Preparation of child for diagnostic procedures

Preparation of the Nurse

The nurse should have good knowledge of the procedure about to be done. Knowledge of what the parents already know and what they told their children about the hospital and the procedures When a child denies knowledge, she/he may be assuming that denial may cancel the procedure

Emphasis on positive outcome

Eg: If you are going to catheterise to obtain a sterile urine sample You can tell a child, We are going to gget a sample of your urine so we can find out why you are feeling sick. DO NOT TELL We are going to take some urine from your body

Timing of Preparation
The initial information should be given by parents at home In hospital the nurse can prepare the parents and the child prior to procedure In case, the parents are allowed to assist the child, prepare them for the acceptance Do not prepare for too long a time the child may get bored.

Verbal Preparation
The words the nurse uses may help the parents and the child understand or get confused. Use concrete terminology. Do not be abstract. Define when a word or term is not understood. Use non threatening terminology to reduce anxiety. Eg.: Tonsils can be treated, repaired or fixed.DO NOT TELL THEM that ur tonsils are going to be cut.

Verbal Preparation
Maintenance of body function is important to children A child on whom ostomy is to be performed can be told, You will be able to have bowel movements. Information about sensations during the procedure is important than where and how the procedure is done. Anxiety producing information, such as an explanation about needles should be given at the END of the explanation Inform that parents WILL be present.

Use of visual aids

It makes verbal explanation more concrete. Role playing the procedure Evaluation of the procedure explanation is

important this stimulates further questions

11.07.2013

Restraints

All infants and children have physiological and psychological needs to be mobile.

Prolonged immobility ===)))))-)-:

Affects respiratory system Peripheral circulation is slowed down Inability to express one self Lack of motor skills exploring, mastering, sharing Lack of comfort Inability to develop body image

Purposes of restraints
For examination To facilitate treatment procedures To protect them from harm

Types of restraints
Jacket restraint Purposes: 1. To keep child in supine position 2. To prevent child from falling from high chair or wheel chair Danger: Strangulation

Mummy restraint

Purpose: to immobilize arms and legs of an infant or a small child for a brief period Indications: head and neck examination /Rx; jugular puncture; insertion of scalp vein needle; gastric gavage/lavage

 Used to hold the elbow in extended position so infant cant reach the face In child with surgery of face & head, eczema or skin disorders, scalp vein needle in place From axilla to wrist Danger: skin excoriation due to friction

Elbow restraint

*Image via Bing

*Image via Bing

Extremity restraint
Used to immobilize one or both the extremities One type CLOVE HITCH restraint

Abdominal restraint
To keep the child in supine position It must be applied loose since it can inhibit the respiratory movements of the abdomen Crib with dome a crib to keep baby who climbs over inside

Nursing diagnosis
Impaired physical mobility related to application of restraints secondary to procedure done Risk for complications related to application of restraints Knowledge deficit related to ignorance regarding restraint application and its purposes

Nursing interventions
Explain the need for restraints to child and parents Demonstrate to a child who can understand on a doll or a stuffed animal Keep talking to the child to provide diversion Sufficient padding Tie to the frame NOT to the rails Check every hour Change position before re-application

Im done