Sl. Ongoing No. Assessment 1 Child does not prefer to get out of bed. He gets tiered easily.

Nursing Diagnosis Activity intolerance r/t anemia as evidenced by easy fatigability.

Expected Outcome Child tolerates moderate activity. Child maintains Hb within normal limits

Nursing Interventions Planning Implementation Assess the childs level Childs level of activity of activity that is and symptoms on exertion tolerated. are assessed and recorded. Assess and record his Encouraged the parents to symptoms on exertion. assist the child in ADL. Administer oxygen if Child is discouraged to run/ needed. engage in sports etc. Assist the child in Child is told the performing his importance of taking iron activities of daily rich foods. living. Child is asked to inform Encourage the child to any dyspnea or signs of eat iron/vit C rich food. respiratory distress. Assess the knowledge of the child and family regarding the illness , treatment and prognosis. Try to explain to them in their own language about the pathology and line of treatment. Encourage them to verbalize their fears and concerns. Encourage them to talk with the consultant while on clinical rounds. Assessed the childs and familys knowledge about the disease condition, pathology, treatment and prognosis. Encouraged them to express their concerns and fears. Explained to them, in a language they can understand, the disease, its management and prognosis.

Evaluation Child is confident about surgery outcome. He still have dyspnea on exertion

2.

Child as well as the parents are anxious about the surgery and its outcome.

Knowledge deficit r/t the surgery and its outcome as evidenced by anxiety, verbalisation.

Child and family have an understanding about the nature of illness and what to expect. Their anxiety is relieved.

child and his parents expressed their doubts and are provided with necessary information.

Sl. Ongoing No. Assessment 3 Child is just received from OT and is getting oxygen.

Nursing Diagnosis Ineffective breathing pattern r/t the immediate post-Op status(effect of anesthesia) and presence of abdominal sutures as evidenced by dyspnea and decreased Sp O2 on room air.

Expected Outcome Oxygen is delivered adequately to meet the cellular metabolic needs. Child breaths normally. Child maintains SpO2 within normal limits. Child does not develop any post-Op complications.

Nursing Interventions Planning Implementation Connect the patient to a Child is connected to the cardiac monitor for cardiac monitor and his continuous monitoring vital signs ECG and SpO2 of crucial parameters. are monitored Administer the child continuously. oxygen via mask as Humidified oxygen is prescribed. being administered via Monitor vital signs at mask @ 5L/min. least half hourly for Child is frequently assessed first 2 hours and record for any respiratory distress them. or any other discomfort. Give him fowlers Analgesics are position to facilitate administered as prescribed. breathing. Suture line is inspected for Auscultate and see the any increased soakage of air entry and look for overlying dressing pad. any crackles. Child is given low fowlers Administer analgesics position. as prescribed. Childs mother is asked to Nebulise the child if keep a close watch to prescribed. detect any of the danger Assess the child for any signs and inform the indications of potential doctor/sister on duty at the complications. earliest. Inform to the mother Encourage the child to take danger signs and rest and sleep if feel like ensure that she informs sleeping. you at the earliest.

Evaluation Child is getting O2 @ 5l/min. Childs SpO2 is 96%. Child is sleeping.

Sl. Ongoing No. Assessment 4 Child is crying from pain.

Nursing Diagnosis

Expected Outcome Altered comfort Childs pain (Pain) r/t underlying is relieved. pathology and sutures in situ as Child gets evidenced by cry adequate rest and verbalization. and sleep.

Nursing Interventions Evaluation Planning Implementation Assess and record Child is assessed for childs pain - its location, type, intensity and intensity, location, duration of pain. type, duration, Analgesics are alleviating/aggravating administered as prescribed. factors if any. Child is given a Administer analgesics comfortable position on Child is as prescribed and bed. cured and record it. Child is given alternative goes home at Give the child the most right and left side lying the earliest. possible comfortable position every 4 hourly. position without Unnecessary manipulation interfering with the of child as well as the sutures. surgical wound is avoided. Provide diversional Antibiotics are also activities like comic administered as prescribed. books or some solitary Parents are encouraged to games like video bring the child story books games or some puzzles or a video game. to solve. Encourage the parents to Couple the timing of talk to the child happy change of dressing of things and divert his the suture line with attention. peak activity of Demonstrated to the analgesics. parents and are encouraged Give the child tender to do tender loving care. loving care. Encourage the parents to be Avoid any unnecessary optimistic about the touching of the patient. outcome and reassure the Administer antibiotics child. as prescribed.

REFERENCES: I. II. III. Grossfield and et al; Kliegman and et al; Text book of pediatric surgery; 4th Edn; vol.2; 1651-65. Nelson Text book of pediatrics; 18th Edn; vol.2; 1709-12. ;

Marlow and et al; Text book of Pediatric Nursing; 6th Edition;