RN Nursing Care of Children Practice B PDF

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ATI Nursing Care of Children Practice B Remediation...

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RN Nursing Care of Children Practice B Remediation Time: 01:11:00 Safety and Infection Control  Burns: Teaching about Sunburn Prevention o Children should use sunscreen while outside o Use sunscreen (SPF 15 or greater) daily while outside o Avoid sun exposure between 1000 and 1400, wear protective clothing, and wear sunscreen to prevent sunburns  Acute Neurological Disorders: Teaching About Droplet Precautions for Bacterial Meningitis o Isolate the client as soon as meningitis is suspected and maintain droplet precautions per facility protocol. o Droplet precautions require a private room or a room with clients who have an infection from the same microorganism, ensuring that each client has his or her designated equipment. o Providers and visitors should wear a mask. o Maintain respiratory isolation for a minimum of 24 hours after initiation of antibiotic therapy. Psychosocial Integrity  Psychosocial Issues of Infants, Children, and Adolescents: Evaluating Understanding of ADHD o Assist with appropriate classroom placement in the school. o Allow more time for testing. o Collaborate with the school nurse. o Place in classroom that has order and consistent rules. o Offer verbal instruction combined with visual cues. o Plan academic subjects in the morning. o Include regular breaks. o Provide for small classroom settings or work groups. Basic Care and Comfort  Cystic Fibrosis: Planning Nutritional Interventions for a Child Who Has Cystic Fibrosis o Provide a well-balanced diet high in protein and calories o Give three meals a day with snacks o Encourage oral fluid intake o Administer pancreatic enzymes within 30 min of eating a meal or snack. o Administer water soluble vitamin supplements: multivitamin; vitamins A, D, E and K. o Administer laxatives or stool softeners for constipation. Polyethylene-glycol electrolyte solution is administered orally or via NG tube. o Administer possible formula supplements in addition to breastfeeding or via gastric tube. o Encourage to add salt to food during hot weather (dehydration). o Increase fat content in child’s diet to 40% of total calories. o Consult a dietitian. Child should receive regular nutritional evaluations.  Sources of Nutrition: Food Choices for Iron Deficiency o Lean red meats provide sources or readily absorbable iron. o Consuming vitamin C (orange juice, tomatoes) with plant sources of iron (beans, raisins, peanut butter, whole grains) will maximize absorption. o Milk should be limited to the recommended quantities (24 oz) because it is a poor source of iron and can displace the intake of iron-rich foods. Pharmacological and Parenteral Therapies

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Fluid Imbalance: Evaluating the Effectiveness of Sodium Polystyrene Sulfonate o Sodium polystyrene sulfonate replaces sodium with potassium in the intestinal tract to promote potassium excretion. o Used to treat severe hyperkalemia; other treatments include calcium salt, glucose and insulin, sodium bicarbonate, peritoneal dialysis or hemodialysis. o Sorbitol induces a bowel movement to promote excretion of excess potassium.  Safe Administration of Medication: Caring for a Child Who Has a Tunneled Central Venous Access Device o Assess the site for redness, swelling, drainage, tenderness, and condition of the dressing. o Clean the insertion port with alcohol for 15 seconds and allow it to dry completely prior to accessing it. o Use transparent dressing to allow for visualization. Follow facility protocol for dressing changes, usually every 7 days and when indicated (wet, loose, soiled) Reduction of Risk Potential  Fractures: Identifying Potential Complications o Complication: Osteomyelitis  Infection within the bone secondary to a bacterial infection from an outside source (with an open fracture [endogenous] or from a bloodborne bacterial source [hematogenous]). o Manifestations  Irritability  Fever  Tachycardia  Edema  Pain is constant but increases with movement  Not wanting to use the affected extremity  Site of infection tender, swollen, and warm to touch.  Cardiovascular Disorders: Postoperative Care Following Cardiac Catheterization o Monitor for possible complications (bleeding, infection, thrombosis) o Limit activity for 24 hours. o Encourage fluids.  Gastrointestinal Structural and inflammatory Disorders: Discharge Teaching Following Cheiloplasty o Cleft lip repair o Monitor the integrity of the post-operative protective device to ensure proper positioning o Position the infant on the back and upright, or on the side during the immediate postoperative period to maintain the integrity of the repair. o Apply elbow restraints to keep the infant from injuring the repair site. Restraints n should be removed periodically to assess skin, allow limb movement, and provide for comfort. o Use water or diluted hydrogen peroxide to clean the incision site. Apply antibiotic ointment if prescribed. o Gently aspirate secretions of mouth and nasopharynx to prevent respiratory complications.  Diabetes Mellitus: Performing a Respiratory Assessment o Ketone levels in the blood and urine o Blood glucose levels o Labs: glucose, electrolytes, BUN, ABG, CBC o Fruity scent to breath o Mental confusion

o Dyspnea o Nausea and vomiting o Dehydration o Weight loss o Electrolyte imbalance o Untreated: Coma, which can progress to death. o Kussmaul respirations Psychological Adaptation  Asthma: Discharge Teaching About the Management of Moderate Persistent Asthma o Identify personal triggering agents o Avoid triggering agents o Provide the family and child with an asthma action plan o Properly self-administer medications (nebulizers, inhalers, and spacers) o Use a peak flow meter. (Use at the same time each day).  Ensure the marker is zeroes  Have the child stand up straight  Remove gum or food from mouth  Close lips tightly around the mouthpiece (ensure the tongue is not occluding)  Blow out as hard and as quickly as possible  Read the number on the meter  Repeat these steps two or more times for a total of three attempts (wait at least 30 seconds between attempts)  Record highest number. o Keep a record of PEFR results. Results over time show the child’s “best” efforts and provide a warning of increased airway impairment. o Learn how to interpret PEFR results and what measures to take for their zone. o Learn how to recognize an asthma exacerbation (decreased PEFR, increased use of SABA, difficulty speaking or eating.) o Perform infection prevention techniques  Promote goof nutrition  Reinforce importance of goof hand hygiene.  Reduce allergens in the child’s environment o Perform prompt medical attention for infections. o Keep immunizations, including seasonal influenza and pneumonia vaccines, up to date. o Perform regular exercise as part of asthma therapy.  Promotes ventilation and perfusion  Maintains cardiac health  Enhances skeletal muscle strength o Children can require education before exercises to prevent induced spasms of the bronchus. o Pulmonary function tests:  The most accurate tests for diagnosing asthma and its severity  Baseline test at time of diagnosis  Repeat testing after treatment is initiated and child is stabilized  Test every 1-2 years.  Skin Infections and Infestations: Evaluating Client Understanding of the Management of Tinea Pedis o Oral griseofulvin o Topical antifungal (tolnaftate, clotrimazole)

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o Apply wet compressions or take sitz bath o Wear light-colored socks, well ventilated shoes o Clotrimazole or ciclopirox twice a day for 2-4 weeks o Ciclopirox or clotrimazole o Griseofulvin for severe infections. o Wear sandals as much as possible. Acute Otitis Media: Management of Fever o Provide comfort measures  Administer pain medication as needed  Provide diversional activities o Place child in an upright position o Management of fevers. o Dressing the child in minimal clothing. Communicable Diseases: Evaluating Understanding of Mononucleosis o Epstein-Barr Virus (EBV)/ mononucleosis o Spread by saliva o Incubation: 30-50 days o Healthy people can carry EBV in saliva, transmitting the virus for a lifetime. o People who have mononucleosis can transmit for weeks. Gastrointestinal Structural and Inflammatory Disorders: Manifestations of Intussusception o Sudden episodic abdominal pain o Screaming with drawing knees o chest during episodes of pain o Abdominal mass (sausage-shaped) o Stools mixed with blood and mucus that resemble the consistency of red currant jelly o Vomiting o Fever o Lethargy o Tender, distended abdomen....