Hospitalization

Question 1

where should we do painful procedures for child? where should we NOT do painful procedures?

Answer 1

Yes = treatment room
No = bedroom, play room

Question 2

How is parent involved in atraumatic care?

Answer 2

• stay with child during procedure

- admin med when appropriate

Question 3

benefits of play therapy?

Answer 3

◦ 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

Question 4

can we say “I’m going to take your blood pressure” to a small child?

Answer 4

No!

- don’t say “take” - take your BP- sounds like you are taking something away from them

Question 5

Newborn HR, RR, Temp?

Answer 5

◦ Resting respiratory rate 30-60 / min
◦ Apical heart rate 110 – 160 / min
Temp 97.7 to 98.9 F (36.5 – 37.2 C)

Question 6

how long do we count the RR? When is the best time to count RR?

Answer 6

1 full minute
–diaphragmatic breathing, not a symmetrical count
‣ count when sleeping or quiet

Question 7

what will happen to BP and HR/RR as child ages

Answer 7

◦ HR/RR will decrease as child ages

◦ BP will increase as child ages

Question 8

do we do a regular head to toe on kids?

Answer 8

no! modify it- do lungs/HR first

do things they don’t want done last

Question 9

how do we weight kids under 2?

Answer 9

◦ weigh child under 2 naked laying on disposable pad with our hand overtop to stabilize if needed

Question 10

how do we get height on kids?

Answer 10

crown of head to heel of foot

Question 11

what should weight be at 6 mo? 1 year?

Answer 11

◦ birth weight should double by 6 mo

◦ birth weight should triple by 1 year

Question 12

when do posterior and anterior fontanels close?

Answer 12

• Posterior fontanel closes by 2 – 3 months

* Anterior fontanel closes by 12 – 19 months

Question 13

WTF is Denver II screening for?

Answer 13

◦ used to further assess language, cognition, fine/gross motor development skills for in depth screening

aka developmental screening

Question 14

why do I care about the growth scale? What are we looking for?

Answer 14

• is child staying at certain % rate over time or is there a drop over time?

Question 15

4 types of pain scales for pedes

Answer 15

FLACC
FACES
OUCHER
Visual Analog

Question 16

components of FLACC scale?

Answer 16

◦ Face, Legs, Activity, Cry, Consolability

◦ scored 0, 1, 2 - add em up = pain rating

Question 17

what age can you use FLACC scale with?

Answer 17

◦ infants - 7 years

Question 18

Faces vs ouchers scale

Answer 18

• 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

Question 19

what is visual analog scale?

Answer 19

◦ 0-10 with a line and corresponding pain face drawings below

Question 20

non pharmacological interventions for pain for infants

Answer 20

kangaroo care, nonnutritive suckling, swaddling

Question 21

non pharmacological pain interventions for not infants

Answer 21

distraction
relaxation
guided imagery
positive self talk 
CAM

Question 22

is regression abnormal in hospitalized kid?

Answer 22

nope!

regression is normal

Question 23

3 ways seperation anxiety is expressed

Answer 23

◦ protest- angry/cry/kick/ don’t want to be held, pulling off bandages- older child
◦ despair- sad, withdrawn, no playing
◦ detachment

Question 24

interventions for separation anxiety

Answer 24

◦ 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

Question 25

how do we get accurate output for kid in diaper?

Answer 25

weigh it

Question 26

1 cup = ____ ounces

Answer 26

8

Question 27

1 oz = _____ mL

Answer 27

30

Question 28

ear drops-
<3?
>3?

Answer 28

‣ <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

Question 29

what do you do if you suspect child abuse? what do you say to the kid?

Answer 29

document and report

*legally required to report it

Reinforce that abuse is not the child’s fault

Question 30

• 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?”

Answer 30

•Provide the child with a pain rating scale.