Upgrade to remove ads
Peds Week 1
Terms in this set (47)
Therapeutic care that minimizes or eliminates the psychological and physical distress experienced by children and their families in the health care system
Three techniques for providing atraumatic care
•Focused and purposeful
•Provides emotional outlet or coping devices
•Helps child understand the reason for the hospitalization/procedures
Major reason children younger than 5 get hospitalized
Major reason older children get hospitalized
Respiratory diseases mental health problems injuries
Major reasons adolescents get hospitalized
Problems related to pregnancy, childbearing, mental health, and injury
Stressors of Hospitalization
Psychological Effects of Hospitalization on Children
Anxiety and fear related to the overall process
Potential for bodily injury, physical harm, and pain
Separation from home, family, friends, etc.
•Anger and guilt
•Other types of defense mechanisms
Three stages of separation anxiety
Protest, Despair, Detachment
Displays crying, agitation, rejection of others, anger, inconsolable grief
withdrawn and quiet without crying; displays apathy, depression, lack of interest, overall feelings of sadness
Uses coping mechanisms, displays resignation but not contentment, may have developmental delays
Anxiety and Concerns
•Children take in parents' anxiety and concerns
•Parents have own fears and insecurities
•Child's reaction often related to parents' reaction to illness and hospitalization
•Hospitalization increases family's stress and anxiety level
Factors Influencing Family Reaction to Illness/Hospitalization
•Family members' coping skills
•Cultural, ethnic, and religious variations
•Values and practices related to illness
•General response to stress
•Attitudes about the care of a sick child
Methods to Promote Coping in Children
•Child teaching before events
Four Phases of Nursing Care for Hospitalized Children
•Building a trusting relationship
•Providing comfort and reassurance
Techniques to Reduce Stress in Children During Procedures
•Perform nursing care on stuffed animals or dolls.
•Avoid the use of medical terms.
•Allow the child to handle some equipment.
•Teach the child the steps of the procedure.
•Show the child the room where he or she will be staying.
•Introduce the child to the health care personnel.
•Explain the sounds the child may hear.
•Let the child sample the food that will be served.
End-of-Life Decision Making
•Health care personnel must assure families that the focus of care is changing and that the child is not being abandoned
•Quality of life must be taken into consideration when decisions to continue or withhold treatment from dying child
•"Do not resuscitate"
•Withholds cardiopulmonary resuscitation if child's heart stops beating
•In some institutions DNR is being replaced by AND "allow natural death"
Guidelines for Organ Donation
•Discussion should be separate from impending death or brain death notification.
•Written consent is necessary.
•All expenses are borne by recipient's family.
•State that the child's appearance will not be marred.
Family culture and spiritual beliefs must be considered
Last Acts Palliative Care Task Force Established Principles
•Respecting children's goals, preferences, and choices
•Using the strengths of interdisciplinary resources
•Acknowledging and addressing caregivers' concerns
•Building systems and mechanisms of support
Focus of Palliative Care
•Managing pain and discomfort
•Providing emotional support to the dying child and family
•Assisting the family through the grief process
•Providing the type of support and education that the dying child needs according to developmental stage
Key Pediatric Nursing Interventions
•Safe medication administration
•Providing Atraumatic Care
•Educating the Child and Parents
•Preventing Medication Errors
Eight Rights of Pediatric Medication
•Right route of administration
•Right to be educated
•Right to refuse
Developmentally Appropriate Explanations for Medications for Children
•Why the drug is needed
•What the child will experience
•What is expected of the child
•How the parents can participate and support their child
Determining Children's Doses by Body Weight
Weigh the child.
•If the child's weight is in pounds, convert it to kilograms (divide the child's weight in pounds by 2.2).
Check a drug reference for the safe dose range (e.g., 10 to 20 mg/kg of body weight).
Calculate the low safe dose.
Calculate the high safe dose.
Determine if the dose ordered is within this range.
Guidelines to Determine BSA
1.Measure the child's height.
2.Determine the child's weight.
3.Using the nomogram, draw a line to connect the height measurement in the left column and the weight measurement in the right column.
4.Determine the point where this line intersects the line in the surface area column. This is the BSA, expressed in meters squared (m2).
Providing Atraumatic Care when giving meds
•Using comforting positions
•Using topical anesthetic prior to injections
•Educating the child and parents
•Preventing medication errors
•Encourage child to participate
•Ensure child does not move to prevent injury with injection
Principles of Atraumatic Care Managing IV Therapy
•Gather equipment before approaching child.
•Select hand rather than wrist or upper arm veins.
•Ensure adequate pain relief.
•Allow anesthetic to prepared site to dry.
•Use a barrier to avoid pinching the skin.
•If needed, use a device to transilluminate the vein.
•Make only two attempts to gain access.
•Encourage parental participation.
•Coordinate care with other departments.
•Secure line with minimal amount of tape.
•Protect the site from bumping.
Factors that influence pain
•Previous pain experiences
•Family and cultural background
•Child and parents understanding
•What health and health care staff do
•Child and parents feel
indicators of pain in infants
•Facial expressions, body movements, crying
•Changes in heart rate, respiratory rate, blood pressure, oxygen saturation levels, vagal tone, palmar sweating, and plasma cortisol or catecholamine levels
Toddlers and Pain
•Encourage to verbalize pain
•Ensure the use of words the toddler understands
Preschoolers and Pain
•May not verbally report their pain
•Thinking that pain is something is expected
•Thinking adults are aware of their pain
Adolescents and Pain
•Concerned primarily with body image
•Concerned with fear of losing control over their behavior
•Can deny or refuse medications
Factors Affecting Children's Responses to Pain
•Type of pain
•Extent of pain
Pediatric Pain Assessment Tools
•FACES pain rating scale
•Oucher pain rating scale
•Poker chip tool
•Word-graphic rating scale
•Visual analog and numeric scales
•Adolescent pediatric pain tool
Pediatric Physiologic and Behavioral Pain Assessment Tools
•Neonatal infant pain scale
•Riley infant pain scale
•Pain observation scale for young children
•CRIES scale for neonatal postoperative pain assessment
•FLACC behavioral scale for postoperative pain in young children
Nonpharmacologic Pain Management
Pharmacologic Pain Management
Patient-controlled analgesia (PCA)
Behavioral-Cognitive Pain Management Strategies
Biophysical Interventions for Pain Management
•Sucking and sucrose
•Heat and cold applications
•Massage and pressure
Factors Affecting the Choice of Pharmacologic Interventions for Pain
•Drug being administered
•The child's status
•The type, intensity, and location of the pain
•Any factors that may be influencing the child's pain
Pain management meds
•Nonopioid and opioid
Preferred routes for pain meds
oral, rectal, IV, topical or local nerve block
other routes for pain meds
epidural, conscious sedation
Required Interventions of Conscious Sedation
•Ensuring that emergency equipment is readily available
•Maintaining a patent airway
•Monitoring the child's level of consciousness and responsiveness
•Assessing the child's vital signs (especially pulse rate, heart rate, blood pressure, and respiratory rate)
•Monitoring oxygen saturation levels
Nurse's Role in managing procedure-related pain
•Use topical anesthetic at site of a skin or vessel puncture.
•Use nonpharmacologic strategies for pain relief.
•Prepare child/family ahead of time about the procedure.
•Use therapeutic hugging to secure the child.
•Use the smallest-gauge needle possible.
•Use intermittent infusion device or PICC for multiple samples.
•Opt for venipuncture in newborns instead of heelsticks.
•Use kangaroo care for newborns before and after heelstick.
•Provide nonnutritive sucking before the procedure.
YOU MIGHT ALSO LIKE...
Peds Lecture 2: Nursing Care of the Hospitalized C…
Ch. 29 and 30
Chapter 21: The childs experience of hospitalizati…
OTHER SETS BY THIS CREATOR
pharm final NSAIDS and GOUT
Peds week 2
Maternity Exam 2 - Cultural Nursing Interventions
NUR 300 Nursing Past and Present
OTHER QUIZLET SETS
A1/3 Safety Communications Communications relative…
Pathophysiology: Skin Integrity
FSW Exam 4
Psychology Ch.2: The Biological Perspective