Pain Flashcards
Hospitalized Child–Infant
How to interact with various ages based on the child’s age to help them with their illness, or while they are in the hospital.
Promoting Infant Development– Trust vs. Mistrust
•Place child in position, possibly an infant seat, so they can see their face and hands.
•Talk about everything in the room.
•Touch, swaddle, talk softly to soothe.
•Smile and put your face in their field of vision.
•Try to simulate home routine & group care to create routines.
•Try to assign the same nurse.
•Keep frightening objects from infant’s view.
•Pay close attention to light and sound stimulation.
•Hold for feedings- even NG or gastrostomy if possible & allow non-nutritive sucking for comfort.
•Toys; mobiles, rattles, squeaking toys, picture books, balls, colored blocks, activity boxes.
Hospitalized Child–Toddler
How to interact with various ages based on the child’s age to help them with their illness, or while they are in the hospital.
How Do We Promote Toddler Development?
Develop patient care rituals (home routines) and write these in the care plan.
Allow security objects from home.
Praise anything appropriately done.
Provide for mobility and appropriate outlets for aggression.
Make sure toddler has access to finger foods.
Allow for reasonable exploration of the environment.
Offer guided choices.
Repeat syllables & talk through all patient care.
Toys: board & mallet, push-pull toys, toy telephone, stuffed animals, story books with pictures.
Hospitalized Child–Preschooler
How to interact with various ages based on the child’s age to help them with their illness, or while they are in the hospital.
Hospitalized Preschooler- What To Expect?
May become overly aggressive or extremely withdrawn.
May bring an imaginary playmate.
Will often refuse to take medicines or cooperate in care.
They like to name objects, familiar people, familiar phrases, familiar routines- take ownership of things in the environment.
Have little understanding of time
Enjoy playing with other children
Are probably toilet trained at home but expect regression in the hospital
Enjoy silly humor
Need transitional objects
Hospitalized Child–School Age
How to interact with various ages based on the child’s age to help them with their illness, or while they are in the hospital.
How Do We Promote School Agers
Development?
Encourage continuation of school work.
Give realistic and truthful explanations, ask them to explain it back to you.
Allow quiet and private time.
Continue to use a lot of language.
Use a school-ager to teach new staff.
Involve them in “making things” even if it is an icepack.
If they seem to enjoy collecting things, suggest things in the hospital (no, not needles!).
Make a game out of normal routines- how long does it take for an antibiotic to run it?
Hospitalized Child–Adolescent
How to interact with various ages based on the child’s age to help them with their illness, or while they are in the hospital.
How Do We Promote Adolescent
Development?
Teach at a realistic level.
Involve with new staff.
Discuss concerns about the future and bring up issues if necessary.
Ask them how much they want parents to be involved.
Have high expectations for appropriate behavior and spell them out.
Help them maintain their identity
Preparing Adolescents
•Capable of abstract thought & reasoning (Answer
why).
•Conscious of appearance.
•Concerned more with present than with future, but
worried about future abilities.
•Striving for independence.
•Peer relationships and group identity very important.
•Suggest ways of maintaining control
FLACC scale
What do the letters represent?
What are the descriptions of the rating for 0,1,2
Who do you use this scale for?
Face 0
Face No particular expression or smile
Face 1
Occasional grimace or frown, withdrawn, disinterested
Face 2
Frequent to constant frown, clenched jaw, quivering chin.
Leg 0 Legs Normal position or relaxed Leg 1 Uneasy, restless, tense Leg 2 Kicking, legs drawn up
Activity 0 Lying quietly, normal position, moves easily Activity 1 Squirming, shifting back & forth, tense Activity 2 Arched, rigid, or jerking
Cry 0 No cry Cry 1 Moans or whimpers, occasional complaint. Cry 2 Crying steadily, screams or sobs, frequent complaints.
Consolability 0 Content, relaxed Consolability 1 Reassured by occasional touching, hugging, or talking to; distractible Consolability 2 Difficult to console or comfort.
This scale is used for infants and small children under 4. At age 4 children can tell you where it hurts
Wong Baker Face Scale
Faces 0 no hurt 2 hurts little bit 4 hurts little more 6 hurts even more 8 hurts whole lot 10 hurts worst
Nonpharmacologic Pain Control; Infants
Massage
Cooling or ice (> 6mo.)
Water or cool cloth
Pacifier (with or without dextrose), holding, rocking
Nonpharmacologic Pain Control; Toddlers
Distraction Frightening objects out of view Play Blowing away the ouch Bubbles Picture book Music
Nonpharmacologic Pain Control; Preschoolers
Band-Aids
Never take off underwear
Praise
Books with sounds
Nonpharmacologic Pain Control; School-age & Adolescent
Guided Imagery and leaving the pain behind Breathing and relaxation Music Thought stopping Heat/cold Massage
