Nan Nijjaree
Nursing Care Management
Nursing care of the child with pneumonia primarily supportive and symptomatic but necessitates thorough respiratory assessment and administration of supplemental oxygen (as required) and antibiotics. The child's respiratory rate and status, oxygenation, general disposition, and level of activity are frequently assessed. If the cough is disturbing, the use of anti tussives, especially before rest times and meals, is often helpful To prevent dehydration, fluids are frequently administered ntravenously during the acute phase. Oral fluids, if allowed, are given cautiously to avoid aspiration and to decrease the possi bility of aggravating a fatiguing cough Nursing care of the child with a chest tube requires close attention to respiratory status, as noted previously; the chest tube and drainage device used are monitored for proper func tion e., drainage is not impeded, vacuum setting is correct, tubing is free of kinks, dressing covering chest tube insertion site is intact, water seal is maintained lif used], and chest tube remains in place). Movement in bed and ambulation with chest tube are encouraged according to the child's respiratory status, but children often require mild analgesic such as acetaminophen. If needed, supplemental oxygen may be administered by nasal cannula; newborns may receive oxygen via a plastic hood Children are usually more comfortable in a semierect position but should be allowed to determine the position of comfort. Control fever by cooling the environment and administering antipyretic drugs as prescribed. Temperature is monitored reg ularly to detect a rise that might trigger a febrile seizure. Monitor vital signs and oxygenation to assess the progress of the and to detect early signs of complications Children with ineffectual cough or those with difficulty han tain a patent especially infants, require suctioning to main sufficient for airway. A simple bulb suction s is usually clearing the nares and nasopharynx of infants, but mechanical suction should be readily available if needed. Older children can usually handle secretions without assistance. Postural drainage and CPT are generally prescribed every 4 hours or more often, depending on the child's condition The hospitalized child may be apprehensive, and the treat ments and tests are frightening and stress producing. It is important to involve entire family in the care as appropriate and to encourage questions and facilitate effective commu tion. Reducing the child's anxiety, apprehension, and psycho logic distress leads relaxation and efforts. Easing decreased respiratory respiratory efforts further reduces the child's apprehension. Encouraging the presence of the caregiver pro the child with a source of comfort and support.