Chapter 37: Diagnostic & Therapeutic Procedures in Children

Central to this care is applying the nursing process, which involves assessing the child's developmental stage and knowledge level before beginning procedures,formulating relevant nursing diagnoses such as fear or injury risk, and implementing care based on QSEN competencies like patient-centered care, safety, and evidence-based practice,. Essential nursing responsibilities include confirming informed consent or assent is obtained for invasive procedures,explaining procedures using age-appropriate language while avoiding confusing terminology,and providing robust physical and psychological preparation, often through the use of anxiolytics or moderate sedation for painful or complex tests like bronchoscopy or magnetic resonance imaging (MRI),. The text details modifications needed for specific age groups, emphasizing minimal invasive procedures for infants to maintain trust, short, simple explanations for toddlers and preschoolers, and involving older children in their care when possible. Detailed methodologies for various procedures are explored, including accurate measurement of vital signs (temperature, pulse rate, blood pressure, and oxygen saturation),managing elevated temperatures with antipyretics like acetaminophen or ibuprofen, and ensuring safety protocols, such as proper patient identification and using the least restrictive restraints when necessary,. Diagnostic techniques covered range from electrical impulse studies and flat-plate X-rays to advanced imaging like computed tomography (CT) and MRI, as well as noninvasive ultrasound and nuclear medicine scans,. The chapter provides specific techniques for collecting specimens such as blood (venipuncture and capillary puncture),and urine (routine, clean-catch, 24-hour collection, and suprapubic aspiration),along with guidance for providing ostomy care and administering enemas,. Finally, critical nutritional support modalities are addressed, including enteral (gavage) feedings and total parenteral nutrition (TPN) via central venous access for children with malabsorption issues,highlighting the need for continual monitoring and the importance of supporting the child's psychological needs surrounding the lack of oral intake.