A preschool-age child has moderate dehydration and needs a rapid bolus of fluids. To provide atraumatic care and administer fluids most effectively, what action will the nurse take?
a. Apply a eutectic mixture of local anesthetic (EMLA) just before inserting an intravenous line.
b. Ask the child's parents to restrain the child during venipuncture so fluids may be administered.
c. Request an order for nasogastric (NG) fluids to avoid the trauma of venipuncture.
d. Use a powdered lidocaine preparation prior to insertion of the intravenous needle.
ANS: D
One method to ensure atraumatic care is through the use of topical analgesics before IV injections. Powdered lidocaine preparations are effective in reducing the pain and fear associated with invasive procedures, such as venipuncture. EMLA is useful only if applied 1 to 2.5 hours prior to IV insertion. Asking parents to restrain the child for a painful procedure can cause stress and anxiety for both the child and the parents. NG fluids are traumatic and are uncomfortable long past the insertion of the NG tube.
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