Clinical Skills Manual for Pediatric Nursing : Caring for Children

by Bindler, Ruth C.; Ball, Jane W., DrPH, RN, CPNP

• ISBN13: 9780136135548
• ISBN10: 0136135544
• Edition: 4th
• Format: Paperback
• Copyright: 2007-04-11
• Publisher: Prentice Hall

Summary

This portable reference to step-by-step pediatric nursing procedures guides the reader through 129 pediatric skills using full-color photographs and rationales. Coverage includes physical assessment, special pain management techniques, cardiorespiratory care, administration of medications (including intravenous access), and other information useful to nurses in the clincal setting.

Author Biography

Ruth C. McGillis Bindler is Professor in the Intercollegiate College of Nursing at Washington State University.

Table of Contents

Preface	p. vii
Introduction	p. ix
Protective Methods	p. 1
Chapter Outline	p. 1
Infection Control Methods	p. 2
Standard Precautions	p. 2
Transmission-Based Precautions	p. 2
Latex Precautions	p. 4
Visitor Identification and Health Insurance Portability and Accountability Act (HIPAA)	p. 5
Informed Consent	p. 7
Chapter Outline	p. 7
General Guidelines for Obtaining Informed Consent	p. 8
Pediatric Considerations for Obtaining Informed Consent	p. 8
Newborn	p. 10
Chapter Outline	p. 10
Nasal Pharyngeal Suctioning	p. 11
Performing Nasal Pharyngeal Suctioning	p. 11
Newborn Apgar	p. 11
Assigning Newborn Apgar Scores	p. 12
Thermoregulation of the Newborn	p. 12
Thermoregulation of the Newborn	p. 13
Umbilical Cord Care	p. 14
Umbilical Cord Clamp: Application, Care, and Removal	p. 14
Circumcision Care	p. 15
Assisting with Circumcision and Providing Circumcision Care	p. 15
Newborn Bath	p. 16
Initial Newborn Bath	p. 17
Jaundice/Bilirubin	p. 17
Phototherapy	p. 18
The Infant Receiving Phototherapy	p. 18
Positioning and Restraining Therapies	p. 20
Chapter Outline	p. 20
Human Restraint	p. 22
Positioning a Child for Injections or Intravenous Access	p. 22
Positioning a Child for Lumbar Puncture	p. 22
Positioning a Child for an Otoscopic Examination	p. 23
Mechanical Restraining Therapies	p. 24
Applying a Papoose Board Immobilizer	p. 24
Applying a Mummy Immobilizer	p. 25
Applying Elbow Immobilizers	p. 26
Transporting the Child	p. 27
Chapter Outline	p. 27
Transport of the Infant	p. 28
Transport of the Toddler	p. 28
Transport of the Child with a Disability	p. 29
Physical Assessment	p. 31
Chapter Outline	p. 31
Growth Measurements	p. 32
Length	p. 32
Height	p. 33
Weight	p. 33
Body Mass Index	p. 34
Head Circumference	p. 34
Chest Circumference	p. 35
Abdominal Girth	p. 35
Vital Signs	p. 36
Heart Rate	p. 36
Respiratory Rate	p. 36
Blood Pressure	p. 37
Body Temperature	p. 39
Oral Route	p. 39
Rectal Route	p. 39
Axillary Route	p. 40
Tympanic Route	p. 40
Special Neurologic Assessments	p. 41
Glasgow Coma Scale	p. 41
Neurovascular Assessment	p. 41
Intracranial Pressure Monitoring and Daily Care	p. 42
Visual Acuity Screening	p. 44
Snellen Letter Chart	p. 44
HOTV, Snellen E, or Picture Chart	p. 44
Hearing Acuity Screening	p. 45
Pure Tone Audiometry	p. 46
Tympanometry	p. 47
Fluid and Electrolyte Balance: Intake and Output	p. 48
Output Measurement	p. 48
Specimen Collection	p. 49
Chapter Outline	p. 49
Blood Samples	p. 50
Performing a Capillary Puncture	p. 50
Newborn Screening	p. 51
Blood Glucose Meters	p. 52
Performing a Venipuncture	p. 53
Blood Cultures	p. 54
Arterial Blood Gases	p. 54
Urine Samples	p. 55
Applying a Urine Collection Bag (Infant)	p. 56
Routine Urine Collection (Older Child)	p. 56
Collecting a Clean-Catch Midstream Urine Specimen (Older Child)	p. 56
Collecting a Sterile Urinary Catheter Specimen	p. 57
Collecting an Indwelling Catheter Urine Specimen	p. 58
Collecting a 24-Hour Urine Specimen	p. 59
Stool Culture	p. 59
Obtaining a Stool Specimen	p. 60
Wound Culture	p. 60
Obtaining a Sample for Wound Culture	p. 60
Throat Culture	p. 61
Obtaining a Sample for a Throat Culture	p. 61
Respiratory Secretions	p. 61
Collecting Respiratory Secretions from an Infant	p. 61
Collecting Respiratory Secretions from a Child	p. 62
Bone Marrow Aspiration	p. 62
Assisting with Bone Marrow Aspiration	p. 62
Administration of Medication and Irrigations	p. 64
Chapter Outline	p. 64
Administration of Medication	p. 65
Preparation	p. 66
Documentation	p. 66
Calculation	p. 67
Oral Medication	p. 67
Administering an Oral Medication	p. 68
Intramuscular Injection	p. 68
Administering an Intramuscular Injection	p. 70
Subcutaneous Injection	p. 71
Administering a Subcutaneous Injection	p. 71
Intravenous Medication	p. 71
Special Considerations	p. 71
Administering an Intravenous Medication	p. 72
Ophthalmic Medication	p. 73
Administering Neonatal Ophthalmic Ointment	p. 73
Administering an Ophthalmic Medication	p. 74
Contact Lens Care	p. 75
Eye Irrigation	p. 75
Performing an Eye Irrigation	p. 76
Otic Medication	p. 76
Administering an Otic Medication	p. 76
Ear Irrigation	p. 77
Performing an Ear Irrigation	p. 77
Nasal Medication	p. 78
Administering a Nasal Medication	p. 78
Aerosol Therapy	p. 78
Administering Nebulizer Aerosol Therapy	p. 79
Metered Dose Inhaler (MDI)	p. 79
Using a Metered Dose Inhaler (MDI)	p. 79
Topical Medication	p. 80
Administering Topical Medication	p. 80
Rectal Medication	p. 80
Administering a Rectal Medication	p. 81
Intravenous Access	p. 82
Chapter Outline	p. 82
Peripheral Vascular Access	p. 83
Choice of Site	p. 83
Accessing a Peripheral Vein	p. 84
Medication Lock	p. 86
Attaching a Medication Lock Cap to an IV Infusion	p. 86
Infusing Medication: Medication Lock in Place	p. 87
Administering an IV Push Bolus of Medication: Medication Lock in Place	p. 87
Intravenous Infusion	p. 88
Pumps	p. 88
Administering IV Fluids	p. 89
Guidelines for Infusion of IV Fluids	p. 90
Blood Administration	p. 90
Administering Blood or Blood Products	p. 90
Total Parenteral Nutrition	p. 92
Central Venous Catheters	p. 93
Site Management	p. 93
Caring for a Central Venous Catheter Site	p. 93
Accessing a Central Venous Catheter	p. 94
Implanted Ports	p. 95
Pain Assessment and Management	p. 96
Chapter Outline	p. 96
Pain Assessment	p. 97
Selected Pediatric Pain Scales	p. 97
Special Pain Management Techniques	p. 100
Administering Patient-Controlled Analgesia (PCA) Pumps	p. 100
Sedation Monitoring	p. 101
Local Pain Blocks	p. 103
Cardiorespiratory Care	p. 104
Chapter Outline	p. 104
Administration of Oxygen	p. 105
Oxygen Delivery Systems	p. 105
Using Oxygen Delivery Systems	p. 106
Cardiorespiratory Monitoring	p. 107
Oxygen Saturation: Pulse Oximetry	p. 107
Cardiorespiratory or Apnea Monitor	p. 108
Placement of Electrocardiogram Electrodes	p. 108
Peak Expiratory Flow Rate (PEFR) Monitoring	p. 109
Central Venous Pressure Monitoring	p. 110
Arterial Pressure Monitoring	p. 111
Artificial Airways	p. 112
Assisting with Oropharyngeal Airway Insertion	p. 112
Assisting with Nasopharyngeal Airway Insertion	p. 113
Tracheostomy General Guidelines	p. 114
Tracheostomy Care	p. 114
Endotracheal Tube Care	p. 116
Assisted Ventilation	p. 117
Bag-Valve-Mask (BVM) Ventilation	p. 117
Ventilator	p. 118
Chest Tubes	p. 119
Assisting with Placement of Chest Tubes	p. 119
Care of the Chest Tube	p. 120
Assisting with Chest Tube Removal	p. 122
Cardiopulmonary Resuscitation	p. 122
Performing Cardiopulmonary Resuscitation	p. 123
Foreign Body Airway Obstruction	p. 125
Removing a Foreign Body Airway Obstruction	p. 126
Suctioning	p. 127
Nasal/Oral Suctioning	p. 127
Performing Nasal/Oral Suctioning	p. 127
Suctioning a Conscious (Awake and Alert) Child	p. 128
Suctioning a Child with a Decreased Level of Consciousness	p. 129
Tracheostomy Tube Suctioning	p. 130
Endotracheal (ET) Tube Suctioning	p. 131
Chest Physiotherapy/Postural Drainage	p. 132
Performing Chest Physiotherapy/Postural Drainage	p. 132
Incentive Spirometry	p. 136
Using the Incentive Spirometer	p. 136
Nutrition	p. 138
Chapter Outline	p. 138
Gastric Tubes	p. 139
Orogastric Tubes	p. 139
Inserting and Removing an Orogastric Tube	p. 139
Nasogastric Tubes	p. 140
Inserting and Removing a Nasogastric Tube	p. 140
Gastrostomy Tubes	p. 142
Gavage/Tube Feeding	p. 142
Administering a Gavage/Tube Feeding	p. 143
Gastric Suctioning	p. 145
Performing Gastric Suctioning	p. 145
Elimination	p. 146
Chapter Outline	p. 146
Urinary Catheterization	p. 147
Performing an Indwelling Urinary Catheterization	p. 147
Double Diapering with a Stent in Place	p. 148
Ostomy Care	p. 149
Changing the Dressing for an Infant with an Ostomy	p. 149
Changing an Ostomy Pouch for an Infant or Child	p. 149
Enemas	p. 150
Administering an Enema	p. 150
Skin and Musculoskeletal Care	p. 152
Chapter Outline	p. 152
Skin	p. 153
Wound Irrigation	p. 153
Burn Wound Care	p. 153
Suture and Staple Removal	p. 154
Casts	p. 156
Providing Cast Care	p. 156
Crutches	p. 158
Setting Crutch Height	p. 158
Braces	p. 158
Traction	p. 159
Applying and Monitoring Skin Traction	p. 159
Monitoring Skeletal Traction and Performing Pin Care	p. 160
Physical Growth Charts	p. 161
Blood Pressure Values by Age, Sex, and Height Percentiles	p. 171
West Nomogram-Body Surface Area	p. 175
Citations and General References	p. 177
Index	p. 178
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