Pediatric Nursing Demystified

Other serum/blood assessments specific to systems reveal adequacy or

deficit in organ function. For example: AST, ALT (elevated in liver dis-

ease), HBeAg/HBsAg, IgM, IgG, anti-HBc (hepatitis B infection current

or past), anti-HCV, HCV RNA (hepatitis C), amylase and lipase (gastroin-

testinal function), T3, T4, TRH, and TSH (elevated or depressed in thyroid

disease), ACTH (pituitary function), or FSH, LH (gonad function).

Peak or trough levels of medications may be drawn to guide treatments;

elevations may result from renal malfunction or insufficient drug dosage.

Urine Testing

Urinalysis may reveal decreased renal function or electrolyte imbalance

such as excess glucose.

Urine specific gravity may reveal low or high levels that may relate to

fluid depletion or overload.

Pulse oximetry might be decreased due to respiratory abnormalities.

Scope procedures: Direct visualization of body cavity to detect tumor,

ulceration or irritation, or foreign body and to obtain specimen (biopsy):

bronchoscopy (lung blockage), gastroscopy (stomach irritation or block-

age), colonoscopy (intestinal blockage or irritation), sigmoidoscopy

(blockage).

Scan or radioscope such as radiograph, magnetic resonance imaging

(MRI), ultrasound, or sonogram allows for indirect view of deep body

structures, detects tumors, foreign bodies, narrowing of body passages,

or openings between chambers (such as between heart chambers).

Nursing alertSome procedures involve the use of contrast dyes to improve

visualization of structures.

 Assess client for allergy to shellfish or iodine because contrast can cause

a severe allergic reaction (anaphylaxis) requiring lifesaving measures.

Electromyography (EMG), nerve conduction studies, and/or electroen-

cephalogram (EEG) may indicate problems in nerve conduction in the

brain or neuromuscular system.

Nursing Implications

The nurse should exercise caution during diagnostic procedures and data inter-

pretation with pediatric clients.

A blood draw can be scary. Use careful language when speaking with

young children, avoiding words with double meanings such as “shot”

or “stick” that might cause a scary mental image.

Explain that the smallest amount of blood possible is being taken to reas-

sure the client and family.

5

4

CHAPTER 3/ Pediatric Assessment^45