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Pediatric Temperature-Related
• The extent of a burn injury is expressed as percentage of total body surface area (TBSA)
• The larger the percentage of TBSA that is burned, the greater the risk for burn shock.
• In managing alterations in skin integrity, it is necessary to individualize the type of treatment and medications to the particular causative agent.
• If you wouldn’t put it into an eye, don’t put it into a wound.
• Wounds heal by the process of moist wound healing and occlusion.
• Dry wounds do not heal.
• Wound debridement promotes healing and prevents infection.
• Immediate care for a major burn is ABC: airway establishment and patency, breathing and absence of respiratory distress, and circulation with fluid initiation.
• Potassium should not be administered during the initial oliguric phase of a burn injury, but should be added when diuresis occurs.
Pediatric Hematology
• For a child with altered platelet function or bleeding disorder, do not administer acetylsalicylic acid (aspirin, ASA) or take rectal temperatures. Perform invasive procedures very cautiously.
• Children with low WBC may not exhibit common findings of infection such as purulent drainage. In a febrile client with granulocytopenia, give antibiotics immediately because this child risks rapid, overwhelming sepsis.
• Morphine is the medication (or opioid) of choice for pain in children with sickle cell disease.
Pediatric Oncology
• Findings of pediatric malignancies vary according to the child’s age, location and type of tumor, and extent of disease
• Cure rate is improving for most types of pediatric malignancies; however the late effects of treatment are of increasing concern and incidence.
• Children typically have longer treatment plans than adults due to their increased metabolic rate and rate of cell turnover.
• Leukemia affects not only the blood, but can metastasize to major organ systems (extramedullary disease), including the central nervous system.
• Nursing care includes monitoring the child for the development of acute complications of treatment including fever, bleeding, and anemia.
• Pediatric oncologic emergencies include: acute tumor lysis syndrome, superior vena cava syndrome, septic shock.