In the pediatric near-drowning victim, hypoxia and related pathophysiologic factors affect the pulmonary, neurologic, cardiovascular, gastrointestinal, and renal systems. Other complications arise from the potential for infection; the immobile state; and anxiety and fear related to the hospitalization. Altered coping mechanisms and knowledge deficits related to home care and drowning prevention offer problems that the family must overcome during the recovery of their child from the near-drowning insult. Using this knowledge and the accurate, comprehensive ongoing nursing assessments, the nurse must recognize the needs of the child and family. The nurse then formulates appropriate nursing diagnoses with measurable patient-centered goals for each diagnosis and develops pertinent nursing interventions that can be continually evaluated for effectiveness and revised as needed. This process is integral to the effective care of the child and family who experience a near-drowning incident.