A convenient position for restraint is having one person on either side of the bed. The extremity from where the blood is drawn is partially stabilized by the person drawing the blood. The other person leans across the child’s upper body, preventing movement, and uses an arm to immobilize the venipuncture site.
The external jugular vein is frequently used to obtain blood samples from infants and young children. Place the child in a mummy restraint and lower his head over the side of the bed, stabilizing his head with your hands.
For femoral venipuncture, the infant is placed on his back and his legs spread apart in a froglike fashion. Restrain and stabilize his legs by placing your hands at the knee area. Note that the nurse’s face is in an advantageous position to soothe the infant by talking and smiling. This technique favors maintenance of the nurse-infant relationship. The genital should be covered with a diaper to prevent contamination of the puncture site by urine. The infant should be observed for signs and symptoms of arteriospasm.
Lumbar Puncture (L.P.)
When positioning an infant for lumbar puncture, restrain his lower limbs with a sheet and hold him. The infant’s knees and neck are in a flexed position.
The sitting position for spinal lumbar puncture is often used for premature infants, who have lower cerebrospinal fluid pressure.
Placing the Infant in Fowler’s and Trendelenburg Positions
In standard-size adult beds, a gatch lever facilitates adjustment of the mattress to Fowler’s and the Trendelenburg position. Infant bassinets, cribs, and incubators are not equipped with gatch adjustments, but the mattress may be placed in Fowler’s and the Traendelenburg position.
The diaper sling
• Place the crib mattress in Fowlers position so that the weight of the infant’s body will rest on the buttocks.
• Place the rolled diaper in a ‘U’ shape on the crib mattress and secure the ends to the sheet.
• Set the baby in the folded diaper as if in a swing. This position prevents strain of the abdominal muscles and is used after abdominal surgery. An infant seat can be used instead of a diaper sling.
Child’s Crib in Fowler’s or Trendelenburg Position
Positioning and Feeding the Infant
• Hold the infant in cradle position with slight elevation of head.
• The nurse’s hand grasps the thigh area to ensure safe positioning.
• Place the entire nipple in the infant’s mouth.
• Formula must always fill the entire nipple area, or discomfort will occur owing to the swallowing of air.
• Holding the infant in a sitting position to burp him allows for observation of his responses.
• Seat the infant upright on your lap with his head and body tilted slightly forward.
• Support his head and chest by placing your fingers over the mandible bone of his face.
• With your free hand, gently pat or massage his back until the infant burps.
Instillation of Nasal Drops
The child may be placed in a mummy restraint.
• Place a pillow under the infant’s shoulders and allow his head to fall back over the edge of the pillow.
• Place your elbow on the mattress above the infant’s head and stabilize the head between your forearm and body. Your hand may be used to restrain the infant’s arms.
• With your free hand, administer the prescribed amount of drops in the nose.