Nursing Care of Children ATI Outline//Nursing Care of Children ATI Outline

BASIC CARE AND COMFORT Acute Infectious Gastrointestinal Disorders: Manifestations of Dehydration ● Dehydration is a body fluid disturbance when the output exceeds intake. It results from many causes such as fluid losses through the skin, respiratory tract, urinary tract, or GI tract. ◯ Nursing Actions ■ Oral rehydration is attempted first for mild and moderate cases of dehydration. Mild: 50 mL/kg rehydration fluid every 4 to 6 hr Moderate: 100 mL/kg rehydration fluid every 4 to 6 hr Replacement of diarrhea losses with 10 mL/kg each stool ■ Monitor parenteral fluid therapy as prescribed. Implemented when a child is unable to drink enough oral fluids to correct fluid losses, and those who have severe dehydration or continued vomiting. Isotonic solution at 20 mL/kg IV bolus with possible repeat for isotonic and hypotonic dehydration. Hypertonic dehydration – Rapid fluid replacement is contraindicated because of the risk of cerebral edema. Administer maintenance IV fluids as prescribed. Avoid potassium replacement until kidney function is verified. Cardiovascular and Hematologic Disorders: Appropriate Diet for a Client who has Iron Deficiency Anemia ■ Dietary sources of iron Infants – iron-fortified cereals and formula Older children – dried beans and lentils; peanut butter; green, leafy vegetables; iron-fortified breads and flour; poultry; and red meat Cardiovascular Disorders: Nutritional Needs of Infants who have Heart Failure Encourage the child to eat foods high in potassium, such as bran cereals, potatoes, tomatoes, bananas, melons, oranges, and orange juice. Cardiovascular Disorders: Planning Care for an Infant who has Heart Failure ● Nursing Care ◯ General Interventions ■ Remain calm when providing care. ■ Keep the child well-hydrated. ■ Conserve the child’s energy by providing frequent rest periods; clustering care; providing small, frequent meals; bathing PRN; and keeping crying to a minimum in cyanotic children. ■ Perform daily weight and I&O to monitor fluid status and nutritional status. ■ Monitor heart rate, blood pressure, serum electrolytes, and renal function for complications. ■ Provide support and resources for parents to promote developmental growth in the child. ■ Monitor family coping and provide support. ■ Administer prescribed medications. ■ Maintain fluid and electrolyte balance. Administer potassium supplements if prescribed. These might not be indicated if the child is concurrently taking an ACE inhibitor. Maintain sodium and fluid restrictions if prescribed. 1 ■ Decrease workload of the heart. Maintain bed rest. Position the infant in a car seat or hold at a 45° angle. Keep safety restraints low and loose on the abdomen. Allow the child to sleep with several pillows and encourage a semi-Fowler’s or Fowler’s position while awake. ■ Provide for adequate nutrition. Plan to feed the infant using a feeding schedule of every 3 hr. The infant should be rested, which occurs soon after awakening. Use a soft preemie nipple or a regular nipple with a slit to provide an enlarged opening. Hold the infant in a semi-upright position. Allow the infant to rest during feedings, taking approximately 30 min to complete the feeding Gavage feed the infant if he is unable to consume enough formula or breast milk. Increase caloric density of formula gradually from 20 to 30 kcal/oz. Encourage mothers who are breastfeeding to alternate feedings with high-density formula or fortified breast milk. ■ Increase tissue oxygenation. Provide cool, humidified oxygen via an oxygen hood (or tent), mask, or nasal cannula. Suction the airway as indicated. Monitor oxygen saturation every 2 to 4 hr. Diabetes Mellitus: Evaluating Understanding of Diabetes Mellitus Dietary Management ◯ Provide nutritional guidelines. ■ Read labels for nutritional value. ■ Meal planning is based on the requirements of growth and development of the child. ■ Plan meals to achieve appropriate timing of food intake, activity, onset, and peak of insulin. Calories and food composition should be similar each day. ■ Eat at regular inte