Assessing coping behaviors

Assessing coping behaviors Approach behaviors Asks for information regarding diagnosis and child’s present condition Seeks help and support from others Anticipates future problems; actively seeks guidance and answers Endows the chronic illness or complex condition with meaning Shares burden of disorder with others Plans realistically for the future Acknowledges and accepts child’s awareness of diagnosis […]

The Familly of the Child with a Chronic or Complex Condition

The Familly of the Child with a Chronic or Complex Condition Adaptive tasks of Parents having children with chronic conditions Accept the child’s condition. Manage the child’s condition on a day-to-day basis. Meet the child’s normal developmental needs. Meet the developmental needs of other family members. Cope with ongoing stress and periodic crises. Assist family […]

Impact of Chronic Illness, Disability, or End-of-Life Care for the Child and Family

Impact of Chronic Illness, Disability, or End-of-Life Care for the Child and Family Scope of the problem Increasing viability of preterm infants Portability of life-sustaining technology Life-extending treatments Rise in the numbers of children with complex and chronic diseases Chronic Conditions of Childhood Specialty Examples of Chronic Conditions Cardiology Complex congenital heart disease, congestive heart […]

Pediatrics : Complementary pain medicine

Complementary pain medicine Classification of complementary and alternative medicine Biologically based Manipulative treatments Energy based Mind-body techniques Alternative medical systems Nursing Actions Assess pain thoroughly and adequately Administer medications in a timely manner Evaluate and monitor the child’s response to treatments Titrate analgesic medications to achieve optimal dosing Make recommendations for alternate medications if needed […]

Pediatrics : Complications

Complications Chronic and Recurrent Pain Assessment Pain that persists for 3 months or longer than the expected period of healing Complex regional pain syndrome Chronic daily headache Multidirectional rating scale Physical functioning Emotional functioning Social functioning School functioning Pain assessment in specific populations Pain in neonates Manifestations of Acute Pain in the Neonate Physiological responses […]

Pediatrics : Side effects of Opioids

Side effects of Opioids General Constipation (possibly severe) Respiratory depression Sedation Nausea and vomiting Agitation, euphoria Mental clouding Hallucinations Orthostatic hypotension Pruritus Urticaria Sweating Miosis (may be sign of toxicity) Anaphylaxis (rare) Signs of Tolerance Decreasing pain relief Decreasing duration of pain relief Signs of Withdrawal Syndrome in Patients With Physical Dependence Initial Signs of […]

Pediatrics : Epidural or Intrathecal

Epidural or Intrathecal Involves catheter placed into epidural, caudal, or intrathecal space for continuous infusion or single or intermittent administration of opioid with or without a long-acting local anesthetic (e.g., bupivacaine, ropivacaine) Analgesia primarily from drug’s direct effect on opioid receptors in spinal cord Respiratory depression rare but may have slow and delayed onset; can […]

Pediatrics : Family-Controlled Analgesia

Family-Controlled Analgesia One family member (usually a parent) or other caregiver designated as child’s primary pain manager with responsibility for pressing PCA button Guidelines for selecting a primary pain manager for family controlled analgesia: Spends a significant amount of time with the patient Is willing to assume responsibility of being primary pain manager Is willing […]

Pediatrics : Routes and Methods of Analgesic Drug Administration

Routes and Methods of Analgesic Drug Administration Oral Oral route preferred because of convenience, cost, and relatively steady blood levels Higher dosages of oral form of opioids required for equivalent parenteral analgesia Peak drug effect occurring after 1 to 2 hours for most analgesics Delay in onset a disadvantage when rapid control of severe or  […]

Pediatrics : Pharmacologic management

Pharmacologic management The World Health Organization states that the principles for pharmacologic pain management should include the following: Using a two-step strategy Dosing at regular intervals Using the appropriate route of administration Adapting treatment to the individual child Nonopioids They include acetaminophens and NSAIDs are suitable for mild to moderate pain Nonsteroidal Anti-inflammatory Drugs for […]