Summary
Nurses who care for infants and children undergoing thoracic surgery must function and make decisions which take into account a multiplicity of complex data. This necessitates a background of knowledge, skill and intuition which guides their nursing practice. The principles of holistic care in which the total needs of the infant and child are met within the context of the family are seen as an important approach to patient care. Selected perspectives in the care of infants with congenital and acquired thoracic anomalies are discussed, in particular infants with congenital diaphragmatic hernia and oesophageal atresia. The preparation of children for chest surgery and the postoperative nursing management are outlined and include aspects of pain management, physiotherapy and chest drain care.
Zusammenfassung
Krankenschwestern, die Kinder und Säuglinge mit throaxchirurgischen Eingriffen betreuen, sind vor Entscheidungen gestellt, die eine Vielzahl komplexer Daten implizieren. Dies erfordert einen soliden Wissensstand, Fertigkeit und Intuition für die tägliche Pflegepraxis. Die Prinzipien einer umfassenden Pflege, die alle Bedürfnisse der Säuglinge und Kinder auch im Kontext mit der Familie berücksichtigt, sind wichtig zur Bewältigung dieser Aufgabe. Ausgewählte Gesichtspunkte bei der Pflege von Säuglingen mit kongenitalen oder erworbenen Thoraxanomalien werden diskutiert, insbesondere bei Säuglingen mit angeborener Zwerchfellhernie und Ösophagusatresie. Die Vorbereitung der Kinder für einen thoraxchirurgischen Eingriff und die postoperative Pflege werden dargestellt; dabei werden Aspekte der Schmerzbekämpfung, der Physiotherapie und der Umgang mit Thoraxdrainagen erörtert.
Résumé
Les infirmières qui s’occupent des nourrissons et des enfants devant subir une intervention chirurgicale du thorax doivent agir et prendre des décisions en tenant compte d’une multiplicité de facteurs extrêmement complexes. Elles doivent donc disposer, ,en plus de leur expérience, d’un important bagage de connaissances, d’adresse et d’intuition. Les principles de la théroie de la totalité (holistic care) prenant en considération l’ensemble des besoins d’un nourrisson et d’un enfants dans son contexte familial sont considérés comme un atout majeur.
Les auteurs traitent des soins à apporter aux nourrissons présentant des anomalies thoraciques congénitales et acquises et en particulier aux nourrissons avec hernie diaphragmatique congénitale ou atrésie oesophagienne.
Il est aussi question de la préparation des enfants à la chirurgie du thorax et de l’organisation des soins postopératoires, y compris la lutte contre la douleur, la physiothérapie et le drainage thoracique.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Benner P (1982) From novice to expert. Am J Nurs 82: 402–407
Roy N (1977) Neonatal transport. Med J Aust 2: 862–864
Roy N, Brown M (1983) Stabilization and treatment. Newborn Emergency Transport Service, Melbourne, Victoria
Kennell JH, Klaus MH (1988) Care of the parents. In: Carlo WA, Chatburn RL (eds) Neonatal respiratory care, 2nd edn. Yearbook Medical, Chicago, pp 213–234
Muller NL, Bryan AC (1979) Chest wall mechanics and respiratory muscles in infants. Pediatr Clin North Am 26: 503–515
McMahon RA (ed) (1984) Physiological differences between adults and children. In: An aid to paediatric surgery. Churchill Livingstone, Edinburgh, pp 4–7
Liebman J, Borkat G, Hirschfeld S (1979) The heart. In: Klaus MH, Fanaroff AA (eds) Care of the high-risk neonate. 2nd edn. Saunders, Philadelphia, pp 294–323
Friedman WF (1973) The intrinsic physiologic properties of the developing heart. In: Friedman WF et al (eds) Neonatal heart disease. Grune and Stratton, New York
Hazinski MF (1984) Children are different. In: Hazinski MF (ed) Nursing care of the critically ill child, Mosby, St Louis, p 2
Rushton CH (1988) The surgical neonate: principles of nursing management. Pediatr Nurs 14: 141–150
Hazinski MF, Pacetti ASP (1988) Nursing care of the infant with respiratory disease. In: Carlo WA, Chatburn RL (eds) Neonatal respiratory care, 2nd edn. Yearbook Medical, Chicago, pp 154–211
Hey E, Scopes JW (1987) Thermoregulation in the newborn. In: Avery GB (ed) Neonatology: pathophysiology and management of the newborn, 3rd edn. Lippincott, Philadelphia, p 209
Dienno ME (1987) Esophageal atresia, corrective procedures and nursing care. AORN J 45: 1364
Shann F (1985) Paedriatric fluid and electrolyte therapy. In: Oh TE (ed) Intensive care manual, 2nd edn. Butterworths, Sydney, pp 425–429
Dorrington KL (1981) Skin turgor, do we understand the clinical sign? Lancet I: 264–266
Smith LJ (ed) (1989) Intravenous nutrition. In: Paedriatric handbook, Roxal Children’s Hospital, Melbourne. Endata Pty Ltd, Australia, pp 224–225
Central venous lines: descriptions, protocols and procedures (1988) Royal Children’s Hospital, Melbourne
Benfield DG, Leib SA, Reuter J (1976) Grief response of parents following referral of the critically ill newborn. N Engl J Med 294: 975
Mercer RT (1974) Mother’s responses to their infants with defects. Nurs Res 23: 133
Klaus MH, Kennell JN (1982) Parent-infant bonding. Mosby, St Louis
MacFarlane JA, Smith DM, Garrow DH (1978) The relationship between mother and neonate. In: Kitzinger S, Davis JA (eds) The place of birth, Oxford University Press, New York
Anisfeld E, Lipper E (1983) Early contact, social support and mother, infant bonding. Pediatrics 72: 79
Berman L, Stringer D, Ein S, Shandling B (1988) The late-presenting pediatric Bochdalek hernia. J Pediatr Surg 23: 735–739
Johnston PW et al (1988) Clinical use of extracorporeal membrane oxygenation in the treatment of persistent pulmonary hypertension following surgical repair of congenital diaphragmatic hernia. J Pediatr Surg 23: 908–912
Bohn D et al (1987) Ventilatory predictors of pulmonary hypoplasia in congenital diaphragmatic hernia, confirmed by morphologic assessment. J Pediatr Surg 111: 423–430
Langer JC et al (1988) Timing of surgery for congenital diaphragmatic hernia: is emergency operation necessary? J Pediatr Surg 23: 731–734
Reynolds M, Luck SR, Lapper R (1984) The ‘critical’ neonate with congenital diaphragmatic hernia: a 21-year perspective. J Pediatr Surg 19: 364–369
Moore KL (1982) The developing human, 3rd edn. Saunders, Philadelphia, pp 172–174
Anderson KD (1986) Congenital diaphragmatic hernia. In: Welsh KJ et al (eds) Pediatric surgery, 4th edn. Yearbook Medical, Chicago, pp 590–600
Phelan PD, Landau LI, Olinsky A (eds) (1982) Lung growth and development. In: Respiratory illness in children, 2nd edn. Blackwell, Oxford 5
Geggel RL et al (1988) Congenital diaphragmatic hernia: arterial structural changes and persistent pulmonary hypertension after surgical repair. J Pediatr 107: 457–463
Moynihan P, Gerraughty A (1985) Diaphragmatic hernia, low stress = higher survival. Am J Nurs June: 662–665
Filston HC, Izant RJ (1985) Congenital anomalies that present with respiratory distress. In: Filston HC, Izant RJ (eds) The surgical neonate. Appleton Century Crofts, Norwalk, Connecticut, p 94
Burge D (1989) Diaphragmatic hernia. Matern Child Health, January: 21–25
Lillehei CW et al (1989) Preoperative ECMO in high-risk CDH. Fifth Annual Children’s Hospital National Medical Center ECMO Symposium, p 68
Schraeder BD, Fischer DK (1986) Using intuitive knowledge to make clinical decisions. MCN 11: 161–162
Stolar C, Dillon P, Reyes C (1988) Selective use of extracorporeal membrane oxygenation in the management of congenital diaphragmatic hernia. J Pediatr Surg 23: 207–211
Gerraughty AB, Younie PLJ (1987) ECMO, the artificial lung for gravely ill newborns. Am J Nurs May: 655–658
Nicks JJ, Bartlett RH (1988) Extracorporeal membrane oxygenation and other new modes of gas exchange. In: Carlo WA, Chatburn RL (eds) Neonatal respiratory care, 2nd edn. Yearbook Medical, Chicago, pp 405–407
Myers NA (1974) Oesophageal atresia: the epitome of modern surgery. Ann R Coll Surg Eng 54: 277–287
Hopkins WA (1972) The esophagus. In: Gray SW, Skandalakis KE (eds) Embryology for surgeons. Saunders, Philadelphia, p 63
Guzetta PC et al (1987) Surgery of the neonate. In: Avery GB (ed) Neonatology: patho-physiology and management of the newborn, 3rd edn. Lippincott, Philadelphia, pp 952–953
Barry JE, Auldist AW (1984) The VATER association, one end of the spectrum of anomalies. Arch Dis Child 128: 769
Connolly B, Guiney EJ (1987) Trends in tracheoesophageal fistula. Surg Gynecol Obstet 164: 308–312
Spitz L, Kiely E, Bereton RJ (1987) Esophageal atresia: five-year experience with 148 cases. J Pediatr Surg 22: 105–106
Puri P, Blake N, O–Donnell B, Guiney EJ (1981) Delayed primary anastomosis following spontaneous growth of esophageal segments in esophageal atresia. J Pediatr Surg 16: 180–183
Bates TA, Broome M (1986) Preparation of children for hospitalization and surgery: a review of the literature. J Pediatr Nurs 1: 230–238
Piaget J, Inhelder B (1969) Psychology of the child. Basic, New York
Pontious SL (1982) Practical Piaget: helping children understand. Am J Nurs, January: 115
Bradshaw C, Zeanah PD (1986) Pediatric nurses’ assessments of pain in children. J Pediatr Nurs 1: 314
Cousins MJ, Mather LE (1989) Relief of post operative pain: advances awaiting application. Med J Aust l50: 355
Dale JC (1986) A multidimensional study of infants’ responses to painful stimuli. Pediatr Nurs 12: 27
Beasley S, Tibballs J (1987) Efficacy and safety of continuous morphine infusion for post operative analgesia in the paediatric surgical ward. Aust NZJ Surg 57: 233–237
Erickson R (1981) Chest tubes, they’re really not that complicated. Nurs 11: 41
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Telfer, H., Willis, S. (1991). Nursing Perspectives in the Management of Infants and Children Requiring Thoracic Surgery. In: Myers, N.A., Angerpointner, T.A. (eds) Paediatric Thoracic Surgery. Progress in Pediatric Surgery, vol 27. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-87767-4_3
Download citation
DOI: https://doi.org/10.1007/978-3-642-87767-4_3
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-87769-8
Online ISBN: 978-3-642-87767-4
eBook Packages: Springer Book Archive