ATI nursing care of children
1. Mebendazole, albendazole, and pyrantel pamoate: Indicated for Enterobius
vermicularis (pinworms)
● Administer in a single dose that can need to be repeated in 2 weeks. ●
Administer mebendazole for children older than 2 years of age. CLIENT
EDUCATION: Entire family should be treated at the same time.
2. Ventricular septal defect (VSD) (20.1)
A hole in the septum between the right and left ventricle that results in increased
pulmonary blood flow (left-to-right shunt)
● Loud, harsh murmur auscultated at the left sternal border
● Heart failure
● Many VSDs close spontaneously
- weight patient daily, a 4 lbs weight gain indicates increased fluid and worsening of
the child’s heart failure; therefore, the nurse should report this finding to the provider.
3. Peak expiratory flow meter:
- Slide the arrow down to “zero.”
- Stand up straight.
- Take a deep breath and close the lips tightly around the mouthpiece.
- Blow out hard and fast.
- Note the number the arrow moves to.
- Repeat three times and record the highest reading.
- Keep a record of daily readings, being sure to measure peak flow at the same time each day.
4. Using eardrop for acute otitis media, massage the anterior area of the infant’s ear
following administration to facilitate instillation of the medication.
5. 2-year-old toddler should consume 1,000 cal, 2 oz of protein, 24 oz of milk, 8 oz of
vegetable daily.
6. Immunization against common childhood illnesses, including the influenza and
pneumococcal disease, is recommended for all children exposed to an infected with HIV.
7. Nephrotic syndrome: Peak incidence is between 2 and 3 years of age
● Provide rest.
● Monitor I&O. Monitor urine for protein.
● Monitor vital signs.
● Monitor daily weights
● Monitor edema and measure abdominal girth daily.
● Assess degree of pitting, color, and texture of skin.
● Monitor and prevent infection.
◯ Assist the client to turn, cough, and deep breathe to prevent pulmonary involvement.
◯ Monitor vital signs, especially temperature, for changes secondary to infection.
◯ Maintain good hand hygiene.
◯ Administer antibiotic therapy as prescribed.
● Encourage nutritional intake within restriction guidelines. Salt can be restricted
during the edematous phase.
, ● Cluster care to provide for rest periods.
● Assess skin for breakdown areas.
8. Celiac disease also known as celiac sprue, is an immunologic disorder in which gluten, a
product most commonly found in grains, causes damage to the small intestine. The child
must adhere to a strict gluten-free diet for his or her entire life. This is often very
challenging, because gluten is found in most wheat products, rye, barley, plain flour pastry,
and possibly oats. Encourage the parents and child to maintain this gluten-free diet.
9. Gastroesophageal reflux (GER) occurs when gastric contents reflux back up into
the esophagus, making esophageal mucosa vulnerable to injury from gastric acid
and resulting in gastroesophageal reflux disease (GERD).
GER
● Offer small, frequent meals.
● Thicken infants formula with 1 tsp to 1 tbsp rice cereal per 1 oz formula.
● Avoid foods that cause reflux (caffeine, citrus, peppermint, spicy or fried
foods). ● Assist with weight control.
● Position the child with the head elevated after meals.
● Position prone with extreme caution; supine is still the recommended position
GERD: Initiate interventions for GER, plus administering a proton pump inhibitor
such as omeprazole, esomeprazole,
pantoprazole and rabeprazole, or an H2-receptor antagonist such as ranitidine,
cimetidine, or famotidine.
10. Chemotherapy:
●Teach the family to recognize manifestations of infection, skin breakdown, and
nutritional deficiency. Monitor the child for increased temperature.
● Encourage the child and family to maintain good hygiene.
● Instruct the family in the proper use of vascular access devices.
● Instruct the child and family about bleeding precautions and management of active
bleeding if a child has a low platelet level.
11. Cystic fibrosis page 118
Gastrointestinal management
● Provide a well-balanced diet high in protein and
calories. ● Give three meals a day with snacks.
● Encourage oral fluid intake.
● Administer pancreatic enzymes within 30 min of eating a meal or snack.
● Administer vitamin supplements: multivitamin; vitamins A, D, E, and K.
● Administer laxatives or stool softeners for constipation. Polyethylene-glycol
electrolyte solution is administered orally or via nasogastric tube.
● Administer histamine-receptor antagonist and motility medications for GERD.
● Administer possible formula supplements in addition to breastfeeding or via
gastric tube. ● Consult a dietitian.
1. Mebendazole, albendazole, and pyrantel pamoate: Indicated for Enterobius
vermicularis (pinworms)
● Administer in a single dose that can need to be repeated in 2 weeks. ●
Administer mebendazole for children older than 2 years of age. CLIENT
EDUCATION: Entire family should be treated at the same time.
2. Ventricular septal defect (VSD) (20.1)
A hole in the septum between the right and left ventricle that results in increased
pulmonary blood flow (left-to-right shunt)
● Loud, harsh murmur auscultated at the left sternal border
● Heart failure
● Many VSDs close spontaneously
- weight patient daily, a 4 lbs weight gain indicates increased fluid and worsening of
the child’s heart failure; therefore, the nurse should report this finding to the provider.
3. Peak expiratory flow meter:
- Slide the arrow down to “zero.”
- Stand up straight.
- Take a deep breath and close the lips tightly around the mouthpiece.
- Blow out hard and fast.
- Note the number the arrow moves to.
- Repeat three times and record the highest reading.
- Keep a record of daily readings, being sure to measure peak flow at the same time each day.
4. Using eardrop for acute otitis media, massage the anterior area of the infant’s ear
following administration to facilitate instillation of the medication.
5. 2-year-old toddler should consume 1,000 cal, 2 oz of protein, 24 oz of milk, 8 oz of
vegetable daily.
6. Immunization against common childhood illnesses, including the influenza and
pneumococcal disease, is recommended for all children exposed to an infected with HIV.
7. Nephrotic syndrome: Peak incidence is between 2 and 3 years of age
● Provide rest.
● Monitor I&O. Monitor urine for protein.
● Monitor vital signs.
● Monitor daily weights
● Monitor edema and measure abdominal girth daily.
● Assess degree of pitting, color, and texture of skin.
● Monitor and prevent infection.
◯ Assist the client to turn, cough, and deep breathe to prevent pulmonary involvement.
◯ Monitor vital signs, especially temperature, for changes secondary to infection.
◯ Maintain good hand hygiene.
◯ Administer antibiotic therapy as prescribed.
● Encourage nutritional intake within restriction guidelines. Salt can be restricted
during the edematous phase.
, ● Cluster care to provide for rest periods.
● Assess skin for breakdown areas.
8. Celiac disease also known as celiac sprue, is an immunologic disorder in which gluten, a
product most commonly found in grains, causes damage to the small intestine. The child
must adhere to a strict gluten-free diet for his or her entire life. This is often very
challenging, because gluten is found in most wheat products, rye, barley, plain flour pastry,
and possibly oats. Encourage the parents and child to maintain this gluten-free diet.
9. Gastroesophageal reflux (GER) occurs when gastric contents reflux back up into
the esophagus, making esophageal mucosa vulnerable to injury from gastric acid
and resulting in gastroesophageal reflux disease (GERD).
GER
● Offer small, frequent meals.
● Thicken infants formula with 1 tsp to 1 tbsp rice cereal per 1 oz formula.
● Avoid foods that cause reflux (caffeine, citrus, peppermint, spicy or fried
foods). ● Assist with weight control.
● Position the child with the head elevated after meals.
● Position prone with extreme caution; supine is still the recommended position
GERD: Initiate interventions for GER, plus administering a proton pump inhibitor
such as omeprazole, esomeprazole,
pantoprazole and rabeprazole, or an H2-receptor antagonist such as ranitidine,
cimetidine, or famotidine.
10. Chemotherapy:
●Teach the family to recognize manifestations of infection, skin breakdown, and
nutritional deficiency. Monitor the child for increased temperature.
● Encourage the child and family to maintain good hygiene.
● Instruct the family in the proper use of vascular access devices.
● Instruct the child and family about bleeding precautions and management of active
bleeding if a child has a low platelet level.
11. Cystic fibrosis page 118
Gastrointestinal management
● Provide a well-balanced diet high in protein and
calories. ● Give three meals a day with snacks.
● Encourage oral fluid intake.
● Administer pancreatic enzymes within 30 min of eating a meal or snack.
● Administer vitamin supplements: multivitamin; vitamins A, D, E, and K.
● Administer laxatives or stool softeners for constipation. Polyethylene-glycol
electrolyte solution is administered orally or via nasogastric tube.
● Administer histamine-receptor antagonist and motility medications for GERD.
● Administer possible formula supplements in addition to breastfeeding or via
gastric tube. ● Consult a dietitian.
