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Definition of atresia?
condition in which a body orifice or passage in the body is abnormally closed or absent.
distress related to removal from family and familiar surroundings
return to a previous stage of development
Three stages of separation anxiety
- Protest-- few hours to several days, distress by crying, agitation, rejects others
- Despair- hopelessness by withdrawing, quiet w/o crying, exhibits apathy, depression , lack of interest in play and food, sadness
- Detachment (denial)- forms coping mechanisms, shows more interest, plays again, forms superficial relationships, child ignores parent upon return
Types of restraints
- soft limb restraint - wrist or ankle restraint to prevent range of motion of extremtities; check wrist or ankle for any sign of circulatory , integumentary, or neurologic compromise.
- elbow restraint- prevents child from flexing and reaching face, head, IV and other tubes.; position the restraint so it does not rub against axilla. Check pulse, temperature, and capillary refill of the extremity
- mummy restraint- body restraint using a sheet folded in a square appropriate to size of infant or young child to secure the whole body of the child or every extremtiy except for one; ensure that all extremities are secured within the sheet.
- Jacket (vest ) restraint- jacket worn by child with ties attached to the child's back and to side of bed. Used to keep children flat in bed, such as after surgery, or safe in chair.; ensure the child can turn head to side and that the head of the bed is elevated. Place ties in back so child cannot manipulate them.
- Crib top bubble restraint - clear plastic cover over the bed to prevent older infant or young child from falling and climbing out of bed.; ensure no tears or loose plastic.
Nursing interventions for using a child restraint
- ensure that the restraint fits properly
- secure the restraints with ties to the bed or crib frame, not the side rails
- use a clove-hitch type of know to secure the restraints with ties (this allows for quick, easy access and release of the restraint)
- check restraints 15 minutes following initial placement and then every hour for proper placement.
- assess the temperature of the affected extremities, pulses, and capillary refill, initially after 15 minutes and then every hour after placement
- remove restraints every 2 hours to allow for range of motion and repositioning, with documentation of this process and any findings
- encourage parent paricipation, providing continuous explanations about the reasons for the restraints and tentative time frame for use.
- offer positive reinforcement to the child and parents
- review the criteria for removing the restraints; document removal and continued assessment
Child life specialist
specially trained individual who provides programs that prepare children for hospitalization, surgery, and other procedures that could be painful