Question

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please use your text book “Maternal child nursing care” as your primary resource to answer there question

1. A 5 year old boy is being admitted to your unit. The physician has ordered IV fluids along with lab work including a CBC, electrolytes, and urine culture. As his nurse, how will you prepare him and his family before the procedure and support them during and after the procedure, to promote best outcome and to ensure atraumatic care?

2. What is included in a CBC? What test would be ordered to reveal electrolytes?

3. An 8 year old is admitted to your unit. Please describe the steps the nurse should take to provide health care teaching to this child.

4. How do children sometimes express fear?

Answer 1

1)Provide a traumatic care is the basic principle in pediatric nursing.the nurse should should ensure that she minimizes the extent of psychological and physiological trauma to the patient .which can be achieved by using excellent communication,playfull method of doing a procedure .Now for this patient who is 5 year old the physician has ordered IV fluids,lab investigations,and urine culture.So the nurse should first explain the procedure involved to the parents which will relieve their anxiety .You should explain the time taken for the entire procedure .You can show them a video of the procedure that the child will be undergoing.The child can be taken to a procedure room. Along with the presence of parents and the child can be placed comfortably on the parents lap or bed.The nurse has to plan in such a way that through the IV cannula which she will be inserting she should also collect the blood for investigations which can reduce the second prick.The nurse who is inserting should be competent and confident to put in a line in single prick.care should be taken that the nurse collects all the required bulbs for investigations and takes adequate amount of blood to prevent further pricks the nurse should playfully approach the child using a rhymes,a story and deviate the attention of the child during procedure.Some children have phobia to white dresses which resembles doctors or nurses so it's better to have uniforms with pink or light blue colour which reduces the fear in them.For a sterile urine culture collection the nurse has to explain the parents that a mid stream urine is required which means that the child should be asked to pass urine while you keep the culture container ready after after few second of the child passing urine the sample can be collected which is midstream urine.The nurse should instruct the parents to clean the genitals with lukewarm water and soap prior to collection of sample .once the procedure is over the child can be taken to a play room or TV room where the child can be relaxed .This can help nurse to provide atraumatic care.The sample should be sent immediately to the lab for processing to avoid hemolysis and need for repeat sample .

2)CBC is complete blood count which gives us details of all the blood components like RBC, hematocrit,WBC,Platelets,Hb,differential cell counts.It is collected in EDTA bulb approximately 3ml is required.Electrolyte investigations are serum potassium, sodium,calcium,magnesium,phosphorus which is collected in plain bulb. A complete body profile can also reveal all the electrolytes.

3) patient and family education is important to provide a continuity of care once discharged so for a 8 year old child the child belong to school going category .The nurse should first assess the child's disease,treatment modalities and educational needs .for example a child withe juvenile diabetes is getting discharged so the nurse have to educate the child on regular medications,insulin adminstration,diet, exercise and regular blood glucose monitoring.She should also assess the child's present knowledge, understanding capability.once she does an overall assessment.She should involve the parents and children for education.in an identified location for education which should be a separate room away from the hustle of ward,telephone calls.She should educate the child using audio visual aids by using charts,videos in insulin Adminstration.She can give practice,demos and redemos to the child and parents.Tge nurse can do role plays,skits,on ills effects of fast foods,lack of exercise which will sensitize the child and parents .Overall the child health education should be fun filled,short and Effective.

4)children express fear multiple ways few ways are

Crying

Being silent

Being aloof or separated from the activitiesfacial grimaces of disinterest,sadness,anxiety.

Being aggressive , irritated, agitated.

Displaying signs of chocking, breathlessness

Sudden physiological changes like hysteria

All these are the ways children express their fears and anxiety.