Nursing Care Management
Nursing care of the child with pneumonia is primarily supportive and symptomatic but necessitates thorough respiratory as sessment and administration of oxygen and antibiotics. The childs respiratory rate and status, as well as general disposition and level of activity, are frequently assessed. Isolation procedures are insthtuted according to hospital policy; rest and conservation of energy are encouraged by the relief of physical and psychologic stress. The child is disturbed as little as possible by clustering care to fostes regular sleep cycle. If the cough is disturbing, the use of antitussives, especially before rest times and meals, is often helpfulnld prevent dehydration, fluids are frequently administered during the acute phase. Oral fluids, if allowed, are given cautiously to avoid aspiration and to decrease the possibility of aggravating a fatiguing cough.
Of needed, supplemental oxygen may be administered by nasal cannula or, rarely, via a mist tent; newborns may receive oxygen via a plastic head hood. Children are usually more comfortable in a semierect position but should be allowed to determine the position of comfort. Lying on the affected side (if pneumonia is)
Atraumatic Care
thoracentesis or Placement of Chest Tube
To reduce the pain of the needle or incision, local anesthesia should be administered with buffered lidocaine and EMLA cream (a mix of
Iidocaine and prilocaine) or LMX4 (lidocaine 4%) Appropriate sedation should also be provided because this is a painful procedure.
Unilateral splints the chest on that side and reduces the pleural rubbing that often causes discomfort. Fever is controlled by the cool environment and administration of antipyretic drugs as prescribed . Temperature is monitored regularly to detect a rise that night trigger a febrile seizure.
Vital signs and oxygenation are to detect early signs of complications. Children with disease and to detect early signs of complications. Children with ineffectual cough or those with difficulty handling secretions, especially infants, require suctioning to maintain a patent airway. A simple bulb suction syringe is usually suctioning for 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 be apprehensive and the treatments and tests are frightening and stress producing . it is important to involve the entire family in the care as appropriate and to encourage questions and facilitate effective communication. Reducing anxiety and apprehension reduces psychologic distress in the child and when the child is more relaxed the respiratory efforts forts are lessened . Easing respiratory efforts makes the child less apprehensive and encouraging the presence of the caregiver provides the child with a source of comfort and support.