NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
Pediatric Procedures and Pain
1. How does body image at different developmental levels influence the
nurse’s approach to patient care?
2. Describe different tools and measures for pain assessment in children
-
3. List nursing approaches to help children deal with pain.
Gastrointestinal Disorders
4. Identify appropriate nursing assessments and interventions related to
childhood GI disorders:
a. cleft lip and palate, TE fistula, imperforate anus, hernias
-Cleft Lip- • A cleft palate defect is noted during the newborn assessment by
palpation of the hard and soft palate with the finger.
• A description of the location and extent of the defect helps the nurse
determine the correct method of feeding.
• Thorough and complete physical assessment is needed since additional defects
are sometimes present.
• Assessment of the family's reactions is an integral part of the overall nursing assessment!
• Physical deformities, especially of the face, can be devastating to parents.!
• Assess the child's developmental level and social interactions with peers.
+
Promote parent-infant bonding by explaining the defects and the procedure.
• Interact and speak to the infant in the parents' presence and point out positive
attributes such as alertness, soft skin, or active movements.
NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
,NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
• Refer parents to foundations for information about the disorder.
• Minimize parental anxiety by giving clear, concise explanations.
-TE FISTULA- Nursing Assessment
-(THIS IS A SERIOUS PROBLEM BECAUSE STOMACH CONTENTS CAN
TRAVEL UP THE ESOPHAGUS AND PASS THROUGH THE FISTULA INTO
THE TRACHEA AND LUNGS. AIR CAN ALSO BYPASS THE LUNGS AND
ENTER THE STOMACH!
-Review the maternal history for polyhydramnios. Often this is the first sign of
esophageal atresia because the fetus cannot swallow and absorb amniotic fluid in
utero, leading to accumulation (Rosenberg & Grover, 2014). Soon after birth, the
newborn may exhibit copious, frothy bubbles of mucus in the mouth and nose,
accompanied by drooling. Note abdominal distention as air builds up in the
stomach. In esophageal atresia, a gastric tube cannot be inserted beyond a certain
point because the esophagus ends in a blind pouch. The newborn may have
NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
,NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
rattling respirations, excessive salivation and drooling, and “the three C’s”
(coughing, choking, and cyanosis) if feeding is attempted. The presence of a
fistula increases the risk of respiratory complications such as pneumonitis and
atelectasis due to aspiration of food and secretions.
Diagnosis is made by radiograph showing either an inserted gastric tube
appearing coiled in the upper esophageal pouch (indicating esophageal atresia) or
air in the gastrointestinal tract (indicating the presence of a fistula between the
trachea and esophagus).
INTERVENTIONS-Maintain a patent airway.
Administer oxygen, as needed, based on the infant's oxygen saturation levels or
arterial blood gas results.
Perform pulmonary physiotherapy and suctioning, as needed.
Place the infant in an upright sitting position. Minimize handling of the infant to
reduce oxygen demands. Maintain the head upright to reduce the risk of
aspiration.
Maintain NPO status. Administer I.V. fluids as ordered; initiate I.V. access if not
already present and maintain I.V. patency.
Obtain a daily weight.
Administer antibiotics as ordered to reduce the infant's risk of infection or to
treat current infection.
Provide a humid environment.
Offer the parents support and guidance in dealing with their infant's acute illness
and possible other anomalies that may be present. Encourage them to verbalize
their feelings and fears, participate in care, and hold and touch their infant as
much as possible to facilitate bonding. Model appropriate bonding and parenting
NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
, NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
behaviors, and point out positive aspects of the infant. Prepare the infant and
parents physically and psychologically for surgery. Explain all treatments and care
measures, such as care in the neonatal intensive care unit, ventilator support, and
drainage tubes as well as expectations for after surgery.
Postoperatively, provide aggressive pulmonary therapy to reduce the risk of
respiratory infection and atelectasis and initiate oral feedings slowly as ordered.
-Imperforate anus- Congenital anomaly where colon fails to acquire a normal
anal opening. Assessment: Nursing Assessment
In the newborn, observe for an appropriate anal opening. If the anal opening exists,
observe for passage of meconium stool within the first 24 hours of life (generally
not passed in the infant with imperforate anus). Assess urine output to identify
accompanying genitourinary problems. Assess for signs of intestinal obstruction,
which may occur as a result of the malformation. These include abdominal
distention and bilious vomiting.
Nursing Management
Nursing management focuses on preparing the newborn for surgery and providing
postoperative care. Preoperatively, maintain the newborn’s NPO status and
provide gastric decompression.
Administer IV therapy and antibiotic therapy as ordered and monitor the newborn’s
hydration status. It is important to provide the parents with a full explanation of the
defect, surgical options,
NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
Update 2022/2023
Pediatric Procedures and Pain
1. How does body image at different developmental levels influence the
nurse’s approach to patient care?
2. Describe different tools and measures for pain assessment in children
-
3. List nursing approaches to help children deal with pain.
Gastrointestinal Disorders
4. Identify appropriate nursing assessments and interventions related to
childhood GI disorders:
a. cleft lip and palate, TE fistula, imperforate anus, hernias
-Cleft Lip- • A cleft palate defect is noted during the newborn assessment by
palpation of the hard and soft palate with the finger.
• A description of the location and extent of the defect helps the nurse
determine the correct method of feeding.
• Thorough and complete physical assessment is needed since additional defects
are sometimes present.
• Assessment of the family's reactions is an integral part of the overall nursing assessment!
• Physical deformities, especially of the face, can be devastating to parents.!
• Assess the child's developmental level and social interactions with peers.
+
Promote parent-infant bonding by explaining the defects and the procedure.
• Interact and speak to the infant in the parents' presence and point out positive
attributes such as alertness, soft skin, or active movements.
NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
,NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
• Refer parents to foundations for information about the disorder.
• Minimize parental anxiety by giving clear, concise explanations.
-TE FISTULA- Nursing Assessment
-(THIS IS A SERIOUS PROBLEM BECAUSE STOMACH CONTENTS CAN
TRAVEL UP THE ESOPHAGUS AND PASS THROUGH THE FISTULA INTO
THE TRACHEA AND LUNGS. AIR CAN ALSO BYPASS THE LUNGS AND
ENTER THE STOMACH!
-Review the maternal history for polyhydramnios. Often this is the first sign of
esophageal atresia because the fetus cannot swallow and absorb amniotic fluid in
utero, leading to accumulation (Rosenberg & Grover, 2014). Soon after birth, the
newborn may exhibit copious, frothy bubbles of mucus in the mouth and nose,
accompanied by drooling. Note abdominal distention as air builds up in the
stomach. In esophageal atresia, a gastric tube cannot be inserted beyond a certain
point because the esophagus ends in a blind pouch. The newborn may have
NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
,NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
rattling respirations, excessive salivation and drooling, and “the three C’s”
(coughing, choking, and cyanosis) if feeding is attempted. The presence of a
fistula increases the risk of respiratory complications such as pneumonitis and
atelectasis due to aspiration of food and secretions.
Diagnosis is made by radiograph showing either an inserted gastric tube
appearing coiled in the upper esophageal pouch (indicating esophageal atresia) or
air in the gastrointestinal tract (indicating the presence of a fistula between the
trachea and esophagus).
INTERVENTIONS-Maintain a patent airway.
Administer oxygen, as needed, based on the infant's oxygen saturation levels or
arterial blood gas results.
Perform pulmonary physiotherapy and suctioning, as needed.
Place the infant in an upright sitting position. Minimize handling of the infant to
reduce oxygen demands. Maintain the head upright to reduce the risk of
aspiration.
Maintain NPO status. Administer I.V. fluids as ordered; initiate I.V. access if not
already present and maintain I.V. patency.
Obtain a daily weight.
Administer antibiotics as ordered to reduce the infant's risk of infection or to
treat current infection.
Provide a humid environment.
Offer the parents support and guidance in dealing with their infant's acute illness
and possible other anomalies that may be present. Encourage them to verbalize
their feelings and fears, participate in care, and hold and touch their infant as
much as possible to facilitate bonding. Model appropriate bonding and parenting
NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
, NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
behaviors, and point out positive aspects of the infant. Prepare the infant and
parents physically and psychologically for surgery. Explain all treatments and care
measures, such as care in the neonatal intensive care unit, ventilator support, and
drainage tubes as well as expectations for after surgery.
Postoperatively, provide aggressive pulmonary therapy to reduce the risk of
respiratory infection and atelectasis and initiate oral feedings slowly as ordered.
-Imperforate anus- Congenital anomaly where colon fails to acquire a normal
anal opening. Assessment: Nursing Assessment
In the newborn, observe for an appropriate anal opening. If the anal opening exists,
observe for passage of meconium stool within the first 24 hours of life (generally
not passed in the infant with imperforate anus). Assess urine output to identify
accompanying genitourinary problems. Assess for signs of intestinal obstruction,
which may occur as a result of the malformation. These include abdominal
distention and bilious vomiting.
Nursing Management
Nursing management focuses on preparing the newborn for surgery and providing
postoperative care. Preoperatively, maintain the newborn’s NPO status and
provide gastric decompression.
Administer IV therapy and antibiotic therapy as ordered and monitor the newborn’s
hydration status. It is important to provide the parents with a full explanation of the
defect, surgical options,
NURS 341 Exam 2 Study Guide Assured Satisfaction New
Update 2022/2023
