Jenny Flashcards
most common symptoms of obstructive sleep apnea
- Loud snoring or noisy breathing during sleep
- Periods of not breathing.
Although the chest wall is moving, no air or oxygen is moving through the nose and mouth into the lungs. The duration of these periods is variable and measured in seconds. - Mouth breathing.
The passage to the nose may be completely blocked by enlarged tonsils and adenoids. - May also speak with a nasal voice.
- Restlessness during sleep.
This occurs with or without periods of being awake. - Excessive daytime sleepiness or irritability.
Because the quality of sleep is poor, the child may be sleepy, hard to wake from a nap, or irritable in the daytime. - Hyperactivity during the day.
May also experience behavioral, school, or social problems.
Tonsillectomy
Tonsils are two small glands in the back of throat
Help to deal with infections, particularly in childhood
An operation to remove tonsils called tonsillectomy
Adenoidectomy
Adenoids are small lumps of soft tissue found at the back of nose
The surgical remove of adenoids are adenoidectomy
Tonsillectomy and adenoidectomy done together is commonly referred as T&As.
T&As - Signs & Symptoms
- Swelling of the tonsils
- Redder than normal tonsils
- A white or yellow coating on the tonsils
- Snorring and difficult in breathing
- Fever
- Recurrent ear infections
T&As -Common treatment
- Throat cultures to identify infections in the throat
- X-ray to visualize the size of the adenoids
- Blood test: infection
- Surgical procedure
T&As -Nursing interventions
- Pain management
- humidified O2
- maintain oral intake
- mouth care
- avoid activities
- post-operative review
Social Development
- Encourage and provide space for physical activity.
- Show your child how to participate in and follow the rules of sporting activities.
- Encourage play and sharing with other children.
- Encourage creative play.
- Teach your child to do small chores, such as setting the table.
- Read together.
- Limit screen time (television and other media) to 2 hours a day of quality programs.
- Expose your child to different stimuli by visiting local areas of interest.
Therapeutic communications
- Hospitals are alien places to most children and the way in which Jenny is greeted and settled into the paediatric surgical unit can have a significant impact of Jenny and her family. Jenny may react strongly and unpredictably to smells, sounds, people and procedures. She may also be worried about unfamiliar people touching and examining her. Hence, therapeutic communication skills are central to establishing an effective rapport with Jenny and her family, and in developing a trusting partnership.
- Address all family members
- Distract/ divert
- Get to know them/ ask about interests
- Avoid negative words
- Give choices and empower
- Explain the procedure
Communicating
- Address the parent first to convey trust •Introduce explain who you are, why you are there and if they have any questions
- Do not rush
- Keep calm
- Explain the procedure and involve them in the care
- Demonstrate assessment techniques on parents or doll
- ei: show them the stethoscope and how it works
- Ask parents to bring a familiar toy
- Use positive language
- Keep parent and toddler together and ask for assistance from them
- Do not use yes or no questions
- Use language easy to understand and give straightforward instruction
If the child is non compliant:
- Make sure the environment is child friendly
- Give choices
- Ask for parents help and comfort
- Take a break
- Ask the child if he/she is scared
Usually tantrum causes are hunger, tiredness, feeling ignored or worries
What is Family Centred Care?
- Empowers patients and their families and fosters independence
- Supports family care-giving and decision-making
- Respects patient and families’ choices and their values, beliefs and cultural backgrounds
- Builds on individual and family strengths
- Involves patients and their families in the planning, delivery and evaluation of health care services.
How can we practice family centred care?
- Believing and trusting parents/carers and patients – they are the experts in their child/themselves.
- Introducing yourself each time you walk into the room and explaining what it is you’re going to do.
- Listening to patients and families and giving them an opportunity to discuss any of their questions, anxieties or concerns.
- Discussing which aspects of care the patient or family would like to provide, where it is safe to do so.
Not every patient or parent/carer will want to contribute to patient care in hospital so this needs to be discussed with each patient/family. - Giving the family – including the child or young person –clear, timely information.
Keeping the family informed of their child’s condition and treatment helps alleviate anxiety and also helps them be part of the decision-making. - Asking the family for their view on the patient’s care plan and as appropriate, incorporating their views.
- Making sure the parents/carers and, where appropriate, patients are involved in decisions that are made for care and treatment.
- Accepting and supporting decisions made by families, whenever possible, or explaining why if it isn’t possible.
- Respecting and promoting the rights and responsibilities of patients, parents and carers
What are the core concepts of family Centred Care
Dignity and respect
Information sharing
Participation
Collaboration
FCC - Dignity and respect
Staff listen to and respect patient and family perspectives and choices. Patient and family knowledge, values, beliefs and cultural backgrounds are incorporated into the planning and delivery of care.
FCC - Information sharing
Staff communicate and share complete, objective and accurate information with patients and families in ways that are supportive and useful. Patients and families receive timely, complete and accurate information in order to effectively participate in care and decision-making