Perioperative Care of the Child: A Nursing Manual / Edition 1

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Overview

Edited by well-known and highly-regarded children's nurse Linda Shields, Perioperative Care of the Child is an essential resource for any children's nurse working in a perioperative setting and all student nurses on the child branch. This timely and valuable text provides comprehensive coverage of the essential skills and knowledge required by practitioners in order to deliver safe and effective perioperative nursing care for the child requiring surgery before, during and after any operation.

Perioperative Care of the Child explores the role of the nurse in a wide variety of perioperative contexts, including anaesthetics, surgical procedures (including coverage of fetal surgery, endoscopic procedures and care of children with burns), paediatric transplantation, postoperative recovery, and pre- and post hospital care. This essential resource benefits from an international perspective with contributions from experienced and highly-specialised clinicians from around the world.

Essential reading for children's and perioperative nurses, and others who work in the perioperative area.

Evidence-based, with clear links to nursing practice.

Focuses on key skills and knowledge.

Emphasises patient-centred care.

Edited by an internationally-regarded children's nurse

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Editorial Reviews

From the Publisher
"This book offers not only an excellent introduction for the new pediatric nurse but also a good review for the experienced nurse." (AORN Journal, October 2010)
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Product Details

  • ISBN-13: 9781405155953
  • Publisher: Wiley, John & Sons, Incorporated
  • Publication date: 12/30/2009
  • Edition number: 1
  • Pages: 288
  • Sales rank: 1,127,316
  • Product dimensions: 6.80 (w) x 9.65 (h) x 0.70 (d)

Meet the Author

Linda Shields is Professor of Nursing at the Faculty of Health and Social Care, University of Hull
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Table of Contents

Contributors ix

Introduction xi

Acknowledgements xiii

Abbreviations xiv

1 The history of children's perioperative care Jeremy Jolley 1

Why history is important 1

What is perioperative nursing? 1

A brief history of perioperative nursing 2

An overview of the history of surgery 3

The development of perioperative nursing 5

Key discoveries in perioperative care 6

Early beginnings of surgery for children 7

The growth of paediatric surgery 9

Conclusion: perioperative nursing of children 10

References 11

2 The psychosocial care of children in the perioperative area Linda Shields 13

Children's perceptions of the operating theatre 13

The effect of hospitalisation on children 14

Models of care 16

The presence of parents 19

Play in the operating theatre suite 20

Emotional, social and spiritual needs of the patient 20

Conclusion 21

References 21

3 Care of the child in the operating room Linda Shields Ann Tanner 23

Preparation of children for theatre 23

Admission prior to surgery 24

Observation 25

Weight 25

Surgical history 25

Medical history 25

Medications 27

Body/site preparation 27

Pre-admission clinic 27

Emergency admission 28

Day of surgery admission 29

Reception in the operating suite 30

Registration on entrance to the OR 31

Fasting 31

Other things to check on admission to the OR 32

Safety of children in the operating theatre 33

Specific safety issues for children during induction 33

Post anaesthetic/post operative 34

Standing orders 36

Conclusion 37

References 37

4 Nursing care and management of children's perioperative pain Bernie Carter Denise Jonas 39

Introduction 39

Preparing and teachingchildren and parents about pain 41

Agency, education and training of health care professionals 42

Assessing children's pain 43

Core approaches to pain assessment 44

What tools to consider using with particular groups of children 46

Non-pharmacological interventions 46

Overview of pharmacological intervention 47

Routes of administration 48

Other local anaesthetic infusions 55

Discharge home 55

Conclusion 56

References 56

5 Surgical procedures on children Linda Shields Ann Tanner 66

Introduction 66

Common surgical procedures performed on children 66

Acknowledgement 96

References 96

6 Day surgery for children Ann Tanner 101

Day procedure centres 101

Pre-admission preparation 105

Admission to the day procedure centre: preparations for surgery 105

Compartment syndrome 112

Admission to theatre 112

Ward stage recovery: post-operative care 113

Conclusion: support at home 116

References 116

7 Anaesthesia in children Wendy McAlister 119

Introduction: What is anaesthesia? 119

The anaesthetic nurse 119

Children undergoing anaesthesia 120

Anaesthetic equipment 121

Airways 124

Anaesthesia 127

Analgesia 130

Patient preparation 130

Fasting 130

Premedication 131

Loose teeth and nail polish 131

Hearing aids and glasses 132

Jewellery 132

Preparation prior to patient arrival 132

Patient arrival in theatre 133

Induction 133

Rapid sequence induction 135

Fluids 135

Monitoring 135

Documentation 136

Anaesthetic emergencies 136

Anaphylaxis 138

Suxamethonium apnoea 138

Malignant hyperthermia 139

Emergence 139

Regional anaesthesia 140

References 141

8 The paediatric post-anaesthetic care unit Eunice Hanisch 144

Introduction 144

In the PPACU 144

The post-operative environment 147

Oxygen delivery 149

Suction 151

Physiological assessment and management of the paediatric post-anaesthesia patient 151

A - Airway management and B - Breaihing 151

Respiratory complications and nursing interventions 152

C - Circulation 155

Thermoregulation and temperature abnormalities 156

Post-operative nausea and vorruting 160

Pain management in the PPACU 164

Infection control 165

Fluid and electrolyte balance 166

Wounds and dressings 168

Patient positioning 168

Latex allergy 169

Children with epilepsy 170

Delayed emergence 170

Emergence delirium 171

Discharge of the patient from the PPACU 171

Psychological assessment l72

References 175

9 Fetal surgery Roy Kimble 179

Introduction 79

History 179

The risks of fetal surgery 180

Fetal conditions amenable to fetal surgery 181

Ex utero intrapartum treatment (EXIT) 183

The future 184

References 184

10 Perioperative care of children with burns Roy Kimble Julie Mill 185

Introduction 185

History 185

Epidemiology of burns in children 186

A multidisciplinary service approach 187

Clinical assessment of bum severity 188

A - Airway 189

B - Breathing 189

C - Chelation 190

D - Neurological disability 190

E - Exposure with environment control 190

Classification of bum depth 190

Determination of bum depth 191

Laser Doppler scanning 191

Electrical burns 192

Chemical burns 193

Calculation of burn surface area 193

Management 193

Burn wound care 195

Preparation for theatre 197

Pain management via acute pain service 199

Post-operative care 200

Physiotherapy 200

Infection control 200

Toxic shock syndrome 201

Tetanus 202

Human immunodeficiency virus (HIV)-positive children 202

Scar management 202

Discharge planning 202

References 204

11 Paediatric transplantation Rebecca Smith Susan Tame 208

Introduction 208

Becoming an organ donor 208

Types of donation 209

Role of the transplant co-ordinator 213

Donor care and management 215

Making the donation request 215

Preoperative care of a potential paediatric donor 216

Perioperative care 222

Recipient management and care 229

Cardiothoracic organs 230

Immediate post-operative care 233

Liver 234

Kidneys 235

Small bowel, liver and multivisceral 237

Reducing the risk of rejection of the new organ 238

Longer-term post-operative care 239

The future 240

References 242

Further reading 243

12 The care of children having endoscopic procedures Janet Roper Linda Shields 245

Introduction 245

The perioperative nurse's role 246

Preparing children for endoscopic procedures 248

Perioperative care 248

Service perspectives 249

Equipment for MIS and endoscopy 251

Conclusion 258

References 258

13 Ethical and legal issues in paediatric perioperative care Linda Shields 261

Patients' rights 261

Self-determination 262

Privacy 262

Confidentiality 262

Consent 263

Legal perspectives 264

Medical futility 265

Conclusion 265

References 266

Index 267

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