Procedures and Treatments Chapter 5

The Nurse’s Role in Performing or Assisting With Procedures Following guidelines set by the health care institution, including: The preparation before the procedure The follow-up needed when the procedure is completed Ensuring patient safety before, during, and after all procedures and treatments

The Nurse’s Role in Preparing the Client for Procedures Providing psychological or emotional support Explaining the procedure and encouraging questions Providing comfort to the child and caregivers Ensuring legal and safety factors are enforced Ensuring an order is written for the procedure Identifying the child Performing handwashing Following standard precautions

The Nurse’s Role After Procedures Leaving child in a safe position Comforting and reassuring the child Answering caregiver questions Removing and disposing of equipment and supplies properly Labeling, preparing, and documenting specimens according to agency policy Documenting the procedure and the child’s response

Types of Restraints Used for Procedures Mummy restraints Papoose boards Clove hitch restraints Elbow restraints Jacket restraints

Common Methods of Holding a Child Horizontal position Upright position Football hold

Performing Procedures Related to Elevated Body Temperature Using methods to reduce fever Maintaining hydration by encouraging fluids Administering acetaminophen Controlling environmental factors Removing excess blankets and clothing Lowering the room temperature Using cooling devices

Performing Procedures Related to Feeding and Nutrition Monitoring and documenting the intake of fluids and nutrients Providing nourishment by means of gavage feedings Inserting a gastrostomy tube surgically

Data Documented During Gavage Feedings The type and amount of contents aspirated by the nurse The amount of feeding given The child’s tolerance for the procedure The positioning of the child after completion

Procedures Related to Respiration Administering oxygen Performing nasal and oral suctioning Caring for a tracheostomy Monitoring and maintaining adequate oxygenation

Role of the Nurse in Using Cold or Heat Therapy Applying the treatment Closely monitoring the effects of the treatment Documenting observations

Procedures Related to Elimination Administering an enema to a child as a treatment or as a preoperative procedure Caring for an ostomy site and documenting the output from an ostomy

Types of Ostomies Colostomy Bringing a part of the colon through the abdominal wall to create an outlet for fecal material elimination Ileostomy A similar opening in the small intestine Urostomy Created to help in the elimination of urine

Procedures for Specimen Collection Collecting nose and throat specimens Collecting urine specimens Collecting stool specimens

Methods Used to Obtain Urine Specimens Collection bag Clean catch Catheterization 24-hour urine collection

Assisting With Procedures Related to Collection of Blood and Spinal Fluid Holding or restraining a child during a blood test Restraining a child in the proper position for a lumbar puncture

Types of Diagnostic Studies X-rays Arteriograms Computed tomography (CT) scans Intravenous pyelograms Bone or brain scans Electrocardiograms (EKGs) Electroencephalograms (EEGs) Magnetic resonance imaging (MRI) scans Cardiac catheterizations

Role of the Nurse in Assisting With Diagnostic Studies Teaching and preparing the child and the caregiver Requesting and scheduling the tests or studies Completing required paperwork; ensuring consents are signed Ensuring that NPO status is maintained Clarifying and documenting any allergies Supporting, comforting, and restraining the child Performing and documenting care after the procedure