NURSING CARE OF
CHILDREN ATI
Acute Otitis Media: Appropriate Instillation of Ear Drops - ◯
Benzocaine (Americaine Otic)
■ Ear drops for topical pain relief
■ Client Education
☐ Reinforce teaching to the family on appropriately administering ear
drops.
☐ Discourage the use of decongestants or antihistamines.
Airflow Disorders: Inhaled Corticosteroid - ■ Combination medications
☐ Fluticasone/salmeterol (Advair)
☐ Inhaled corticosteroid/long-acting beta2-agonist)
■ Nursing Considerations
☐ Observe oral mucosa for infection secondary to use of inhaled
medication.
☐ Monitor weight, blood pressure, electrolytes, glucose, and growth
with oral corticosteroid use
,Asthma: Evaluating Teaching about Inhaler - ■ Instruct the child how to
use a peak flow meter.
☐ Use same time each day.
☐ Ensure the marker is zeroed.
☐ Stand up straight.
☐ Close lips tightly around the mouthpiece (ensure the tongue is not
occluding).
☐ Blow out as hard and as quickly as possible.
☐ Read the number on the meter.
☐ Repeat two more times (wait at least 30 seconds between attempts).
☐ Record highest number.
■ Instruct the child and family how to recognize an asthma exacerbation.
■ Inform the child and family about when to use each of the prescribed
medications (rescue vs. maintenance medications).
■ Instruct the child how to properly self-administer medications
(nebulizers, inhalers, and spacer).
■ Educate the child and family regarding infection prevention
techniques.
☐ Promote good nutrition.
☐ Reinforce importance of good hand hygiene
Asthma: Evaluating Understanding of Inhaled Medications - ☐ Observe
oral mucosa for infection secondary to use of inhaled medication.
,☐ Monitor weight, blood pressure, electrolytes, glucose, and growth
with oral corticosteroid use
Asthma: Reinforcing Medication Teaching - ■ Stress the importance of
keeping immunizations, including seasonal influenza and pneumonia
vaccines, up to date.
■ Encourage regular exercise as part of asthma therapy.
☐ Promotes ventilation and perfusion
☐ Maintains cardiac health
☐ Enhances skeletal muscle strength
■ Children can require medication before exercise
Asthma: Reinforcing Teaching about a Beta2-Adrenergic Agonist -
Administer three nebulizer treatments of a beta2-agonist 20 to 30 min
apart or continuously. Ipratropium bromide can be added to the nebulizer
to increase bronchodilation.
Care of the Child in Traction: Balanced suspension traction - suspends
the leg in a flexed position. The hip and hamstring muscles are relaxed.
Care of the Child in Traction: Halo traction - uses a halo-type bar that
encircles the head. Screws are inserted into the outer table of the skull.
The halo is attached to either bed traction or rods that are secured to a
vest worn by the client.
, Care of the Child in Traction: Nursing Actions - ☐ Maintain body
alignment.
☐ Provide pharmacological and nonpharmacological interventions for
the management of pain and muscle spasms.
☐ Notify the provider if the client experiences severe pain from muscle
spasms that is unrelieved with medications and/or repositioning.
☐ Monitor neurovascular status.
☐ Routinely monitor the client's skin integrity and document findings.
☐ Inspect pin sites for pain, redness, swelling, drainage, or odor. Provide
pin care per facility protocol.
☐ Check for changes in elimination, and maintain usual patterns of
elimination.
☐ Ensure that all the hardware is tight and that the bed is in the correct
position.
☐ Maintain weights so that they hang freely and the ropes are free of
knots. Do not lift or remove weights unless prescribed and supervised by
the provider.
☐ Ensure that the wrench to release the rods is attached to the vest when
using halo traction in the event that CPR is necessary.
☐ Move the client in halo traction as a unit without applying pressure to
the rods. This will prevent loosening of the pins and pain.
☐ Consult with the provider for an overbed trapeze to assist the client to
move in bed.
☐ Provide range of motion and encourage activity of nonimmobilized
extremities to maintain mobility and prevent contractures.
CHILDREN ATI
Acute Otitis Media: Appropriate Instillation of Ear Drops - ◯
Benzocaine (Americaine Otic)
■ Ear drops for topical pain relief
■ Client Education
☐ Reinforce teaching to the family on appropriately administering ear
drops.
☐ Discourage the use of decongestants or antihistamines.
Airflow Disorders: Inhaled Corticosteroid - ■ Combination medications
☐ Fluticasone/salmeterol (Advair)
☐ Inhaled corticosteroid/long-acting beta2-agonist)
■ Nursing Considerations
☐ Observe oral mucosa for infection secondary to use of inhaled
medication.
☐ Monitor weight, blood pressure, electrolytes, glucose, and growth
with oral corticosteroid use
,Asthma: Evaluating Teaching about Inhaler - ■ Instruct the child how to
use a peak flow meter.
☐ Use same time each day.
☐ Ensure the marker is zeroed.
☐ Stand up straight.
☐ Close lips tightly around the mouthpiece (ensure the tongue is not
occluding).
☐ Blow out as hard and as quickly as possible.
☐ Read the number on the meter.
☐ Repeat two more times (wait at least 30 seconds between attempts).
☐ Record highest number.
■ Instruct the child and family how to recognize an asthma exacerbation.
■ Inform the child and family about when to use each of the prescribed
medications (rescue vs. maintenance medications).
■ Instruct the child how to properly self-administer medications
(nebulizers, inhalers, and spacer).
■ Educate the child and family regarding infection prevention
techniques.
☐ Promote good nutrition.
☐ Reinforce importance of good hand hygiene
Asthma: Evaluating Understanding of Inhaled Medications - ☐ Observe
oral mucosa for infection secondary to use of inhaled medication.
,☐ Monitor weight, blood pressure, electrolytes, glucose, and growth
with oral corticosteroid use
Asthma: Reinforcing Medication Teaching - ■ Stress the importance of
keeping immunizations, including seasonal influenza and pneumonia
vaccines, up to date.
■ Encourage regular exercise as part of asthma therapy.
☐ Promotes ventilation and perfusion
☐ Maintains cardiac health
☐ Enhances skeletal muscle strength
■ Children can require medication before exercise
Asthma: Reinforcing Teaching about a Beta2-Adrenergic Agonist -
Administer three nebulizer treatments of a beta2-agonist 20 to 30 min
apart or continuously. Ipratropium bromide can be added to the nebulizer
to increase bronchodilation.
Care of the Child in Traction: Balanced suspension traction - suspends
the leg in a flexed position. The hip and hamstring muscles are relaxed.
Care of the Child in Traction: Halo traction - uses a halo-type bar that
encircles the head. Screws are inserted into the outer table of the skull.
The halo is attached to either bed traction or rods that are secured to a
vest worn by the client.
, Care of the Child in Traction: Nursing Actions - ☐ Maintain body
alignment.
☐ Provide pharmacological and nonpharmacological interventions for
the management of pain and muscle spasms.
☐ Notify the provider if the client experiences severe pain from muscle
spasms that is unrelieved with medications and/or repositioning.
☐ Monitor neurovascular status.
☐ Routinely monitor the client's skin integrity and document findings.
☐ Inspect pin sites for pain, redness, swelling, drainage, or odor. Provide
pin care per facility protocol.
☐ Check for changes in elimination, and maintain usual patterns of
elimination.
☐ Ensure that all the hardware is tight and that the bed is in the correct
position.
☐ Maintain weights so that they hang freely and the ropes are free of
knots. Do not lift or remove weights unless prescribed and supervised by
the provider.
☐ Ensure that the wrench to release the rods is attached to the vest when
using halo traction in the event that CPR is necessary.
☐ Move the client in halo traction as a unit without applying pressure to
the rods. This will prevent loosening of the pins and pain.
☐ Consult with the provider for an overbed trapeze to assist the client to
move in bed.
☐ Provide range of motion and encourage activity of nonimmobilized
extremities to maintain mobility and prevent contractures.
