Pediatric Considerations - PEDIATRIC CONSIDERATIONS...

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PEDIATRIC CONSIDERATIONS Encompasses problems related to childhood through adolescence. CARE SETTING Any setting in which nursing contact with children occurs/care is provided. ASSESSMENT FACTORS (IN ADDITION TO ROUTINE ASSESSMENTS) Age and gender Developmental level Patterns of communication with SOs Perception of body and its functions: in health and illness Behavior when anxious, afraid, withdrawn, angry SIGNIFICANT OTHERS Nuclear family, extended family Family developmental cycle Child’s role in family tasks and functions Peer group, friends SOCIOECONOMIC Social class, value system Social acceptability of current situation CULTURAL Ethnic background, heritage, and residence DISEASE (ILLNESS) Condition requiring treatment and response of patient/family to situation Nature of condition—acute, chronic, recurrent Emotional response to current treatments Past experience with illness, hospitalization, and healthcare providers If illness is terminal, what do patient and family expect? Availability/use of resources NURSING PRIORITIES 1. Enhance level of comfort/minimize pain. 2. Reduce anxiety/fear. 3. Provide growth-promoting environment for child and parent(s). 4. Prevent/minimize complications. DISCHARGE GOALS 1. Reports/indicates pain relieved. 2. Child/family dealing appropriately with current situation. 3. Safe environment maintained. 4. Plan in place to meet needs after discharge.
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NURSING DIAGNOSIS: Pain, acute May be related to Injuring agents (biological, chemical, physical, psychological) Possibly evidenced by Verbal cues Changes in appetite and eating, sleep pattern Guarded/protective behavior; restlessness, moaning, crying, irritability Autonomic responses DESIRED OUTCOMES/EVALUATION CRITERIA—CHILD WILL: Pain Level (NOC) Report pain is relieved/controlled. Manifest decreased restlessness/irritability. Demonstrate age-appropriate blood pressure, pulse and respiratory rates. ACTIONS/INTERVENTIONS Pain Management (NIC) Independent Perform routine comprehensive pain assessment, including location, characteristics, onset/duration, frequency, quality, severity (using 0–10 scale, facial expressions, or color scale). Accept child’s description of pain. Investigate changes in frequency or description of pain. Observe for guarding, rigidity, and restlessness. Monitor heart rate, blood pressure (BP) (using correctly sized cuff), and respiratory rate, noting age-appropriate normals/variations. Note location/type of surgical incisions, injuries/trauma. Provide comfort measures, e.g., repositioning, back rub, use of heat/cold. Encourage diversional activities, e.g., TV, music, reading, playing quiet games. Review procedures/expectations and tell patient when it will hurt.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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Pediatric Considerations - PEDIATRIC CONSIDERATIONS...

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