Consent & Ethics
Who provides legally informed consent for a 3-year-old child?
parents or legal guardian
What role do child life specialists play in pediatric procedures?
They prepare children through play, education, and coping strategies.
What are the main goals of preoperative medications in children?
- anxiety reduction
- amnesia
- sedation
- antiemetic affect
- decreased secretions
Pediatric medication doses are usually based on what factor?
mh/kg body weight
Children over 50kg get the adult dose
What is the main purpose of antipyretics in febrile children?
What is... comfort
At what age can older children/adolescents provide 'assent' in addition to parental consent?
7 years & up, parents still provide legal consent
A toddler resists a procedure. Why is this behavior developmentally expected?
Due to autonomy, egocentrism, and a limited concept of time.
What is the purpose of parental presence during surgery?
- reduces anxiety
- supports coping
- strengthens family involvement
Which IM injection site is recommended for infants?
vastus lateralis (thigh)
What is the safest way to transport a hospitalized infant between units?
What is... secure conveyance (crib, bed, or stretcher with belts)
only to be carried in arms for short distances.
What is the difference between a mature minor & emancipated minor in terms of consent?
Mature minor = legally underage but allowed to consent for certain treatments (e.g., reproductive, mental health, substance use).
Emancipated minor = legally independent (married, military, parent) → can consent for all care.
What are the common fears of preschoolers related to hospitalization?
punishment, mutilation, loss of body parts
Name two priority nursing assessments in the immediate postoperative period.
- airway & breathing
- pain control
- vital signs
- bleeding assessment
What are the signs of IV infiltration in children?
swelling, coolness, pallor, discomfort, and decreased infusion rate
What restraint is commonly used for venipuncture or IV placement in children?
What is.. mummy (swaddle) wrap or elbow restraints.
What is treatment without parental consent permitted in pediatrics?
Emergency situations, life saving interventions
Why is a treatment room preferred over the child's hospital bed for procedures?
helps preserve the hospital bed as a safe space-- reduces trauma
What rare but life-threatening complication should be monitored for after anesthesia?
What is the main nursing care for a child with a gastrostomy tube?
g tube - check placement, keep clean/dry, monitor skin, teach family flushing technique, feeding
What nursing action prevents complications when suctioning a tracheostomy?
What is... use sterile technique, pre-oxygenate, limit suction to 5-10 seconds, monitor O2 stat.
A nurse asks a 3-year-old to sign a consent form. What does this demonstrate?
inappropriate understanding of development
What is the nurse's best strategy to reduce anxiety before a school-age child's diagnostic test?
honest explanations, allow questions, and use concrete thinking
A child develops a fever and muscle rigidity post-op. What condition should the nurse suspect?
malignany hyperthermia
What's the difference between gavage and TPN feeding?
gavage = enteral nutrition (ng/og/g)
tpn = iv nutrition (bypasses gi)
A nurse notes diminished breath sounds after a chest tube placement. What is the priority intervention?
What is.. possible tube obstruction, assess tube & child, call provider, prepare for possible intervention.