Pediatric nursing
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The methodologic study addressed the validity of subjective, physiologic, behavioral, and maternal indicators of pain intensity among 149 preschoolers who received immunizations at four clinics in the Southwest. Instruments used to measure children's responses included the Global Mood Scale (GMS) to measure anxiety, apical heart rate to measure physiologic response, the Wong and Baker Faces Scale to measure psychologic response, and the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) to measure behavioral response. The visual analogue scale (VAS) was used to measure mothers' perceptions of their children's pain. ⋯ The child's behavioral activity, mother's perception, and change in heart rate correlated positively with the child's anxiety. Children discriminated between anxiety and pain using the Faces Scale. More than one method may be required to fully assess the pain intensity experience by young children.
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The unconsented use of placebo pain medicine raises numerous ethical and legal issues. Generally, the use of placebo for the assessment of pain is unjustified. Nurses who are asked to participate in placebo pain medication must be knowledgeable of the ethical and legal ramifications of their actions.
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The death of a child is a severe and profound loss to all family members. The many tasks of the grieving process can be supported and facilitated by a bereavement program. ⋯ A bereaved parent, clinical nurse specialist, and chaplain share program coordination at a cost per year of less than $20.00 per family. Program evaluation efforts to date suggest a high level of family satisfaction with the program.
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Laws mandating parental involvement in adolescent abortion decisions are in contrast to laws governing other aspects of adolescent health care. Studies support that adolescents are often capable of making mature, informed health care decisions. Nurses encountering these adolescents have a unique opportunity to support them through the system and enhance the decision-making process.
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Nurses sought parental collaboration in developing The Pediatric Family Satisfaction Questionnaire, an instrument used to obtain family feedback as part of an inpatient quality assessment and improvement program. A focus group of parents assisted in item generation. ⋯ The final questionnaire included input from parents and the nursing, medical, and child life departments of the hospital. Data obtained from use of the questionnaire gives direction to quality improvement projects in the pediatric areas.