L1: Theories for ped Flashcards
What is FCC
Family centered care: Health care providers, pts, and families are involved in the planning, deliver, and evaluation of care.
Why is FCC important
- improves patient safety. We make sure families understand pt teaching.
- improved outcomes
- good care experiences
- less malpractice and legal action against us
- Family support and knowledge about child makes our job easier
- Effective resource use
What are the key concepts of FCC
- Empowerment
- Enabling
What is atraumatic care?
Care with setting, personnel, and intervention that eliminate or reduces physical and psychological distress experienced by the children and their families.
Making sure the 4Ws and 1H of care does not harm them
What is the goal of Atraumatic care?
Do not harm
3 Principles of Atraumatic care are:
- Prevent pt separation from family
- Promote sense of control (providing them wit options)
- Minimize or prevent pain or injury
What is the role of the pediatric nurse?
- Make a therapeutic relationship
- Care about the family and advocate for them
- Prevent disease and promote health
- Patient teaching
- Support families
- Collaborate with family
Most important attribute about peds nurse
Passion for helping families
Define consanguineous
Blood related
Define affinal
in-laws
Define Family of origin
Family you grew up with
How to obtain consent
The person consenting must be fully informed, they must have the ability to make decisions, and consent should be voluntary.
You need written consent or assent for less serious treatments
Restraint orders expire after ___hr
24
What is the main pt stressor of illness and hospitalization
Separation anxiety or anaclitic depression: It has 3 phases
- protest: resisting and emotional
- despair: stop resisting but evidence of depression. Not interested in food or play
- detachment: Sad and withdrawn. Detached from parents
Describe separation anxiety in young childhood vs late childhood and ados
- Younger children: Being hospitalized may be their biggest stressor at this point in their lives. Abnormal overreactions are common responses (tantrums, bed-wetting, and regression). Preschoolers have object permanence, unlike toddlers, so they handle the situation better.
- Older children and ados: handle separation anxiety much better than the latter. You may see regression. Separated from friends and being excluded can affect them too
Which is more important to consider when predicting anxiety: intellectual maturity or concept of illness
Concept of illness
When can hospitalization effects be observed in children
Before admission, during, and after discharge
Risk factors that make kids more vulnerable to hospitalization stress
- Being within developmental age range (6m-5yrs)
- Already a weak bond with parents
- Boys are pressured to hide emotions
- Children with developmental delays
- long or multiple hospital stays
Parent reactions to their child being hospitalized
- Feeling helpless
- questioning nurse’s skills
- fear and uncertainty
- Want reassurance
- accept reality
Sibling reactions to pt hospitalization
- Loneliness, fear, guilt, jealousy, resentment, etc…
- Not informed about pt’s situation
- Believe that their parents will treat them differently
explain different age groups ability to self-report pain
- 18m to 3yrs can use alternative words for pain (e.g. booboo)
- 4 to 5 yrs can quantify pain
- school-age children can understand the word “pain”
- Children older than 6 can give you PQRST
Physiological signs of pain
- BP
- RESP
- SPO2
- Skin conductance
- EGG
- Cerebral blood flow
Pain management for neonates
- Sugar (floods endorphins)
- kangaroo care (skin-skin)
- swaddling
- breast-feeding
- non-nutritive sucking
Pain management for infants up to 1 yr old
- sweet solution (not as effective as in neonates)
- topical anesthetic (e.g. Emla)
- Breast-feeding
- distractions
Pain management toddlers to preschool
- sucrose (distraction but not effective)
- topical anesthetic
- distraction
- held in an upright or comfortable position
- play
pain management in school-age to ado
- Topical anesthetic
- guided imagery
- distraction
- cognitive behaviour therapy
- try to time it at a good time for them
Why is medication weaning important
- Prevent withdrawal symptoms esp when using opioids
