A Comprehensive Manual of

Pediatric Nursing Procedures

A Comprehensive Manual of

Pediatric Nursing Procedures

Kavitha K MSc (N) Associate Professor and Head Department of Child Health Nursing BLDEA’s Shri BM Patil Institute of Nursing Sciences Bijapur, Karnataka, India

Foreword

Shalmon S Chopade GA Kshirasagar

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Dedicated to My heavenly parents (Late) Mr S Krishnamoorthy and (Late) Mrs K Savithri

Foreword It is our proud privilege to write this letter of foreword to the unique book of “A Comprehensive Manual of Pediatric Nursing Procedures” written by our young, energetic, and dynamic faculty, Mrs Kavitha K. This book has many unique attributes to its credit. Because, this is the first book from our faculty, Mrs Kavitha K and of our institution also, towards the unique contribution to the growth of nursing professional knowledge. Presently, she is working in our institution as an Associate Professor of Pediatric Nursing. As an individual, she is very dynamic with profound professional knowledge. She has very high concern towards the student community. There was an urgent demand from students to have such a book that certainly helps them in mastering the pediatric nursing techniques. Mrs Kavitha K, as a pediatric faculty for undergraduate and postgraduate, having vast versatile experience in the pediatric nursing field, has understood the problems of the students, and has tried to pour all her years of nursing experience in bringing out this book. There is no doubt that this book is going to be the “Bible” for those students who are pursuing to master the techniques of pediatric nursing procedures. She is an asset to the students and to this institution. Also, we wish her good luck and many more books to contribute for development of the profession and fulfill the deficiency. Shalmon S Chopade

Principal BLDEA's Shri BM Patil Institute of Nursing Sciences Bijapur, Karnataka, India

GA Kshirasagar

Director BLDEA's Shri BM Patil Institute of Nursing Sciences Bijapur, Karnataka, India

Preface The health care of pediatric age group is being delivered in a new service formats and a range of settings. These demand the nurses to equip with thorough knowledge, big attitude and high, level skills in caring this age group. I believe that this manual will help the student nurses of both undergraduate as well as postgraduate and the staff nurses working in pediatric setting to equip with the thorough knowledge and techniques of common pediatric nursing procedures. A sincere effort is made to incorporate the modern trends in pediatric nursing, such as atraumatic care, family centered care, etc. in carrying out the procedures. I hope this manual will serve as a valuable guide to all the nurses, who provide a comprehensive care to the most precious pediatric age group. Kavitha K

Acknowledgments • I pay my humble tribute to Lord Almighty for his showers of blessing in all my endeavors. • I am most grateful to my teachers for sowing a seed of wisdom in me. • I extend my sincere thanks to Professor Shalmon S Chopade, Principal, and Professor GA  Kshirasagar, Director, BLDEA’s Shri BM Patil Institute of Nursing Sciences, Bijapur, Karnataka, India, for their encouragement in completing this manual and writing foreword. • I pay my sincere gratitude to all my family members who stood by me and gave me the most lovable and conducive environment for completing this strenuous task. • My sincere thanks to faculties of Bijapur Liberal District Educational Association’s (BLDEA’s) Shri BM Patil Institute of Nursing Sciences, Bijapur, Karnataka, India, for their support and encouragement. • I extend my sincere thanks to Mr Satish Sagare and Ms Smita Rani, PBBSc (N) students for their valuable help in typing the manuscript. • My sincere thanks to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), and Mr Tarun Duneja (Director-Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for giving me an opportunity to publish this manual. A special thanks to Mr Shantaraju for his guidance and support in successful publication of this manual. • A special thanks to Mr Sireesh S who motivated me to take up this task. • Above all, I am grateful to my beloved husband Mr Basheer Ahamed and my sweet sons Master Md Ehsan and Master Md Arsh for their unconditional love and support in balancing the glorious professional career and most beautiful personal life.

Contents   Chapter 1

Newborn Care

1

Neonatal Resuscitation  1 Newborn Examination  5 Baby Bath  14 Kangaroo Mother Care  18 Radiant Warmer  19 Phototherapy 21 Incubator 24 Apnea Monitor  26

  Chapter 2

Assessment Procedures

28

Admission Procedures  28 History Taking  29 Measurement of Vital Signs  33 Anthropometric Measurement  39 Physical Examination  46 Developmental Assessment  58 Neurological Examination  62 Abdominal Girth  66

  Chapter 3

Assisting in Diagnostic Procedures Collection of Blood Sample (Venipuncture)  67 Arterial Puncture  68 Blood Gas Analysis  70 Capillary Blood Sampling  72 Urine Specimen Collection  74 Stool Specimen Collection  76 Lumbar Puncture  76 Liver Biopsy  79 Kidney Biopsy  80

67

xiv A Comprehensive Manual of Pediatric Nursing Procedures Bone Marrow Aspiration  82 Cardiac Catheterization  83 Electrocardiogram 87 Fine Needle Aspiration  92

  Chapter 4

Meeting Nutritional Needs

94

Assisting in Breastfeeding  94 Cleaning and Sterilization of Feeding Articles  98 Formula Preparation and Artificial Feeding  98 Katori and Spoon Feeding/Paladai Feeding  99 Gavage Feeding  101 Gastrostomy Feeding  103 Total Parenteral Nutrition  105

  Chapter 5

Respiratory Care

109

Steam Inhalation  109 Nebulization 110 Oxygen Therapy  112 Chest Physiotherapy  114 Incentive Spirometry  117

  Chapter 6

Administration of Medications

119

Administration of Medications  119 Oral Medications  121 Intramuscular Injections  124 Intradermal Injection  126 Subcutaneous Administration of Medications  128 Intravenous Therapy  129 Instillation and Topical Application  132

  Chapter 7

Elimination Needs Urinary Catheterization  137 Suprapubic Catheterization  142 Enema 145 Colostomy Care  146 Colonic Irrigation  148 Double Diapering  150

137

Contents   Chapter 8

Emergency Procedures

151

Manual Removal of Foreign Body from Airway  151 Cardiopulmonary Resuscitation  152 Tracheostomy Care  157 Care of Child on Mechanical Ventilation  161 Abdominal Paracentesis  167 Pulse Oximetry  168 Blood Transfusion  171 Exchange Blood Transfusion  176 Gastric Lavage  179 Umbilical Vein Catheterization  181 Thoracentesis 182

  Chapter 9

Safety and Recreation

184

Play Therapy  184 Restraints 187

  Chapter 10 Care of Child with Fracture

193

Traction Care  193 Cast Care  197

  Chapter 11 Care of Child Undergoing Surgery

200

Pre- and Postoperative Nursing Care  200

  Chapter 12 Meeting Children’s Hygiene Needs

204

Oral Hygiene  205 Eye Care  206 Ear Care  206 Bathing 207

Appendix:  Normal Values

209

Index 217

xv

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