Issues in comprehensive pediatric nursing
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Issues Compr Pediatr Nurs · Jan 1998
Nurses' assessments and management of pain in children having orthopedic surgery.
The specific aims of this research project were to (a) describe selected verbal, nonverbal, and physiological arousal indicators of the child's pain; (b) describe which pain indicators were most influential to nurses in decision-making about interventions for managing the child's pain; (c) describe pain interventions used by nurses; (d) compare postoperative analgesic orders to recommended dosages for the children; and (e) explore relationships between the child's self-report of pain and medication dosages administered. Subjects included 19 children aged 5-17 years who experienced 20 orthopedic surgical procedures (one child had two surgeries one week apart). Data were collected by staff nurses for the first five days after surgery. ⋯ All children received medications for pain; 49% of the orders were within the recommended therapeutic dosage range. A small but significant correlation was found between the child's reported pain level and the morphine equivalents of pain medication received. Recommendations included development of nursing flow charts that provide space to record pain levels and nursing interventions, in-service education for nurses on nonpharmacological interventions, and further research with a larger sample and a single pain rating scale.
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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.