Hospitalized child and pain Flashcards
What is the reason for the majority of hospitalizations for children <5?
Respiratory issues
What is the reason for the majority of hospitalizations for older children?
Respiratory/injuries
GI/gastro/mental health
What is the reason for the majority of hospitalizations for adolescents?
Injuries, pregnancy, mental health
During a child’s reactions to hospitalizations, what are the phases of separation?
Protest
Despair
Detachment
What are some nursing interventions to help decrease anxiety in infants?
Rooming‑in of parents Minimize number of caretakers Volunteers to hold and cuddle Provide comfort measures Minimize use of restraints Tactile, auditory, visual stimulation Toys: stuffed animals, mirrors, mobiles
What are some nursing interventions to help decrease anxiety in toddlers?
Rooming‑in of parents Transitional objects (bring to hospital) Set time frame for parents to return if parent leaves the hospital Teach parents how to assess child for stress Follow home routine PLAYROOM Medical play Expect regression
What are some nursing interventions to help decrease anxiety in preschoolers?
Rooming‑in of parents Transitional objects (bring to hospital) Set time frame for parents to return if parent leaves the hospital Teach parents how to assess child for stress Follow home routine PLAYROOM Medical play Expect regression Offer choices and encourage participation Medical & Therapeutic play Worry beads, Worry dolls Be truthful
What are some nursing interventions to help decrease anxiety in school-age children?
Communication with parents, siblings & friends
Promote normalcy (homework)
Available to talk with child & listen to feelings
Provide explanations of medical care (diagrams, equipment)
Promote developmental goal of industry
Provide choices
What are some nursing interventions to help decrease anxiety in adolescents?
Promote peer interactions Encourage parents to visit/stay Develop plan of care with adolescent Respect need for independence Privacy Be open & honest about medical care
What are safety measures for the hospitalized newborn and infant?
Use age-appropriate crib and bedding
Secure equipment cords under the infant’s gown or shirt
Do not allow child to chew on cords
Properly dispose of syringe caps and other small items that may present a choking hazard
Establish with parents a list of persons who may visit the child
Keep bed rails up at all times
What are safety measures for the hospitalized toddler and preschooler?
Maintain bed in low position
Keep side rails up when a parent is not at the bedside
Do not allow child to chew on any cords
Keep room clutter free
Remove all unnecessary equipment from the child’s room
Latex balloons should not be permitted due to the risk of suffocation
What are safety measures for the hospitalized child?
Properly dispose of syringe caps and other small items that may present a choking hazard
If toddlers are curious about hospital equipment provide them the opportunity to explore the equipment safely and with guidance
Keep in mind that these children are naturally curious and explorative
Instruct family members to inform staff when they are leaving the room to ensure that the child is being supervised
Treatment room
What are safety measures for the hospitalized school-age child?
Instruct the child to avoid manipulating hospital equipment such as IV pumps, PCA, and oxygen gauges
Allow the child the opportunity to explore hospital surroundings and equipment with guidance
Instruct family members to inform staff when they are leaving the to ensure that the child is being supervised.
What are safety measures for the hospitalized adolescent?
Address issues such as smoking in the room and consuming alcohol since friends could possibly bring cigarettes or alcohol to the hospitalized adolescent
Assess teen for signs he/she could elope from institution
What are some strategies to promote coping for the hospitalized child?
Rooming in for parents Child Life programs Meeting the educational needs Therapeutic play Learn about health care Express anxieties Work through feelings Achieve a sense of mastery or control over frightening or little-understood situations
What are some myths and misconceptions about children and pain?
Newborns don’t feel pain.
Exposure to pain at an early age has little or no effect later.
Infants and small children have little memory of pain.
Intensity of the child’s reaction to pain indicates intensity of pain.
A child who is sleeping or playing is not in pain.
Children are truthful when asked if they are in pain.
Children learn to adapt to pain and painful procedures.
Children are more prone to addiction to narcotic analgesics.
What factors influence pain?
Cognitive-behavioral factors
Emotional factors
Environmental factors
What are some indicators of pain in infants?
Facial expressions Body movements Crying Increased irritability Refusal to move injury part Interrupted sleep Changes in HR RR O2 sat levels Vagal tone Plantar or palmar sweating
What are some indicators of pain in preschoolers, school-age children, and adolescents?
Short attention span Posturing Drawing up knees Flexing limbs Massaging affected area Lethargy Remaining quiet Withdrawal Sleep disturbances Depression and/or aggressive behavior
What is the FACES pain rating scale?
Emoticon-like faces are used for ages 3+ to express pain level
What is the Oucher pain rating scale?
Photos of children are used for ages 3+ to express pain level
What is the poker chip tool for pain?
Using 1-4 poker chips to describe pain
What is the word-graphic rating scale?
Rating scale child from 8-15 uses to select pain rating
What is the FLACC scale?
Behavioral scale for post-op pain in young children
What are some opioid side effects?
Sedation Nausea and vomiting Constipation Urinary retention Pruritis Resp depression CV collapse Addiction
What are non-pharmacological pain management techniques?
Behavioral distraction Assorted visuals Breathing techniques Comfort measure Repositioning, holding Touching, massaging Warm or cold compresses Diversional talk Guided imagery Biofeedback Progressive muscle relaxation
What are some complementary therapies?
Cutaneous stimulation Sucrose solution (<1mo) Guided imagery Relaxation techniques Breathing techniques Hypnosis CBT Application of heat or cold Electroanalgesia (TENS) Acupuncture
