Outline a plan of care for Z.O., describing at least two nursing interventions that would be
appropriate for managing fluid status, providing preoperative teaching, facilitating family
coping, and preparing Z.O. and his family for surgery.
What will be an ideal response?
Fluid status:
• Placement of an IV line
• NPO status
• Strict I&O
Patient and family teaching:
The family will be overwhelmed, and information should be presented in small amounts to
patient and family. Explanations should be age appropriate and in simple, honest terms.
• Explain the purpose of the surgical procedure.
• Explain that Z.O. will return with his head shaved and a dressing.
• Explain that Z.O. will probably be in the pediatric intensive care unit (PICU) and there will be lots of
machines making noise and attached to him. That is normal.
• Explain that Z.O. will have a special IV in his chest to get medication delivered through.
• Explain to Z.O. and his family how he will feel after surgery and that he will probably be lethargic
and sleepy and might have a headache. Family visitation will be limited until he returns to the
regular unit. Medications will most likely be ordered for nausea and pain.
Family coping:
Anticipatory grieving can be expected, and a multidisciplinary conference should be arranged.
• Encourage the family to express feelings. Guilt and fear are common emotions.
• Assess support systems. Initiate social work or pastoral care if indicated.
Preoperative preparation:
• Monitor vital signs. Notify surgeon of any changes.
• Monitor for any changes in neurologic status or level of consciousness.
• Make sure consent for procedure is obtained.
• Hair will be shaved or clipped short preoperatively, but this is often done in the operating room.
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