o Oral Hygiene o Sores infections o Say ahhh depresses tongue Physical Exam

O oral hygiene o sores infections o say ahhh

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o Oral Hygiene o Sores, infections o Say “ahhh” = depresses tongue  Physical Exam Variations, Based on Age  Talking to Kids Medication Administration o Physiological differences  Immature liver and kidneys Higher risk for med errors due to different dosages for each patient ( weight based ) Different concentration of medications Medication Administration o Oral syringes  Caps – choking hazard o Medication cups o Pills vs Liquid  Depends on child o Crushed pills in pudding, applesauce o Mix in baby bottles?  NO – would have to take entire thing o Coercion and using Child Life o Offer to let parent give (in your presence) IVs o Can place in the head on an infant o Feet are acceptable until the child is walking o May need to use protective equipment to guard IV (but must be removable to assess site)  IVs Pediatric IM Injections o Site based on child’s size o Limit on volume injected in one site o May or may not be able to give the child a choice of injection location Comfort Holds and Restraining o Often necessary to use restraints to protect medical equipment and/or keep child from injuring himself o Comfort holds are used for painful procedures and allow the child to be held by parent/nurse while the procedure is completed Pain o Assessing pain in children can be very difficult o Each child is different in terms of how they can explain /report their pain o Several different pain scales for pediatrics o Parental input is often necessary o Generally want pain level 3/10 or less o Document pain number and scale used Pain Scale: Numeric o Generally for ages 8 and up (school aged children) o Pain Scale: Faces  For children ages 3-4 years and up  Must explain to child what the faces mean o Pain Scale: Oucher  Similar to the Faces Scale, but with photos instead of cartoons  Use for preschoolers  Use the photo that most like the patient o Pain Scale: FLACC  Face, Legs, Activity, Cry, Consolability  Good for infants through school age children about 7 years old o Pain Scale: CRIES  Used in neonates ( generally 2 months old and younger) o Pain Scale: OPS  Observational Pain Scale  Infants to preschoolers Chronic Pain o Kids with cancer, Sickle Cell, other chronic conditions o May require a higher does of pain medication due to CNS sensitization o Their pain symptoms may be less severe or not present at all (no elevation in HR or BP, for example) o Treat whatever pain they say they have Pain Myths o Infants cannot feel pain o Infants feel pain but they can’t remember it o Children tolerate pain better than adults o Opioids are unsafe for children Analgesic Options for Kids o Non-pharamlogical interventions  Warm pack, cold pack, light up toys, baths
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o Oral OTCs  Tylenol, motrin o IV/IM prescription analgesics (Toradol) o Oral controlled substances (oxycodone) o IV/IM controlled substances (Morphine, Fentanyl) o PCAs for ages 5 and up o Epidurals/blocks Trust o If you don’t know, say you don’t know (“Does it taste yucky?”)
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