Pediatric Nursing Care Plan (PDF)

1. Acute Respiratory Disease: a. What are the assessment findings for a child with bronchiolitis and RSV? i. Appear air hungry, cyanosis, resp. Distress, tachypnea, retractions, gunting, cough, wheeze, apnea periods, listless, uninterested in...

1. Acute Respiratory Disease: a. What are the assessment findings for a child with bronchiolitis and RSV? i. Appear air hungry, cyanosis, resp. Distress, tachypnea, retractions, gunting, cough, wheeze, apnea periods, listless, uninterested in feeding ii. Early-wheezes throughout; serious-quiet iii. s/s clear runny nose, pharyngitis, low grade fever, bronchiolitis-cough 1-2 days, then wheezing; excess mucus production, poor feeding 1. What is the appropriate nursing care for a child with RSV? a. Protect airway b. Supportive treatment i. Supplemental o2, HOB elevated; PO/IV hydration; frequent suctioning; inhaling bronchodilators; frequent airway assessment c. Reduce risk for infection i. Isolation for droplet precautions b. What are priority assessments for patients post tonsillectomy? 1. What is the appropriate post-operative care? a. Promote airway: i. Position: Recovery - side lying or prone; Awake- HOB elevated or sitting ii. Suctioning if needed (don’t use so it doesn’t hit the surgical site) iii. Dry blood on teeth and nare, possible in emesis b. Maintain fluid  i. Continuous swallowing (surgical site might be bleeding) ii. No deep suctioning/straws c. Pain control: Rx/OTC/Ice collar c. What is the treatment for a patient admitted to the hospital with croup? 1. How does the nurse know the treatment is effective? a. Decreased stridor and cough (opens up airway) 2. What are the complications of croup? a. Severe airway obstruction 2. Integumentary Disease: a. What are the assessment findings for a child with tinea capitis (HAIR) (ringworm)? 1. What are the appropriate nursing interventions? a. Hand hygiene, wash sheets, clothes in hot water, antifungal agents (oral griseofulvin, shampoo), no school, daycare for 1 week 2. Which medication will be prescribed? a. mechanism of action, complications, patient education 3. What patient education would you provide to parents? 3. Musculoskeletal Compromise: a. Describe what assessments are necessary for a child with a fracture/cast. i. Odor or drainage, skin irritation, early compromise signs, 5 Ps (pain, pulseness, pallor, paresthesia, paralysis) ii. Peripheral assessment - bilaterally 4. Acute GI Disorders: a. What are the signs of mild, moderate, and severe dehydration?  i. Mild: alert, soft & flat fontanels, normal eyes, pink and moist, elastic skin turgor ii. Moderate: alert - listless, sunken fontanels, mildly sunken orbits, pale and slightly dry mucosa, decreased skin turgor, delayed cap refill iii. Severe: alert - comatose, sunken fontanels, deeply sunken orbits, dry oral mucosa, tenting skin turgor, cool/mottled/significant delayed cap refill b. Describe appropriate rehydration and diet for the dehydrated toddler with diarrhea and vomiting. i. Vomiting: Oral Rehydration (ORS) - Pedialytes; IV fluids for severe dehydration; antiemetics (ondansetron) ii. Diarrhea: ORS, give real food with no dairy 5. Infectious Diseases: a. Describe the signs and symptoms associated with mumps. i. S/S: fever, tiredness, swollen cheeks, tender swollen jaw ii. What are the potential long-term effects of the disease? 1. Deafness, brain swelling, painful & swelling testicles or ovaries