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Table 4 Nursing status, observations and recommendations of care related to children suffering from MIS-C

From: Multi-inflammatory syndrome in children (MIS-C) associated with COVID-19: a nursing perspective experience report from a high-income tertiary paediatric hospital context

Nursing status

Observations

Recommendations of care

- Activity

Fatigue

Coordinate care to facilitate rest

- Breathing

Decreased saturation

High respiration rate

Oxygen when needed, antipyretics when high respiration rate in connection to fever

- Circulation

High fever, swelling

Add cold blankets to antipyretics

Strict monitoring of fluid intake and elimination

- Coordination/

- communication

Heavy workload

Poor communication

Agitated children

Decrease patient–nurse ratio during the first critical phase

The interprofessional team is very important, looping in at the end of the day to evaluate team work

- Drug administration

Time consuming preparation and administration

If not possible to decrease patient–nurse ratio, add a pharmacist to the team

- Elimination

Control challenges

Controlling elimination is very important; if the children and parents cannot document quantities, there must be a clear plan as to who is responsible for this

- Nutrition

Loss of appetite

Great thirst

Nutrition plan, together with a dietician. Optimise food and fluids within the confines of the restrictions

- Pain

Difficult to locate

Act to have a pain strategy plan that includes clearly addressing multiple pain locations as well as monitoring and regular re-evaluation

- Procedures

Traumatic

Repetitious

Early central venous line access

Use distraction methods and child-adapted information

- Psychosocial

Anxiety

Parents in despair

Family-centred care approach; social worker should be invited in the care of the family

Skin/tissue- Access

Burning, rashes, collapsed veins

Cold blankets Central venous line

- Sleep

Disturbed due to management of symptoms and treatment

Coordinate procedures and drug administrations to minimise the number of times the child’s room is entered during the night