Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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Review
Guide to a systematic physical assessment in the infant with suspected infection and/or sepsis.
This article provides the resources for the bedside caregiver to conduct a focused physical assessment of the infant with suspected sepsis. The importance of obtaining a complete history to identify associated obstetric and neonatal risk factors is emphasized. ⋯ The international consensus definitions for the sepsis continuum are presented and are compared and contrasted to the definitions more commonly used in the neonatal population. The article provides tables that can serve as checklists to structure a thorough obstetric and neonatal history and to further evaluate the infant's systemic inflammatory response to infection.
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To examine the issue of pain assessment in infants by acquiring all available published pain assessment tools and evaluating their reported reliability, validity, clinical utility, and feasibility. ⋯ When choosing a pain assessment tool, one must also consider the infant population and setting, and the type of pain experienced. The decision should be made after carefully considering the existing published options. Confidence that the instrument will assess pain in a reproducible way is essential, and must be demonstrated with validity and reliability testing. Using an untested instrument is not recommended, and should only occur within a research protocol, with appropriate ethics and parental approval. Because pain is a multidimensional phenomenon, well-tested multidimensional instruments may be preferable.