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 |