A After the child has been
returned to his or her room, nursing care focuses on careful observation of the vital signs for any signs or symptoms of complications: shock, hemorrhage, or respiratory distress. An IV flow sheet is begun that documents the type of fluid administered, the amount of fluid to be absorbed, the rate of flow, any additive medications, the site, and the site's appearance and condition. The physician should be notified if anuria (absence of urine) persists longer than 6 hours. Postoperative orders may
or may not provide for ice chips or clear liquids to prevent dehydration; these may be administered with a spoon or in a small medicine cup. Frequent repositioning is necessary to prevent skin breakdown, orthostatic pneumonia, and decreased circulation. Coughing, deep breathing, and position changes are performed at least every 2 hours.