urses coming into room to give medications: try to schedule medication doses so that normal sleep time is not disrupted.
2. Noise in the hallways: keep patient room doors closed as much as possible to lessen noise levels.
3. Laboratory technicians coming in very early to take
blood specimens: try to arrange to have blood specimens collected as late as possible so patients don't have to be wakened.
4. Patients being awakened extra early for vital signs to
be taken before shift changes: have vital signs taken by
new shift coming on, and not the one going off to avoid
5. Nurses changing IV fluids when patients are sleeping.
Try to adjust timing of IV fluid changes at more reasonable
hours - if they are almost through as patient is ready to go to sleep, change it rather than waiting for it to run
through completely and having to wake patient when it is changed.
4. Pre-operatively, the care of an appendectomy patient will be the same whether they are a 5-year-old child or an adult (Acute, 2004; Appendicitis, 2004). A complete history will be taken, the patient will be given a physical examination and the lower right abdomen check for pain (in a young child, the doctor may ask them to touch the area where it hurts). Blood tests will be taken to look for an elevated white cell count indicating infection, and a urinalysis will be performed to rule out a urinary tract problem. An ultrasound or CAT scan may be performed to confirm the diagnosis. The actual appendectomy can be performed laparoscopically or through an open incision in the lower right abdomen. A general surgeon could perform the surgery in either case, but usually children are operated on by a pediatric surgeon. Postoperatively, most children recover within 2
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