Nursing Care of Children Proctored 1
remediation
· Head Injury: Priority Finding to Report for a Brain Tumor - ANSo Care for the client who has a
head injury should include professionals from other disciplines as indicated. These might
include physical, occupational, recreational, and/ or speech therapists.
o Social services should be contacted to provide links to social service agencies and schools.
o Rehabilitation facilities are frequently used to compress the time required to recover from a
head injury.
o Epidural Hematoma
§ Bleeding between the dura and the skull
§ Manifestations
· Short period of unconsciousness followed by a normal period for several hours then lethargy
or coma due to the accumulation of the blood in the epidural space and compression of the
brain
o Subdural hematoma
§ Bleeding between the dura and the arachnoid membrane
§ Might be a result of birth injury, falls, or violent shaking
§ MANIFESTATIONS:
· irritability, vomiting, increased head circumference, lethargy, seizures, coma
o Cerebral Hematoma
§ Can develop within 24 to 72 hr posttrauma
§ Manifestations
· Increased ICP, changes in cerebral flow
o Brain herniation
§ Downward shift of brain tissue
§ Manifestations:
· Loss of blinking, loss of gag reflex. Pupils fail to react to light, systemic hypertension,
bradycardia, coma, and respiratory arrest
· Skin Infections and Infestations: Pediculosis Capitis - ANSo Pediculosis capitis (head lice),
Pediculus humanus capitis, is spread by direct contact with an infected person, bedding, and
objects (e.g., hair brush, clothing). The life span of the adult louse life is 1 month and they can
live up to 48 hr without a human host. The female lays eggs at night, close to the skin surface
and at the junction of the hair shaft. The nits hatch in 7 to 10 days.
o Intense itching
o Small red bumps on the scalp
o Nits (white specks) on the hair shaft
o 1% permethrin shampoo
o Spinosad 0.9% topical suspension
, o Remove nits with a nit comb repeat 7 days after shampoo treatment
o Wash clothing, bedding in hot water with detergent
o Difficult cases use malathion 0.5%
o Teach the child and parents about medications.
o Teach the child and parents to avoid home remedies, as it can worsen infection.
o Teach the parent about correct laundering of potentially infected clothing, bedding.
o Teach the parent to bag items that cannot be laundered into tightly sealed bag for 14 days.
o Teach the parents to boil combs, brushes and hair accessories for 10 min or soak in lice-killing
products for 1 hr.
o Discourage sharing of personal items
· Safe Administration of Medication: Restraining Methods for an Infant - ANSo Oral
§ Hold the infant in a semi reclining position similar to a feeding position
o Injection, intradermal, subcutaneous, intramuscular
§ Secure the infant or child prior to injections
o Intravenous
§ Swaddle
§ Allow parents to hold infant
· Physical Assessment Findings: Assessment of the Head and Neck of an Infant - ANSo Head
§ The shape of the head should be symmetric.
§ Fontanels should be flat. The posterior fontanel usually closes by 6 and 8 weeks of age, and
the anterior fontanel usually closes between 12 and 18 months of age.
o Face
§ Symmetric appearance and movement
§ Proportional features
o Neck
§ Short in infants§ No palpable masses
§ Midline trachea
§ Full range of motion present whether assessed actively or passively
· Health Promotion of Adolescents (12 to 20 Years): Teaching About Healthy Eating - ANSo
Rapid growth and high metabolism require increases in quality nutrients, and make adolescents
unable to tolerate caloric restrictions.
§ During times of rapid growth, additional calcium, iron, protein, and zinc are needed.
§ Inadequate intake of folic acid, vitamin B6, vitamin A, iron, calcium, and zinc is common.
o Overeating and undereating present challenges during the adolescent years.
§ Yearly assessments of height, weight, and BMI for age are needed in order to identify
nutritional issues and intervene early.
o Advise parents to:
§ Avoid using food as a reward.
§ Emphasize physical activity.
§ Ensure that a balanced diet is consumed by following the U.S. Department of Agriculture's
healthy diet recommendations (www.choosemyplate.gov).
remediation
· Head Injury: Priority Finding to Report for a Brain Tumor - ANSo Care for the client who has a
head injury should include professionals from other disciplines as indicated. These might
include physical, occupational, recreational, and/ or speech therapists.
o Social services should be contacted to provide links to social service agencies and schools.
o Rehabilitation facilities are frequently used to compress the time required to recover from a
head injury.
o Epidural Hematoma
§ Bleeding between the dura and the skull
§ Manifestations
· Short period of unconsciousness followed by a normal period for several hours then lethargy
or coma due to the accumulation of the blood in the epidural space and compression of the
brain
o Subdural hematoma
§ Bleeding between the dura and the arachnoid membrane
§ Might be a result of birth injury, falls, or violent shaking
§ MANIFESTATIONS:
· irritability, vomiting, increased head circumference, lethargy, seizures, coma
o Cerebral Hematoma
§ Can develop within 24 to 72 hr posttrauma
§ Manifestations
· Increased ICP, changes in cerebral flow
o Brain herniation
§ Downward shift of brain tissue
§ Manifestations:
· Loss of blinking, loss of gag reflex. Pupils fail to react to light, systemic hypertension,
bradycardia, coma, and respiratory arrest
· Skin Infections and Infestations: Pediculosis Capitis - ANSo Pediculosis capitis (head lice),
Pediculus humanus capitis, is spread by direct contact with an infected person, bedding, and
objects (e.g., hair brush, clothing). The life span of the adult louse life is 1 month and they can
live up to 48 hr without a human host. The female lays eggs at night, close to the skin surface
and at the junction of the hair shaft. The nits hatch in 7 to 10 days.
o Intense itching
o Small red bumps on the scalp
o Nits (white specks) on the hair shaft
o 1% permethrin shampoo
o Spinosad 0.9% topical suspension
, o Remove nits with a nit comb repeat 7 days after shampoo treatment
o Wash clothing, bedding in hot water with detergent
o Difficult cases use malathion 0.5%
o Teach the child and parents about medications.
o Teach the child and parents to avoid home remedies, as it can worsen infection.
o Teach the parent about correct laundering of potentially infected clothing, bedding.
o Teach the parent to bag items that cannot be laundered into tightly sealed bag for 14 days.
o Teach the parents to boil combs, brushes and hair accessories for 10 min or soak in lice-killing
products for 1 hr.
o Discourage sharing of personal items
· Safe Administration of Medication: Restraining Methods for an Infant - ANSo Oral
§ Hold the infant in a semi reclining position similar to a feeding position
o Injection, intradermal, subcutaneous, intramuscular
§ Secure the infant or child prior to injections
o Intravenous
§ Swaddle
§ Allow parents to hold infant
· Physical Assessment Findings: Assessment of the Head and Neck of an Infant - ANSo Head
§ The shape of the head should be symmetric.
§ Fontanels should be flat. The posterior fontanel usually closes by 6 and 8 weeks of age, and
the anterior fontanel usually closes between 12 and 18 months of age.
o Face
§ Symmetric appearance and movement
§ Proportional features
o Neck
§ Short in infants§ No palpable masses
§ Midline trachea
§ Full range of motion present whether assessed actively or passively
· Health Promotion of Adolescents (12 to 20 Years): Teaching About Healthy Eating - ANSo
Rapid growth and high metabolism require increases in quality nutrients, and make adolescents
unable to tolerate caloric restrictions.
§ During times of rapid growth, additional calcium, iron, protein, and zinc are needed.
§ Inadequate intake of folic acid, vitamin B6, vitamin A, iron, calcium, and zinc is common.
o Overeating and undereating present challenges during the adolescent years.
§ Yearly assessments of height, weight, and BMI for age are needed in order to identify
nutritional issues and intervene early.
o Advise parents to:
§ Avoid using food as a reward.
§ Emphasize physical activity.
§ Ensure that a balanced diet is consumed by following the U.S. Department of Agriculture's
healthy diet recommendations (www.choosemyplate.gov).
