Pediatric nurses, help please.

SnowymtnRN · Jan 24, 2005

We get a few spill over pedi pts each winter on our med/surg unit, and I need a little refresher before they start coming, if you don't mind. We measure the diapers, and report the number of grams the diapers weighed for the entire shift. I can't remember how many grams are okay, and what amount needs to be reported to the physician???
Also, when doing the RSV screening, we have a special swab & solution to transport it in to the lab. Do you just swab far back in the baby's nose, or do you suction the nasopharynx & use one of those in-line mucous traps to obtain the speciman. (I've seen it done both ways, and the in-line mucous traps seem difficult as there is usually not enough mucous to make it all the way through the suction tubing). I guess you could suction normal saline to bring the small amount of mucous in the tubing into the trap? Which is the best way?
Is it okay to wear a mask only when suctioning, or being very close up to an RSV baby? Otherwise, just wear gloves/gowns if providing care?
Does anyone know of any good pedi websites, that you could find answers to these, and other questions?
Thanks ahead of time for your help. As I said, we only get spill over, so none of our nurses are that experienced when it comes to pedi pts., and everyone seems to have slightly different answers.
(I would post this in the pedi nurses forum,but I thought it might get seen more here)

IF i remember right, 30cc=28gms os roughly 30cc=30gms. i need to look it up.

As far as RSV testing, what i've been taught and works well is to squirt some saline (just a few drops) in their nose, then use a bulb suction and suck out the saline and nasal drainage. Then use that as your testing sample. make sure your bulb syringe is a brand new one tho. lol But saline makes the nasal drainage much easier to handle and does not contaminate the specimen.

As far as ANY suctioning goes, especially with RSV its contact isolation. BUt with very wet droplets i'd worry about airborne pathogens. So when suctioning, i always wear gown, gloves and eye wear. That's just me tho. Otherwise contact precautions, but ESPECIALLY when suctioning i wear it all. RSV is very very contagious.

Good luck and have fun with the kiddos!

RN4NICU, LPN, LVN · Jan 24, 2005

Acceptable urine output for pediatrics is about 2cc/kg/hr. 1-2cc/kg/hr is marginal and under 1cc/kg/hr is considered oliguric. Also pay attention to the quality of the urine. It should not be dark in color or have a strong odor. When in doubt, always ask - better to err on the safe side. :)

jeepgirl, LPN, NP · Jan 24, 2005

I've been taught that 1 mL = 1 g

Gompers, BSN, RN · Jan 24, 2005

Agree with RN4NICU - 2cc/kg/hr of urine is considered normal in babies. We let the docs know when they fall below that, or if they're consistently above 4cc/kg/hr.

For RSV, we squirt some sterile saline into the nose, then use a regular suction catheter (not inline) to deep suction the nares. We have the catheter connected to a Luken's specimen trap, and we'll suck a little sterile water into the catheter afterwards to clear the secretions into the trap.

We always wear gown, glove, and mask for RSV at all times - but we're a NICU and don't like to take chances that our nurses will get sick with RSV themselves.

plumrn, BSN, RN · Jan 25, 2005

Thanks so much for all the replies! I will share them with my fellow co-workers.

plumrn, BSN, RN · Jan 25, 2005

Thanks so much for all the replies! I will share them with my fellow co-workers.

KRVRN, BSN, RN · Jan 25, 2005

Ewww, our RSV swabs aren't a swab per se, they're a STICK. And we have to push it FAR back into the baby's nose and SCRAP a sample, because the test requires cells, not mucus. I cringe every time I have to do one. And it's one stick per nostril, so you have to do it twice! I wish we could just collect some snot for it.

KRVRN, BSN, RN · Jan 25, 2005

Ewww, our RSV swabs aren't a swab per se, they're a STICK. And we have to push it FAR back into the baby's nose and SCRAP a sample, because the test requires cells, not mucus. I cringe every time I have to do one. And it's one stick per nostril, so you have to do it twice! I wish we could just collect some snot for it.

nursepotter05, RN · Jan 26, 2005

We take a syringe with about 1-2 cc's of saline hook it to the end of a butterfly needle which we cut the needle off of leaving just a small amount of the tubing. We squirt the saline into the nose and pull back on the sryinge. We squirt the saline into the viral medium, which has to be put on ice.

plumrn, BSN, RN · Jan 26, 2005

TNnurse05, that sounds like a great way to do it, but you probably don't squirt the whole 1cc or 2 of saline in their nose, do you? Do you just put that much in the syringe so that you will have enough to be able to squirt it all into the viral medium container, but really only squirt a fraction of that in?