Issues in comprehensive pediatric nursing
-
Issues Compr Pediatr Nurs · Jan 1998
Spasticity in children with cerebral palsy: a retrospective review of the effects of intrathecal baclofen.
The administration of baclofen by intrathecal pump is a new technique used to reduce spasticity for individuals with upper motor neuron system injuries. Children with cerebral palsy often have difficulty in mobility because of this form of spasticity. The purpose of this study was to assess the functional outcomes of intrathecal baclofen pump therapy with spasticity in children with cerebral palsy. ⋯ Complications were resolved with conservative management without long-term sequelae. No infections, respiratory depressions, or deaths occurred as a result of intrathecal baclofen therapy in this study. Although intrathecal baclofen had a significant effect in reducing lower extremity spasticity in children with cerebral palsy, further prospective studies are needed to determine the effects of intrathecal baclofen on such indicators as activities of daily living.
-
Issues Compr Pediatr Nurs · Jul 1996
ReviewNonpharmacological interventions to use with children in pain.
Children's pain is often poorly managed, and interventions other than medications are rarely used. Yet many nonpharmacological interventions are helpful in managing children's pain. ⋯ A discussion of the three major classifications (sensory, cognitive, and cognitive-behavioral) of interventions follows. Factors that influence the use of nonpharmacological techniques, including type of pain and developmental level, are discussed.
-
Physiologic and psychologic changes associated with sleep disturbance decrease the ability of a critically ill child to adapt to hospitalization and thus hamper recovery. Research demonstrates that intensive care settings interfere with sleep of adults, but little is known about the impact of these settings on children's sleep. An exploratory field study was conducted to describe the sleep-wake patterns of 1- and 2-year-old children in intensive care, identify intensive care environmental stimuli associated with sleep and waking states, compare the intensive care sleep-wake pattern to the pre-illness sleep-wake pattern, and determine the time required for children to return to their pre-illness sleep-wake pattern. ⋯ Sleep changes persisted after discharge from the PICU and the hospital. Total sleep time recovered more rapidly than nighttime awakening. Parents perceived that their child's sleep remained different longer than total sleep time and night awakening values demonstrated.
-
This study explores the role of temperament in pediatric pain perception and responses. The sample consisted of 3- to 7-year-olds (N = 137) who required preoperative blood test by venipuncture. Blood sampling procedures were videotaped. ⋯ The temperament category threshold was found to relate to self-report and distress behaviors during the preparation phase. The temperament categories of activity, mood, approach, adaptability, intensity, and threshold related to children's previous pain responses and usual pain behaviors. These previous behaviors were strong predictors for their responses to venipuncture pain.
-
Issues Compr Pediatr Nurs · Oct 1995
Pediatric nurses' knowledge and practice related to infant pain.
A convenience sample of 181 registered nurses completed questionnaires about their knowledge, attitudes, and clinical practice related to infant pain. The majority of respondents thought infants felt pain with the same intensity as adults and were comfortable administering narcotic and nonnarcotic pain medications. The most frequently identified infant pain cues were: crying, irritability, and inability to be consoled. ⋯ There were no associations for noncritical versus critical care unit assignment or participation in postlicensure education about pain with number of assessment cues. There were no associations for pain severity or noncritical versus critical care unit assignment with pain management strategies. Until the research base about management of infant pain is expanded, nurses should continue to use and evaluate a variety of pain management interventions on a case-by-case basis.