Pediatrics (Week 2)

Visual Impairment risk factors

medications

trauma

chronic illness

Where do you go to get visual impairment checked?

doctors + school

if bad, refer to eye doctor

Acute otitis media (infection)

• Recent infection of middle ear

• can see if infected by otoscope

• kids have smaller eustachian tube and its horizontal, harder for fluid to drain, then causes infection

• CAN’T HEAR, SPEECH IS DELAYED

Acute otitis media treatment

• antibiotics (prescription now, if it gets worse get meds later)

• Myringotomy is done and a tympanoplasty tube is placed in ear, can last 18 months

Retinoblastoma (Ocular Cancers)

• Whiteness in retina when light is flashed (red means healthy)

• may end up with brain tumor, hard to treat

• most common in kids from asian countries

• treated with surgery/chemotherapy

How different ages react to pain

• Infant = cry

• Toddlers = start to localize, noncooperation

• Preschooler = think weird things

• School age = guard it and don’t tell (scared)

• Adolescents = make them different, cooperation

Tools for Pain (0-10)

• FLACC (2 months - 7 years)

• FACES (3+ years) (point at face)

Avoiding Trauama

• look at age (plan ahead)

• distraction

• numbing cream

Pharmacological Measures

• assess for pain BEFORE medication

Non-Pharm Measures

• Infant - Kangaroo care, pacifier

• School age - distraction

Child abuse

• physical

• neglect

• emotional (humiliating)

• sexual

Screening questions

• Are you afraid of anyone at home?

• Has anyone hurt you?

• Who could you tell if someone hurt you?

• FOR PARENT: Do you feel like you may hit your child when frustrated?

Expected Findings for pain

• story doesn’t add up

• vague description

• physical evidence

• delayed care

Nursing Care for pain

• safety

• what other kids where there?

• assessment and document

• photograph (to see how it progesses)

• report (everyone can report)

Grief types

• Anticipatory (expected)

• Complicated (prolonged)

• Parental (grief from child)

• Sibling (grief of sibling)

Responses to death from different age groups

• infants/toddlers = no concept (swaddle)

• preschoolers = egocentric, thoughts can change

• School-age = fear, curious after death

• Adolescents = what do peers think, difficult accepting

Palliative care vs hospice

Palliative care at any stage to improve quality of life and manage symptoms

Hospice care is specialized care for patients with a terminal illness nearing the end of life, focusing solely on comfort and support

How to care for patient/yourself

comfort, sing, snuggle

talk to someone

Therapeutic Play

• acts out feelings with stuffed animals, play games to make memories

• coping mechanism