Perioperative Care of the Child A Nursing Manual

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ISBN: 9781405155953 | 1405155957
Cover: Paperback
Copyright: 12/21/2009

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Perioperative Care of the Child explores the core principles for delivering safe and effective nursing care of the child requiring surgery. It identifies the essential skills and knowledge required by perioperative practitioners in order to care effectively for children before, during, and after an operation. This practical and comprehensive text explores the role of the nurse in pre-hospital preparation, anaesthetics, surgical procedures, safety issues, postoperative recovery care, discharge issues, recovery in the ward, going home, and post-hospital care. It also addresses ethical issues and psychosocial factors on the child.

Contributors	p. ix
Introduction	p. xi
Acknowledgements	p. xiii
Abbreviations	p. xiv
The history of children's perioperative care	p. 1
Why history is important	p. 1
What is perioperative nursing?	p. 1
A brief history of perioperative nursing	p. 2
An overview of the history of surgery	p. 3
The development of perioperative nursing	p. 5
Key discoveries in perioperative care	p. 6
Early beginnings of surgery for children	p. 7
The growth of paediatric surgery	p. 9
Conclusion: perioperative nursing of children	p. 10
References	p. 11
The psychosocial care of children in the perioperative area	p. 13
Children's perceptions of the operating theatre	p. 13
The effect of hospitalisation on children	p. 14
Models of care	p. 16
The presence of parents	p. 19
Play in the operating theatre suite	p. 20
Emotional, social and spiritual needs of the patient	p. 20
Conclusion	p. 21
References	p. 21
Care of the child in the operating room	p. 23
Preparation of children for theatre	p. 23
Admission prior to surgery	p. 24
Observation	p. 25
Weight	p. 25
Surgical history	p. 25
Medical history	p. 25
Medications	p. 27
Body/site preparation	p. 27
Pre-admission clinic	p. 27
Emergency admission	p. 28
Day of surgery admission	p. 29
Reception in the operating suite	p. 30
Registration on entrance to the OR	p. 31
Fasting	p. 31
Other things to check on admission to the OR	p. 32
Safety of children in the operating theatre	p. 33
Specific safety issues for children during induction	p. 33
Post anaesthetic/post operative	p. 34
Standing orders	p. 36
Conclusion	p. 37
References	p. 37
Nursing care and management of children's perioperative pain	p. 39
Introduction	p. 39
Preparing and teaching children and parents about pain	p. 41
Agency, education and training of health care professionals	p. 42
Assessing children's pain	p. 43
Core approaches to pain assessment	p. 44
What tools to consider using with particular groups of children	p. 46
Non-pharmacological interventions	p. 46
Overview of pharmacological intervention	p. 47
Routes of administration	p. 48
Other local anaesthetic infusions	p. 55
Discharge home	p. 55
Conclusion	p. 56
References	p. 56
Surgical procedures on children	p. 66
Introduction	p. 66
Common surgical procedures performed on children	p. 66
Acknowledgement	p. 96
References	p. 96
Day surgery for children	p. 101
Day procedure centres	p. 101
Pre-admission preparation	p. 105
Admission to the day procedure centre: preparations for surgery	p. 105
Compartment syndrome	p. 112
Admission to theatre	p. 112
Ward stage recovery: post-operative care	p. 113
Conclusion: support at home	p. 116
References	p. 116
Anaesthesia in children	p. 119
Introduction: What is anaesthesia?	p. 119
The anaesthetic nurse	p. 119
Children undergoing anaesthesia	p. 120
Anaesthetic equipment	p. 121
Airways	p. 124
Anaesthesia	p. 127
Analgesia	p. 130
Patient preparation	p. 130
Fasting	p. 130
Premedication	p. 131
Loose teeth and nail polish	p. 131
Hearing aids and glasses	p. 132
Jewellery	p. 132
Preparation prior to patient arrival	p. 132
Patient arrival in theatre	p. 133
Induction	p. 133
Rapid sequence induction	p. 135
Fluids	p. 135
Monitoring	p. 135
Documentation	p. 136
Anaesthetic emergencies	p. 136
Anaphylaxis	p. 138
Suxamethonium apnoea	p. 138
Malignant hyperthermia	p. 139
Emergence	p. 139
Regional anaesthesia	p. 140
References	p. 141
The paediatric post-anaesthetic care unit	p. 144
Introduction	p. 144
In the PPACU	p. 144
The post-operative environment	p. 147
Oxygen delivery	p. 149
Suction	p. 151
Physiological assessment and management of the paediatric post-anaesthesia patient	p. 151
A - Airway management and B - Breaihing	p. 151
Respiratory complications and nursing interventions	p. 152
C - Circulation	p. 155
Thermoregulation and temperature abnormalities	p. 156
Post-operative nausea and vorruting	p. 160
Pain management in the PPACU	p. 164
Infection control	p. 165
Fluid and electrolyte balance	p. 166
Wounds and dressings	p. 168
Patient positioning	p. 168
Latex allergy	p. 169
Children with epilepsy	p. 170
Delayed emergence	p. 170
Emergence delirium	p. 171
Discharge of the patient from the PPACU	p. 171
Psychological assessment	p. l72
References	p. 175
Fetal surgery	p. 179
Introduction	p. 79
History	p. 179
The risks of fetal surgery	p. 180
Fetal conditions amenable to fetal surgery	p. 181
Ex utero intrapartum treatment (EXIT)	p. 183
The future	p. 184
References	p. 184
Perioperative care of children with burns	p. 185
Introduction	p. 185
History	p. 185
Epidemiology of burns in children	p. 186
A multidisciplinary service approach	p. 187
Clinical assessment of bum severity	p. 188
A - Airway	p. 189
B - Breathing	p. 189
C - Chelation	p. 190
D - Neurological disability	p. 190
E - Exposure with environment control	p. 190
Classification of bum depth	p. 190
Determination of bum depth	p. 191
Laser Doppler scanning	p. 191
Electrical burns	p. 192
Chemical burns	p. 193
Calculation of burn surface area	p. 193
Management	p. 193
Burn wound care	p. 195
Preparation for theatre	p. 197
Pain management via acute pain service	p. 199
Post-operative care	p. 200
Physiotherapy	p. 200
Infection control	p. 200
Toxic shock syndrome	p. 201
Tetanus	p. 202
Human immunodeficiency virus (HIV)-positive children	p. 202
Scar management	p. 202
Discharge planning	p. 202
References	p. 204
Paediatric transplantation	p. 208
Introduction	p. 208
Becoming an organ donor	p. 208
Types of donation	p. 209
Role of the transplant co-ordinator	p. 213
Donor care and management	p. 215
Making the donation request	p. 215
Preoperative care of a potential paediatric donor	p. 216
Perioperative care	p. 222
Recipient management and care	p. 229
Cardiothoracic organs	p. 230
Immediate post-operative care	p. 233
Liver	p. 234
Kidneys	p. 235
Small bowel, liver and multivisceral	p. 237
Reducing the risk of rejection of the new organ	p. 238
Longer-term post-operative care	p. 239
The future	p. 240
References	p. 242
Further reading	p. 243
The care of children having endoscopic procedures	p. 245
Introduction	p. 245
The perioperative nurse's role	p. 246
Preparing children for endoscopic procedures	p. 248
Perioperative care	p. 248
Service perspectives	p. 249
Equipment for MIS and endoscopy	p. 251
Conclusion	p. 258
References	p. 258
Ethical and legal issues in paediatric perioperative care	p. 261
Patients' rights	p. 261
Self-determination	p. 262
Privacy	p. 262
Confidentiality	p. 262
Consent	p. 263
Legal perspectives	p. 264
Medical futility	p. 265
Conclusion	p. 265
References	p. 266
Index	p. 267
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Perioperative Care of the Child A Nursing Manual

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