Hospitalization Flashcards
where should we do painful procedures for child? where should we NOT do painful procedures?
Yes = treatment room No = bedroom, play room
How is parent involved in atraumatic care?
- stay with child during procedure
- admin med when appropriate
benefits of play therapy?
◦ preschool children - perform procedure on doll
◦ therapeutic play lets children demonstrate emotions to decrease stress about hospitalization
◦ help with misconceptions about treatment
◦ cope with stress about illness
can we say “I’m going to take your blood pressure” to a small child?
No!
- don’t say “take” - take your BP- sounds like you are taking something away from them
Newborn HR, RR, Temp?
◦ Resting respiratory rate 30-60 / min
◦ Apical heart rate 110 – 160 / min
Temp 97.7 to 98.9 F (36.5 – 37.2 C)
how long do we count the RR? When is the best time to count RR?
1 full minute
–diaphragmatic breathing, not a symmetrical count
‣ count when sleeping or quiet
what will happen to BP and HR/RR as child ages
◦ HR/RR will decrease as child ages
◦ BP will increase as child ages
do we do a regular head to toe on kids?
no! modify it- do lungs/HR first
do things they don’t want done last
how do we weight kids under 2?
◦ weigh child under 2 naked laying on disposable pad with our hand overtop to stabilize if needed
how do we get height on kids?
crown of head to heel of foot
what should weight be at 6 mo? 1 year?
◦ birth weight should double by 6 mo
◦ birth weight should triple by 1 year
when do posterior and anterior fontanels close?
- Posterior fontanel closes by 2 – 3 months
* Anterior fontanel closes by 12 – 19 months
WTF is Denver II screening for?
◦ used to further assess language, cognition, fine/gross motor development skills for in depth screening
aka developmental screening
why do I care about the growth scale? What are we looking for?
• is child staying at certain % rate over time or is there a drop over time?
4 types of pain scales for pedes
FLACC
FACES
OUCHER
Visual Analog
components of FLACC scale?
◦ Face, Legs, Activity, Cry, Consolability
◦ scored 0, 1, 2 - add em up = pain rating
what age can you use FLACC scale with?
◦ infants - 7 years
Faces vs ouchers scale
• FACES scale
◦ 3-18 years
◦ explain each face and child will choose face they feel
◦ 0-10 scale
OUCHER scale
◦ 3-13
◦ photographs of faces in pain- cultural and ethnic differences
◦ same type of thing as faces scale but with photos
what is visual analog scale?
◦ 0-10 with a line and corresponding pain face drawings below
non pharmacological interventions for pain for infants
kangaroo care, nonnutritive suckling, swaddling
non pharmacological pain interventions for not infants
distraction relaxation guided imagery positive self talk CAM
is regression abnormal in hospitalized kid?
nope!
regression is normal
3 ways seperation anxiety is expressed
◦ protest- angry/cry/kick/ don’t want to be held, pulling off bandages- older child
◦ despair- sad, withdrawn, no playing
◦ detachment
interventions for separation anxiety
◦ Have parent bring transition object- treasured object from home
◦ encouraging communication through facetime, phone calls, videos, pictures of family
◦ maintain continuity of care
◦ give as much control as possible, rituals/routines
◦ encourage parent not to sleep out when child falls asleep - child feel betrayed
◦ reassure child you are with them and taking care of them
how do we get accurate output for kid in diaper?
weigh it
1 cup = ____ ounces
8
1 oz = _____ mL
30
ear drops-
<3?
>3?
‣ <3 - pull pinna DOWN and BACK
• (if child is small I have to reach down to pick them up)
‣ >3 - pull pinna UP and BACK
what do you do if you suspect child abuse? what do you say to the kid?
document and report
*legally required to report it
Reinforce that abuse is not the child’s fault
• The nurse is assessing a 5-year-old child with a possible fractured leg following a bicycle
accident. Which of the following actions would best determine the child’s pain level?
• Observe the child’s behavior.
• Ask the child, “How bad does your leg hurt?”
•Provide the child with a pain rating scale.
• Ask the parent, “How much pain do you think he is in?”
•Provide the child with a pain rating scale.
