV, and Hep B 4 months: DTaP, RV, IPV, Hib, PCV 6 months: DTaP, IVP, PCV, Hep B, RV, Hib 6-12 months: seasonal influenza vaccine death and dying: age-appropriate response to death chapter 11 INFANTS/TODDLERS BIRTH TO 3 YEARS o Have little to no concept of death o Egocentric thinking prevents their understanding of death (toddler) o Mirror parental emotions (sadness, anger, depression, anxiety). o Can regress to an earlier stage of behavior. PRESCHOOL CHILDREN (3 TO 6 YEARS) o Egocentric Thinking o Magical thinking allows for the belief that thoughts can cause an event such as death (as a result, child can feel guilt and shame). o View dying as temporary because of the lack of a concept of time and because the dead person can still have attributes of living (sleeping, eating, breathing). SCHOOL- AGE CHILDREN (6 TO 12 YEARS) o Begin to have an adult concept of death (inevitable, irreversible, universal), which generally applies to older school-age children (9 to 12 years). o Experience death process, the unknown, and loss of control. o Fear often displayed through uncooperative behavior. o Can be curios about funeral services and what happens to the body after death. ADOLESCENTS (12 TO 20 YEARS) o Can have an adult-like concept of death o Can have difficulty accepting death because they are discovering who they are, establishing an identity, and dealing with issues of puberty. o Can become increasingly stressed by the prospect of death. dermatitis and acne: evaluating parent understanding of diaper rash chapter 31 Advise parents that their child should avoid bubble baths and harsh soaps Encourage children to wear long sleeves and pants when there is risk of possible exposure to irritants Educate parents to remove an offending agent as soon as exposure takes place Promptly remove the soiled diaper. Clean urine the perineal area with a nonirritating cleanser. Expose the affected area to air. Use superabsorbent disposable diapers to reduce skin exposure. Apply a skin barrier, such as zinc oxide. Do not wash it off with each diaper change fractures: caring for a client who is in 90/90 skeletal traction 27 o Maintain body alignment o Provide pharmacological and nonpharmacological interventions for the management of pain and muscle spasms. o Notify provider if the client experiences severe pain from muscle spasms that is unrelieved by medications or repositioning. o Assess and monitor neurovascular status. o Routinely monitor skin integrity and document findings. o Assess pin sites for pain, redness, swelling, drainage, or odor. Provide pin care per protocol. o Assess for changes in elimination and maintain usual patterns of elimination. o Ensure that all hardware is tight and that the bed is in the correct position. o Assess and maintain weights so that they hang freely, and the knots do not touch the pulley. Do not lift or remove weights unless prescribed and supervised by the provider. o Consult with the provider for an overbed trapeze to assist the client to move in bed. o Provide range of motion and encourage activity of nonimmobilized extremities to maintain mobility and prevent contractures. o Encourage deep breathing and use if the incentive spirometry. o Promote frequent position changes within restriction of traction. o Remove sheets from the head of the bed to the foot of the bed and remake the bed in the same manner. pain management: rating a child's postoperative pain level chapter 9 -FLACC (2 months to 7 years): assess behaviors of the child -FACES (3 years and older): using diagram of six faces -Oucher (3-13 years): pain on a scale of 0 to 5 using six photographs -Numeric scale (5 years and older): rate pain on scale of 1-10 -Non-communicating children's pain (3-18 years): behaviors observed for 10 min & categories scored from 0 to 3 gastrointestinal disorders: menu items for celiac disease chapter 13 Nutrition Gluton intolerance. eliminate gluten, wheat, rye, and barley. Encourage milk, cheese, rice, corn, eggs, potatoes, fruits, veggies, fresh meats, fish, dried beans. antibiotics affecting protein synthesis: administration of aminoglycosides chapter 45 SELECT PROTOTYPE MEDICATION: Gentamicin OTHER MEDICATIONS • Tobramycin • Neomycin • Streptomycin • Paromomycin USES: Treats aerobic gram-negative bacilli, such as E.Coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa. • Paromomycin (an oral aminoglycoside) treats intestinal amebiasis and tapeworm infections. • Oral neomycin suppresses the normal flora of the GI tract postoperatively in preparation for colorectal surgery: topically, it treats infections of the eye, the ear, and skin. • Streptomycin can treat tuberculosis in combination with other medications, but newer and safer ones (ethambutol, rifampin, isoniazid) are preferable. COMPLICATIONS: Ototoxicity, Nephrotoxicity, Intense neuromuscular blockade, Hypersensitivity. CONTRAINDICATIONS/PRECAUTIONS: • Use cautiously in patients with kidney impairment, hearing loss, and myasthenia gravis. INTERACTIONS: Penicillin inactivate aminoglycosides when in the same IV solution NURSING ADMINISTRATION: • Most aminoglycosides, such as gentamicin and streptomycin (IM Only), are parental. Neomycin also has oral and topical formulations; tobramycin also has inhalation formula. • Base acquisition of aminoglycoside levels on dosing schedules. o With ONCE-A-DAY DOSING, it is only necessary to obtain a blood sample for measuring trough levels. o DIVIDED DOSES Peak: 30 min after admin of aminoglycoside IM or 30 min after completion of an IV infusion. Trough: Right before next dose. cardiovascular disorders: evaluating client response to digoxin and understanding of digoxin administration chapter Pharm o Withhold for infant if pulse is less than 90/min. o Withhold if pulse is less than 70/min o Signs of toxicity: bradycardia, dysrhythmias, nausea, vomiting, anorexia o Therapeutic serum levels 0.8 -2 mcg/L