Nursing care of the general pediatric surgical patient / edited by Barbara V. Wise ... [and others]

Format:

Book

Contributor:

Wise, Barbara Vollenhover, 1953-

Language:

English

Subjects (All):

Children--Surgery--Nursing.

Children.

Pediatric nursing.

Pediatric Nursing.

Perioperative Nursing.

Medical Subjects:

Pediatric Nursing.

Perioperative Nursing.

Physical Description:

xxiv, 528 pages : illustrations ; 29 cm

Place of Publication:

Gaithersburg, Md. : Aspen Publishers, 2000.

Summary:

This the first book to address all aspects of pediatric general surgery from a nursing perspective. Pediatric surgical nurses have to be clinically competent, technologically savvy, able to coordinate the multi-disciplinary care team, and tend to the emotional and psychosocial needs of the family and child. This book is appropriate for nurses in pediatric surgery departments, student nurses interested in pediatric surgery and nurse managers.

Contents:

Part I Special Considerations in the Care of the Pediatric Surgical Patient 1

Chapter 1 Preparation of the Child and Family for Surgery / Renee C.B. Manworren, Marti Fledderman 3

Psychological Preparation: The Patient 3

Psychological Preparation: The Parents 4

Preparation Strategies 5

Preparation Program Development Guidelines 8

Physical Preparation 9

Dietary Restrictions 11

Transition to the Operating Room 11

Chapter 2 Perioperative Management of the Child / Kathleen M. Leack 16

Preoperative Care 16

Preoperative: Holding Room 17

Intraoperative Roles 17

General Nursing Considerations of the Pediatric Patient in the Operating Room 17

Induction of Anesthesia 17

Surgical Preparation and Positioning 18

During the Operation 19

Transfer to the Postanesthesia Care Unit 20

Miscellaneous Perioperative Care Issues 21

Chapter 3 Fluid and Electrolyte Management of the Pediatric Surgical Patient / Nancy Rabin 24

Body Fluid Compartments and Composition 24

Normal Exchange of Fluid and Electrolytes 25

Preoperative Considerations 25

Calculating Fluid and Electrolyte Requirements 25

Intraoperative Management 27

Daily Maintenance Fluid and Electrolyte Requirements 27

Replacement of Ongoing Abnormal Losses 28

Types of Intravenous Solutions 28

Third-Spacing 30

Chapter 4 Nutrition in the Pediatric Surgical Patient / Annie McKenna, Jose M. Saavedra 32

Nutrition Assessment and Estimation of Nutritional Requirements 32

Metabolic Consequences of Injury and Nutritional Repletion 34

Enteral Nutrition Support 35

Parenteral Nutrition Support 36

Nutritional Management of the Burn Patient 39

Nutritional Management: Liver Disease and Liver Transplantation 40

Chapter 5 Vascular Access / Melanie A. Kenney 44

Catheter Types 44

Care and Maintenance of Central Venous Catheters 48

Potential Complications 50

Appendix 5-A Caremap for Vascular Access 55

Chapter 6 Pain Management and Sedation in Children / Wendy Lord Mackey 56

Pain in Children: An Overview 56

Developmental Considerations in Pediatric Pain Control 57

Pain Assessment and Measurement 57

Nonpharmacologic Methods of Pain Management in Children 60

Pharmacologic Management of Pain 62

Patient-Controlled Analgesia 68

Epidural Pain Control 71

Sedation 74

Chapter 7 Caring for the Child with Technology Needs in the Home / Kimberly Haus McIltrot, Laura Phearman 78

Developing a Plan of Care for Home 78

Funding and Services 79

Technology Services in the Home 80

Education 82

Family Coping Strategies 82

Chapter 8 The Death of a Child / Kelly A. Jedlicki 85

Unexpected Loss 85

Anticipated Loss 85

Caring for the Pediatric Surgical Patient 85

Caring for the Entire Family 87

Nurses Who Care for Dying Children 89

After the Death 90

Part II Surgical Procedures Using Innovative Technology 93

Chapter 9 Fetal Surgery / Lori J. Howell, Susan K. Von Nessen, Kelli M. Burns 95

Fetal Congenital Diaphragmatic Hernia 95

Fetal Lung Lesions 96

Fetal Sacrococcygeal Teratoma 97

Obstructive Uropathy 99

Giant Neck Masses 100

Maternal-Fetal Management 102

The Fetal Diagnosis and Treatment Center 103

Future Directions 104

Appendix 9-A Critical Pathway for Fetal Surgery 106

Chapter 10 Minimally Invasive Surgery in Infants and Children / Allen F. Browne, Nancy J. Tkacz 110

Historical Development 110

Instrumentation 111

Anesthetic Management 112

Basic Laparoscopy 113

Basic Thoracoscopy 113

Specific Procedures 114

Nursing Considerations 114

Future Considerations 116

Appendix 10-A Critical Pathway for Laparoscopic Nissen Fundoplication 120

Part III Nursing Care of Children with Surgical Lesions of the Head, Neck, and Thoracic Cavity 121

Chapter 11 Common Cysts / M. Elizabeth Foster 123

Branchial Cleft Remnants 123

Thyroglossal Duct Cyst 126

Lymphangioma (Cystic Hygroma) 128

Hemangiomas and Vascular Malformations 131

Lymphadenopathy 132

Dermoid Cyst 133

Ganglion Cyst 134

Appendix 11-A Critical Pathway for Removal of Common Cysts 137

Chapter 12 Tracheostomy / Beverly B. Kelleher 139

Preoperative Preparation 140

Operative Considerations and Postoperative Care 141

Care of the Child with a Tracheostomy 142

Discharge Preparation 147

Decannulation 148

Appendix 12-A Critical Pathway for Tracheostomy 151

Chapter 13 Esophageal Defects / Danuta E. Nowicki 154

Congenital Defects 154

Acquired Defects 163

Functional Defects of the Esophagus 166

Esophageal Replacement 166

Appendix 13-A Critical Pathway for Esophageal Atresia with Distal Tracheoesophageal Fistula 174

Chapter 14 Congenital Lung Malformations / Teri Crawley-Coha 176

Congenital Cystic Adenomatoid Malformation, Pulmonary Sequestration, Bronchogenic Cyst, and Congenital Lobar Emphysema 176

Cystic Adenomatoid Malformation 179

Pulmonary Sequestration 179

Bronchogenic Cyst 181

Congenital Lobar Emphysema 181

Nursing Considerations for Children Undergoing Thoracic Surgery 182

Congenital Diaphragmatic Hernia 182

Appendix 14-A Critical Pathway for Thoracic Surgery 187

Chapter 15 Chest Wall Defects: Surgical Interventions and Nursing Issues / Louise Flynn 188

Pectus Excavatum 188

Pectus Carinatum 190

Jeune Syndrome 191

Sternal Clefts 191

Poland Syndrome 192

Nursing Considerations 192

Appendix 15-A Critical Pathway for Nuss Procedure 196

Chapter 16 Gastroesophageal Reflux Disease: Recognition and Management / Frances N. Price, Maureen Smith 197

Pathophysiology 197

Clinical Presentation 198

Differential Diagnosis 198

Diagnostic Studies 198

Medical Management 200

Surgical Intervention 200

Preoperative Care 201

Postoperative Care 201

Gastrostomy Devices 202

Postoperative Feeding 202

Nursing Interventions 203

Transitioning to Home 204

Research 204

Appendix 16-A Critical Pathway for Nissen/Gastrostomy 207

Part IV Nursing Care of Children with Congenital Abdominal Conditions 209

Chapter 17 Abdominal Wall Defects / Beth Zimmermann 211

Incidence 212

Diagnosis 212

Parental Counseling 212

Transport and Admission 213

Operative Procedure 213

Nutrition 215

Discharge Planning and Parent Care 216

Complications and Long-Term Outcomes 216

Chapter 18 Intestinal Atresias, Duplications, and Meconium Ileus / Judith J. Stellar, Kelli M. Burns, Susan K. Von Nessen 218

Intestinal Atresias 218

Gastrointestinal Duplications 227

Meconium Ileus 228

Appendix 18-A Caremap for Jejunoileal Atresia 232

Chapter 19 Hirschsprung's Disease / Jennifer Chamberlain, Daniel H. Teitelbaum 234

Embryology 234

Incidence 234

Pathology 234

Associated Anomalies 235

Pathophysiology 235

Diagnosis 236

Differential Diagnosis 239

Surgical Techniques 239

Postoperative Management 240

Complications 242

Appendix 19-A Critical Pathway for Hirschsprung's Disease 245

Chapter 20 Anorectal Malformations in Children / Kathleen O'Connor Guardino 247

Physical Examination/Workup 247

Description of Specific Defects 249

Treatment 252

Postoperative Bowel Function 255

Chapter 21 Caring for Children with Ostomies and Wounds / Gail Garvin 261

The Pediatric Ostomy Patient 261

Postoperative Nursing Consideratons 261

Ostomy Complications 262

Dietary Restrictions 264

Discharge Teaching 266

Care of the Pediatric Surgical Patient with a Wound 266

Current and Potential Research 270

Appendix 21-A Caremap for New Ostomy 273

Appendix 21-B Discharge Teaching Plan for Ostomy Care 275

Appendix 21-C Discharge Teaching Checklist for Ostomy Care 277

Appendix 21-D Stoma Care Plan 278

Part V Nursing Care of Children with Acute Abdominal Problems 279

Chapter 22 Common Outpatient Pediatric Surgical Procedures: Inguinal and Umbilical Hernias, Hydroceles, Undescended Testes, and Circumcision / Carmel A.

McComiskey 281

Inguinal Hernias in Children 281

Umbilical Hernias in Children 283

Hydroceles 284

Undescended Testis 285

Circumcision 286

Outpatient Surgery Caremap 287

Appendix 22-A Critical Pathway for Outpatient Surgery 289

Chapter 23 Necrotizing Enterocolitis / Betty R. Kasson 291

Epidemiology 291

Pathogenesis 291

The Presentation of NEC 293

Management 294

Developmental Issues 301

Planning for Home 301

Future Research 301

Appendix 23-A Critical Pathway for Necrotizing Enterocolitis 303

Chapter 24 Malrotation and Volvulus / Tina Shapiro, Jeannette A. Diana-Zerpa 305

Description 305

Embryology 305

Pathophysiology of Malrotation 306

Pathophysiology of Midgut Volvulus 306

Clinical Presentation 307

Differential Diagnosis 307

Workup 308

History and Physical Examination 308

Laboratory Work 308

Radiologic Diagnosis 308

Treatment and Operative Considerations 310

Surgical Procedure 310

Preoperative Nursing Management 311

Postoperative Nursing Management 311

Complications 312

Prognosis 312

Appendix 24-A Caremap for Volvulus/Malrotation (Symptomatic) 314

Chapter 25 Hypertrophic Pyloric Stenosis / Joanna Joyce Morganelli 316

Pathophysiology 316

Embryology 316

Incidence 317

Presentation 317

Differential Diagnosis 317

Physical Examination 317

Serum Laboratory Work 317

Radiology 317

Recommended Therapy 318

Operative Considerations/Surgical Procedure 319

Developmental Considerations 320

Special Services/Referrals/Discharge Needs 320

Preoperative and Postoperative Nursing Considerations 320

Appendix 25-A Critical Pathway for Pyloric Stenosis 323

Chapter 26 Intussusception / Lynn Fagerman, Margaret Meyer 325

Pathophysiology 325

Clinical Presentation 326

Physical Examination 326

Laboratory Studies 326

Radiographs 326

Surgical Treatment 328

Developmental Considerations 329

Indications for Referral 329

Research 329

Nursing Considerations 329

Discharge Instructions 330

Appendix 26-A Caremap for Intussusception 331

Chapter 27 Appendicitis / Luanne Pelosi 333

Pathophysiology 333

Bacteriology 333

Classification 333

History 333

Physical Examination 334

Laboratory Findings 334

Radiographic Findings 334

Differential Diagnosis 334

Treatment 335

Operative Procedure 335

Laparoscopic Appendectomy 335

Appendiceal Abscess 336

Postoperative Management 336

Discharge Instructions 336

Complications 337

Research 337

Appendix 27-A Caremap for Appendicitis 338

Chapter 28 Splenectomy, Cholecystectomy, and Meckel's Diverticulum / Susan E. Olsen, Marilyn Miller Stoops 339

Splenectomy 339

Cholecystectomy 344

Meckel's Diverticulum 347

Appendix 28-A Caremap for Splenectomy 353

Part VI Nursing Care of Children with Complex Surgical Conditions 355

Chapter 29 Biliary Atresia and Choledochal Cysts / Laura M. Flanigan 357

Biliary Atresia 357

Choledochal Cyst 361

Nursing Care of the Child with Biliary Atresia and Choledochal Cysts 363

Chronic Liver Disease 364

Research 365

Appendix 29-A Critical Pathway for Biliary Atresia 366

Appendix 29-B Critical Pathway for Choledochal Cyst 368

Chapter 30 Solid Tumors / Barbara S. Ehrenreich, Laura San Miguel 370

Neuroblastoma 370

Wilms' Tumor 377

Hepatic Tumors 380

Operative Considerations 391

Preoperative Management of the Pediatric Patient with a Solid Tumor 391

Postoperative Management 392

Appendix 30-A Caremap for Thoracic Solid Tumors 397

Appendix 30-B Caremap for Extremity Solid Tumors 400

Appendix 30-C Caremap for Abdominal/Pelvic Solid Tumors 403

Chapter 31 Pediatric Abdominal Organ Transplants / Kathleen Falkenstein, Caroline Brass, Joanne Palmer 408

Renal Transplantation 408

Liver Transplantation 414

Intestinal Transplantation 420

Postoperative Care of the Pediatric Abdominal Transplant Recipient 423

Living with a Transplant 426

Chapter 32 Nursing Care of the Cardiothoracic Transplant Patient / Jeanette M. Teets 431

Heart Transplantation 431

Lung Transplantation 434

Heart-Lung Transplantation 437

Immunosuppression 438

Cytomegalovirus Prophylaxis 439

Immunizations 440

Compliance 440

Dietary Issues 440

Returning to School 441

Use of Over-the-Counter and Prescription Medications 441

Chapter 33 The Surgical Neonate / Katherine E. Keener, Kimberly D. Knoerlein, Wendy M. McKenney, Linda Miranda McNamara, Dorothy M. Mullaney, Susan M. Quinn 443

Prenatal Diagnosis, Perinatal Management, and Prenatal Family Counseling 443

Neonatal Management 444

Cardiovascular and Respiratory Stabilization 444

Thermoregulation 446

Fluids and Electrolytes 447

Drug Therapy 448

Wound Care 450

Nutritional Support 450

Family Focus, Discharge, and Follow-Up 452

Part VII Nursing Care of the Injured Child 457

Chapter 34 Pediatric Trauma / Pam Pieper 459

Clinical Presentation 460

Psychosocial Issues 474

Discharge Planning 474

Current and Potential Research 476

Appendix 34-A Caremap for Isolated Splenic Injury (AAST Grades I, II, and III as Determined by Initial CT) 479

Chapter 35 Burn Care of Children / Robin Moushey, Lisa Meadows 480

Introduction to Pediatric Burn Care 480

Assessing Burn Acuity 480

Airway Management 481

Intravenous Fluid Guidelines 483

Wound Assessment 484

Pain in Children with Burns 485

Wound Care 486

Nutrition 487

Infection 487

The Multidisciplinary Approach to Care 488

Appendix 35-A Caremap for Postgraft Burns 490

Appendix 35-B Wound Care Product Glossary 494

Chapter 36 Clinical Nursing Research / Elaine Stashinko 496

Nursing Science 496

Conducting Clinical Nursing Research 497

Integrating Research in Clinical Practice 501.

Notes:

Includes bibliographical references and index.

ISBN:

083421170X

OCLC:

43523083