ATI NURSING CARE OT THE CHILD RETAKE

1. Hematological Disorders: Determining Priority Client A. Acute vs. chronic, urgent vs. nonurgent, stable vs. unstable -A client who has an acute problem takes priority over a client who has a chronic problem. -A client who has an urgent need takes priority over a client who has a nonurgent need. -A client who has unstable findings take priority over a client who has stable findings. B. Sickle Cell Anemia- Vaso-occlusive crisis (painful episode) -Acute (related to dehydration and decreased oxygen) -Severe pain, usually in bones, joints, and abdomen -Swollen joints, hands, and feet -Abdominal pain -Hematuria -Obstructive jaundice -Visual disturbances -Chronic -Increase risk of respiratory infections and osteomyelitis -Retinal detachment and blindness -Systolic murmurs -Renal failure and enuresis -Liver cirrhosis; hepatomegaly -Seizures -Skeletal deformities; shoulder or hip avascular necrosis 2. Pediatric Emergencies: Planning Interventions for Lead Exposure -Nursing Actions -Provide prevention measures to families -Routine screening for lead levels at 1, 2, and 3 years of age -Provide case management for children who have elevated lead levels -Make appropriate referrals (community nurse, teacher, early intervention) 3. Acute Neurological Disorders: Findings that Indicate Bacterial Meningitis -CSF analysis indicative of meningitis -Bacterial -Cloudy color -Elevated WBC count -Elevated protein content -Decreased glucose content -Positive Gram stain -Viral -Clear color -Slightly elevated WBC count -Normal or slightly elevated protein content -Normal glucose content -Negative Gram stain 4. Cardiovascular Disorders: Planning Care for a Child Who Has Heart Failure Nursing Care: -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 and nutritional status -Monitor heart rate, blood pressure, blood electrolytes, and kidney function to assess 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 -Decrease workload of the heart -Provide adequate nutrition -Increase tissue oxygenation ..................................................................................................CONTINUE.