Chapter 39: Pediatric Nursing Interventions & Skills

Pediatric Nursing Interventions & Skills begins with a robust discussion on the legal and ethical requirements of informed consent, noting that while parents or guardians typically provide legal permission, children over the age of seven should be involved in the decision-making process through developmentally appropriate assent. The role of the child life specialist is emphasized as vital for minimizing medical traumatic stress through therapeutic play and psychological preparation tailored to the child’s cognitive stage. Comprehensive surgical care is detailed, including preoperative fasting protocols to prevent aspiration and the urgent recognition of malignant hyperthermia, a life-threatening pharmacogenetic reaction to anesthesia. Safety is a recurring theme, covering environmental protection, fall risk assessments, and infection control via standard and transmission-based precautions. Nursing responsibilities for medication administration are rigorous, requiring precise weight-based or body surface area calculations and the use of "Tall Man" lettering to distinguish look-alike, sound-alike high-alert drugs. Hygiene and skin care protocols utilize assessment tools like the Braden Q Scale to prevent pressure injuries, particularly in critically ill children or those with medical devices. The chapter differentiates between fever and hyperthermia, guiding nurses on the appropriate use of antipyretics versus environmental cooling. Specialized technical skills are outlined, including horizontal and "football" holds for infant transport, the ethical application of restraints, and various specimen collection techniques for blood, urine, and stool. Advanced therapies such as intravenous (IV) management, total parenteral nutrition (TPN), and alternative feeding methods like nasogastric or gastrostomy tubes are discussed, focusing on verifying placement and preventing occlusions. Finally, respiratory interventions are detailed, ranging from oxygen delivery via nasal cannula or masks to complex procedures like tracheostomy care, suctioning, and the monitoring of chest tube drainage systems to maintain pulmonary stability.