Psychosocial Flashcards
Define atraumatic care
Therapeutic care that minimizes or eliminates the psychological and physical distress experienced by children and their families
What are the three major principles of atraumatic care?
(DO NO HARM)
- Prevent or minimize the child’s separation from the family
- Promote a sense of control
- Prevent or minimize bodily injury and pain
Child Life Specialist
Health care professional with knowledge of child growth, development, and the psychosocial needs of children. Helps to prepare children for hospitalization, surgery, and procedures.
Stages of separation anxiety
(Anaclitic Depression)
- Stage of protest - child acts aggressively (cry, scream, refuse attention)
- Stage of despair - child withdraws from others (depression)
- Stage of detachment - child more interested in surroundings, appears happy (builds superficial relationships)
Factors that affect a child’s response to illness/hospitalization
- The child’s ability to work through a situation
- Child’s age
- Perception of the event
- Previous encounters with healthcare professionals
- Support from family
Magical Thinking
Children often interpret words literally and believe that pain inflicted is punishment
Strategies a nurse can use to reduce fear in hospitalized children
- Prevent or minimize separation with parents
- Parental absence (bring familiar items from home, child friendly room, limit stimuli)
- Minimize loss of control (keep routine, promote movement, allow ADLs)
How can a nurse minimize the loss of control a child feels when hospitalized?
- Keep routines
- Promote movement and play time
- Allow child or parent to perform the ADLs
- Give directions appropriate per development
- Limit or combine stressful procedures
- Allow child to express feelings
- Stay busy
- Give choices
Define therapeutic play and how it’s used in pediatrics
The universal language and “work” of children.
- Provides diversion, and relaxation
- Helps child feel secure in strange environment
- Lessens stress of homesickness
What principles and techniques would a nurse use to prepare a child for a procedure?
- Describe description and reason for procedure
- Describe where procedure will occur
- Introduce strange equipment child may see
- Be honest with child about pain
- Identify special care required after the procedure
Facts about children experiencing pain
- Infants in pain can display changes in their cry or poor feeding and sucking
- Toddlers react to pain with fear and may regress
- Preschoolers may not report pain, withdraw, or ty to hide
- School aged children can deny pain to appear brave
- Adolescents in pain may display a lack of interest/decreased concentration
What are nonpharmacological pain reducing methods that are used in infants and children?
Biobehavioral Techniques - (Distraction, Guided imagery, Hypnosis, Cognitive behavioral therapy, Heat, Cold, Massage, Tens
Distraction and relaxation - (Music therapy)
Preterm and Newborns - (Swaddling, sweet-ease sucrose)
Around the Clock Analgesia (ATC)
- Used for continuous pain (postop) over 5
- Does not require a doctor’s order
- Don’t wait until pain is extreme
- Less risk for over medicating and toxicity
What is the standard RSD for for acetaminophen?
10-15 mg/kg/dose q 4-6 hours, not to exceed 5 doses in 24 hours
What is the standard RSD for Ibuprofen in children?
5-10 mg/kg/dose q 6-8 hours
At what age can Ibuprofen be administered to children?
6 months
Pharmacological Management of Pain: Nonopioids
mild to moderate pain
Pharmacological Management of Pain: Opioids
moderate to severe pain (administer IV opioids over 3-5 minutes)
List distraction methods a nurse can use while performing a procedure on a child
FLACC Pain Scale
Rating scale to determine rate of pain based on patient behavior
Used on infants and children, used in ICU, and children with cognitive impairment (nonverbal)
- Faces
- Legs
- Activity
- Crying
- Consolability
Face Pain Rating Scale
For childen as young as 3 y/o. Provides facial expression, numbers, and words.
Face 0 - no hurt Face 1/2 - hurts little bit Face 2/4 - hurts little more Face 3/6 - hurts even more Face 4/8 - hurts whole lot Face 5/10 - hurts worst
0 - 10 Numeric Pain Intensity Scale
For children as young as 8 y/o.
Explain to child that 0 is no pain (hurt), and 5 or 10, is the worst pain.
What are Blocks to Communication?
- socializing
- giving unrestricted advice
- offering premature assurance
- giving overready encouragement
- asking closed ended questions
- interrupting a person
- talking more than the interviewee
