Pediatric Nursing Skills and Procedures

"Caring for children requires special consideration." This statement was the genesis for Pediatric Nursing Skills & Procedures, which is a resource preparing the nurse to perform both basic and advanced procedures on their younger patients. Over one hundred skills have been uniquely crafted to instill confidence when treating children, complete with equipment needs and documentation essentials. The categories of skills include assessment and monitoring, specimen collection, diagnostic tests, and wound care. In addition, procedures specific to body system have been categorized as such, including those for the gastrointestinal, neurological, genitourinary, musculoskeletal, and respiratory systems.

Barbara L. Mandleco is Associate Professor and Undergraduate Coordinator at the College of Nursing, Brigham Young University, Provo, Utah.

Preface

ix

Contributors

xi

Reviewers

xiii

Unit I Principles and Concepts of Pediatric Care

Nurse, Child, and Family Communication

3

(8)

Informed Consent

11

(1)

Adherence

12

(1)

Protective Precautions

13

(4)

Unit II General Procedures

Preparing Children for Procedures

17

(4)

Transporting a Child

20

(1)

Restraints

21

(12)

Applying a Papoose Board

22

(1)

Applying a Mummy Restraint

23

(2)

Applying a Modified Mummy Restraint

25

(1)

Applying an Elbow Restraint

26

(1)

Applying a Wrist and Ankle Restraint

27

(2)

Applying a Jacket Restraint

29

(4)

Unit III Health Assessment

Health Assessment

33

(9)

Obtaining a Health History

34

(4)

Conducting a Physical Examination

38

(4)

Growth Measurements

42

(5)

Measuring Weight

43

(1)

Measuring Height

44

(1)

Measuring Recumbent Length

45

(1)

Measuring Head Circumference

46

(1)

Vital Signs

47

(11)

Measuring a Temperature

48

(4)

Measuring a Pulse

52

(2)

Counting Respirations

54

(2)

Measuring a Blood Pressure

56

(2)

Standard Assessments

58

(6)

Nutritional Assessment

59

(1)

Developmental Assessment

60

(3)

Vision Screening

63

(1)

Special Assessments

64

(7)

Applying an Apnea Monitor

65

(1)

Applying a Cardiac Monitor

66

(1)

Applying a Pulse Oximeter

67

(4)

Unit IV Specimen Collection

Specimen Collection

71

(1)

Blood Drawing

72

(8)

Performing Capillary Blood Draw (Heel and Finger Stick)

73

(2)

Performing Venipuncture

75

(2)

Drawing Blood from a Central Venous Catheter

77

(1)

Measuring Arterial Blood Gases

78

(2)

Nose, Throat, and Sputum Specimens

80

(4)

Obtaining a Nasopharyngeal Swab

81

(1)

Obtaining a Throat Culture

82

(1)

Collecting Sputum

83

(1)

Stool Specimens

84

(2)

Collecting Stool Specimens

84

(1)

Obtaining a Stool Specimen for the Fecal Occult Blood Test (FOBT)

85

(1)

Urine Specimens

86

(4)

Collecting a Urine Specimen with Infant or Young Child

87

(2)

Collecting a Midstream, Clean-Catch Urine Specimen with Older Child

89

(1)

Wound Culture

90

(5)

Obtaining a Wound Culture

91

(4)

Unit V Diagnostic Tests

Diagnostic Tests

95

(8)

Assisting during Lumbar Puncture

96

(2)

Assisting during Bone Marrow Aspiration and Biopsy

98

(5)

Unit VI Medication Adminstration

Medication Administration

103

(22)

Administering a Medication

104

(1)

Administering an Oral Medication

105

(2)

Administering an Intravenous (IV) Medication

107

(3)

Administering an Intramuscular (IM) Medication

110

(3)

Administering a Subcutaneous (SC) Medication

113

(2)

Administering a Rectal Medication

115

(1)

Administering an Ophthalmic Medication

116

(2)

Administering an Otic Medication

118

(1)

Administering a Nasal Medication

119

(1)

Administering a Topical Medication

120

(1)

Administering a Nebulized Medication

121

(4)

Unit VII Intravenous Access

Intravenous Access

125

(7)

Inserting a Peripheral IV Line

127

(2)

Applying an Intermittent Infusion Device

129

(1)

Changing the IV Bag and Tubing

130

(1)

Monitoring Intravenous Infusions and Flow Rates

131

(1)

Central Venous Catheter

132

(5)

Changing Dressing on a Central Venous Line

133

(4)

Unit VIII Respiratory System

Respiratory Suctioning

137

(5)

Performing Bulb Suctioning

138

(2)

Performing Nasotracheal Suctioning

140

(2)

Administering Oxygen

142

(3)

Administering Oxygen via Nasal Cannula, Mask, Hood, Tent, Blow-by Cannula

143

(2)

Artificial Airways

145

(4)

Assisting in Placement of Oropharyngeal or Nasopharyngeal Airway

146

(1)

Suctioning Oropharyngeal or Nasopharyngeal Airway

147

(2)

Endotracheal Tubes

149

(5)

Monitoring Endoctracheal Tube (ETT)

150

(2)

Endotracheal Suctioning

152

(2)

Tracheostomies

154

(9)

Monitoring a Tracheostomy

155

(2)

Changing a Tracheostomy Tube

157

(2)

Cleaning a Tracheostomy Tube or Inner Cannula

159

(2)

Suctioning a Tracheostomy

161

(2)

Peak Expiratory Flow Rates (PEFRs)

163

(2)

Measuring PEFR

164

(1)

Chest Physiotherapy and Postural Drainage

165

(3)

Positioning for CPT

166

(2)

Closed Chest Drainage and Chest Tubes

168

(9)

Assisting with Chest Tube Insertion

169

(1)

Preparing the Chest Tube Drainage System

170

(1)

Caring for a Child with a Chest Tube

171

(2)

Assisting with Removal of a Chest Tube

173

(4)

Unit IX Gastrointestinal System and Nutritional Procedures

Gastrointestinal System

177

(9)

Inserting a Nasogastric Tube

178

(2)

Managing Gastrointestinal Suction

180

(1)

Irrigating a Nasogastric Tube

181

(1)

Performing Nasogastric Tube Lavage

182

(1)

Removing the Nasogastric or Orogastric Tube

183

(1)

Administering a Bolus Feeding (NG, NJ, Gastrostomy)

184

(1)

Administering NG, NJ, Gastrostomy, and Continuous Feeding

185

(1)

Ostomies

186

(3)

Changing a Fecal Ostomy Appliance

187

(1)

Emptying an Ostomy Pouch

188

(1)

Enemas

189

(4)

Administering an Enema

190

(3)

Unit X Genitourinary System

Urinary Catheterization

193

(5)

Performing Urinary Catheterization

194

(2)

Performing Routine Catheter Care

196

(2)

Unit XI Neurological System

Neurological Status

198

(3)

Increased Intracranial Pressure

201

(1)

Seizures

202

(3)

Intraventricular Shunts

205

(1)

Extraventricular Drain (EVD)

206

(9)

Maintaining EVD System at Correct Level and Functioning

207

(1)

Assessing a Client with an EVD

208

(1)

Monitoring Cerebrospinal Fluid (CSF) in the Client with an EVD

209

(1)

Changing the EVD Drainage Bag

210

(1)

General Nursing Care and Safety with EVDs

211

(4)

Unit XII Musculoskeletal System

Casts

215

(2)

Petaling a Cast

216

(1)

Braces

217

(1)

Skeletal Traction

218

(7)

Performing Pin Site Care

219

(1)

Caring for the Child in an External Fixation Device

220

(1)

Performing Pin Care, External Fixation Device

221

(4)

Unit XIII Integumentary System

Rashes

225

(1)

Wound Care

226

(4)

Applying a Dry Dressing

227

(1)

Applying a Wet-to-Dry Dressing

228

(2)

Wounds with Drains

230

(17)

Cleaning and Dressing a Wound with Penrose Drain

231

(2)

Monitoring Jackson-Pratt and Hemovac Drains

233

(4)

Unit XIV Care of the Pediatric Surgical Client

Assessing Pain

237

(3)

Monitoring Patient-Controlled Analgesia

240

(1)

Performing Preoperative Care

241

(1)

Performing Postoperative Care

242

(5)

Unit XV Emergency Care

Fever and Hyperthermia Management

247

(2)

Administering a Sponge Bath

248

(1)

Respiratory and Cardiac Emergencies

249

(22)

Treating an Inhalation Injury

250

(1)

Performing Emergency Airway Management

251

(2)

Treating an Airway Obstruction

253

(2)

Performing Cardiopulmonary Resuscitation

255

(11)

Unit XVI Community and Camp Nursing Procedures

Removing a Tick

266

(1)

Treating Contact Dermatitis Caused by Poison Ivy or Poison Oak

267

(1)

Removing a Splinter

268

(3)

Unit XVII Hygiene Skills

Hair Care

271

(10)

Assisting with Oral Hygiene

272

(1)

Bathing a Child

273

(5)

Unit XVIII Special Skills

Performing Umbilical Cord Care of the Newborn

278

(1)

Performing Circumcision Care

279

(2)

Bibliography

281

(4)

Index

285

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Pediatric Nursing Skills and Procedures

Summary

Author Biography

Table of Contents

Supplemental Materials