pain is an expected assessment finding in patients who have which of the following lung diseases? This is a topic that many people are looking for. amritsang.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, amritsang.org would like to introduce to you Pediatric Nursing – Pain Assessment, Hospitalization and Death/Dying. Following along are instructions in the video below:
In this video. We are going to finish up part 1 of my pediatric video video series. So we are first going to talk about pain assessment for children.
If are following along with cards. Im on card. 30.
Theres a lot of details to remember here so i would know the different pain scales. I would know what age range. You would use each scale for and then i would know the components of each scale.
So first up is the cries scale. So that cri es. You would use this scale for infants.
Under six months of age components. Include crying. Requires o2 increased vital signs expression and sleepless.
The flat scale could be used from ages to months to seven years components of the flacc scale include face legs activity. Cry and console ability then we have the faces scale. Which can be used from ages.
Three and up so in this scale. It uses a diagram of six faces to help rate. The childs pain on a scale from zero to five and then you have that outer scale.
Which can be used from ages. 3 to 13 years of age. It uses.
Six photographs to rate pain on a scale from zero to five and then you have the numeric scale. Which is what we use for adults primarily you can use that for children ages. Five and older so not below that so this is where you would have the child rate.
Their pain on a scale from zero to ten zero being no pain. Ten being the worst pain. Theyve ever had and then you have a non communicating childs pain checklist.
So this can be used for children. Three. And up.
And you basically basically youre going to observe the childs behaviors for ten minutes in order to really gauge their level of pain when they cannot communicate all right so thats pain assessment. Lets talk about hospitalization and this is how each age range kind of deals with hospitalization and illness. So as an infant they have no ability to verbalize their discomfort.
Which is very frustrating as a parent when you have an infant you know somethings wrong. But you dont know exactly whats wrong because they cant verbalize it so important thing to do when youre dealing with an infant who is sick is that you want to provide consistency in caregivers. When you have a toddler.
They also have a limited ability to verbalize discomfort and follow directions. So they may be a little verbalize. A little bit.
But not a lot so they may exhibit separation anxiety during this time and they may exhibit regression. So you may have like a toddler who was potty trained. But when theyre sick or dealing with a hospitalization they may regress back to wetting their pants.
Again. You should encourage parents to provide routine care for the toddler. While theyre in the hospital as much as possible for preschoolers.
I think you probably remember when i talked about magical thinking so magical thinking may leave the preschooler to believe that illness is a punishment for something they did or they thought okay they may also exhibit separation anxiety. And you want to really avoid the use of medical jargon with this really with any children and offer choices. Whenever possible for school aged children they can actually describe their pain.
And understand the concept of cause and effect. So you always want to provide factual information to a school aged child and then for adolescents. The most important thing for you to know here is that they may experience body image issues and feelings of isolation from their peers.
So body image and peer interactions are like key concerns for adolescents. So you want to provide sexual information to this age group as well and encourage contact with their peers. Maybe they can come visit them at the hospital.
If theyre hospitalized or something. Like that okay in terms of death and dying. Infants and toddlers really have no concept of death.
However you may find them mirroring their parents emotions and they may also exhibit regression like if theyve been paying. They may no longer be pi trained or if theyre pretty well behaved. They may start acting acting out when dealing with death and dying preschoolers view death as temporary so thats super important for you to know for your exam.
They also engage in magical thinking so they may this may lead the child to feel guilt or shame. Because maybe they think their thoughts or actions cause you know someones death or dying. And they may believe that separation from parents is punishment for bad behavior for the school aged child they begin to have a more adult like concept of death and dying fear of the unknown and fear of death may lead to uncooperative behavior in school aged children and then for adolescents.
They are likely to have an adult like understanding of death and dying they are influenced by their peers. More so than their parents and they are stressed out by changes in their physical appearance. So again they have those body image issues and then lets talk briefly about signs of impending death.
So when someone is dying they may have the sensation of heat. But their skin will feel cool you may exhibit decrease movements and sensations in the patient. They will likely exhibit a decreased level of consciousness.
They may have swallowing issues as well as incontinence bradycardia is usually indicative that death is nearing as well as hypotension and then they may exhibit abnormal respirations such as chained stokes respirations. Which is basically periods of apnea. Alternating with periods of hyperventilation so in terms of nursing care when when someone a patient dies when a child dies.
You want to remove the tubes and equipment from the body you want to allow the family to stay with the childs body as long as they like and you want to allow the family to rock the infant and toddler. If thats what they want to do and you want to offer to have the family assist in preparation of the body. So if you get like a question that says you know a child has passed away and one of the options is youre asking the parents to like leave the room while preparing the body when they want to stay thats not the right answer.
You really should allow the parents to engage in care and preparation as much as they want to and stay with that body as much as they want to in terms of grief. Obviously parents of a deceased child are going to be experiencing a lot of grief. When does it become complicated grief well if it extends for over a year after loss and affects.
The parents ability to perform their adls or activities of daily living. Then that would be indicative of complicated grief also if it causes such intense thoughts and emotions that they like cant leave. The house cant work those type of things.
And that is also indicative of complicated grief. So that is it for our first first part of the pediatric video series. When i come back were going to start talking about pediatric disorders.
By body system. Its a big unit. So well be in there for a while.
But hang in there and we will get through this information together take care. .
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