Key Nursing Assessment

It is an important part of a practitioner’s job to observe and assess children in order to establish where a child is at with regards to their development, health and well being and if they require extra support. The factors that need to be taken into account when assessing development are:

INTRODUCTION Throughout the clinical attachment in SGH for Paediatric Nursing Practicum, I get to know that there are a lot of clinical and critical thinking skills that I had to sharpen in order to manage various types of cases and situations in the future. I learned that we as nurses have to always be prepared for whatever situations that we encounter and had to deal with. I am a person who does not love kids as much as my colleagues do, but through this practicum, I had learnt to be more patient and caring towards them as they are so fragile and vulnerable to different types of injuries and diseases. Kids are sensitive to the environment as they are not familiar with their surroundings, thus, they tends to express their anger, fear or even cry in front of you in order to show their unpleasant feelings.

This objective will affect my future nursing practice because conducting physical head to toe assessments and obtaining vital signs is a different process when working with paediatric patients rather than adults. It is crucial to note any changes that I can catch throughout my assessments, and vital signs since paediatric patients might not be able to communicate with me if they feel any changes in their health. By understanding the anatomy and physiology, the developmental stages of children, and obtaining accurate vital signs and assessments, it will increase my knowledge, skill, ad judgment to successfully complete and distinguish any abnormities and changes during my assessments. Also, knowing the developmental stages and distraction therapy method techniques can help me provide thorough examinations and find ways to help my patients cope if they are feeling anxious and scared.

This essay is going to explore the nursing process with regard to the prevention of pressure ulcers.

Children presenting to the emergency department are often subjected to painful and anxiety-producing procedures, both for diagnostic purposes and for treatment of symptoms. Historically, pediatric patients have not been afforded the same level of care as adults with regard to the management of procedural pain. Pain in the young child age group (1-7 years) has often been under-treated,

Children have multiple or prolonged exposure to trauma, experience various symptoms and reactions, and long for progressive techniques to heal their pain.

The American Counseling Association’s fact sheets provides various symptoms for children and adolescents that are experiencing trauma. According to the American Counseling Association’s Traumatology Interest Network and facilitator, Karin Jordan (2015) children exhibit different trauma related symptoms at different periods in their lives (ACA et al., 2015). While I am providing therapy as a new LCPC, my client may not explicitly say that they have undergone some sort of trauma, but may unknowingly talk about their symptoms. It will then be my responsibility to consult a colleague, or in this case, the ACA to better serve my client’s needs. I will study the specified age group symptoms, while comparing the symptoms of my client and continue with the diagnosis of trauma (ACA et al., 2015).

The study was started at Addenbrooke’s Hospital in Cambridge with 85 children, based on the concept

As a nurse there are many variations of the pain assessment I could undertake with Mrs Jones. (Herr & Garand, 2011)

The national league for nurses defines critical thinking in the nursing process as “a discipline specific, reflective reasoning process that guides a nurse in generating, implementing, and evaluating approaches for dealing with client care and professional concerns” (Kozier, 2008). This definition is imperative to help a nursing student learn how to think in terms of nursing care. Nursing students must achieve a comprehensive understanding of critical thinking in order to understand the nursing process. The purpose for this paper is for nursing students to learn how to use the nursing process, how to properly document their findings and assessments, and correctly implement APA formatting in a formal paper.

Jonah is a 5 year old boy complaining of a leg pain 3/5 and does not remember of injuring his leg. Even though there is no sign of visual injury I would do a thorough pain assessment. Before we do a table top examination we can ask Jonatan to hop on one foot or jump? I would use PQRST to obtain more information regarding pain assessment (CCCN, 2016.) The questions I would include are: what precipitated the pain? What makes it worse or better? If he has any pain right now? How does it feel like? Does he feel more pain or less pain than before? Tell Jonatan to point where in the body he feels the pain? Ask him if he feels pain anywhere else except the leg? Use the face scale to describe the level of pain. When did the

The assessment I have chosen to expand upon is the VAS(visual analogue scale for pain) assessment. The vas tool provides a health care worker with an indication of the intensity of pain. It consists of a 10m line with the anchor words ‘no pain’ and ‘worst pain imaginable’. This tool has been developed to add numeric indicators and also descriptive like ‘mild’ (Bijur et al 2001). The use of VAS tool post-operatively has been validated by some research (price et al 1983)and is recommended by nursing literature

Nurses play a pivotal role in assessment, reassessment, and documentation of pain in ED. Pain management in children within ED will be improved by training nurses on mandatory documentation of pain and comprehensive assessment of pain and therefore, time to analgesia will further decrease (Chafe et al., 2016).

Pediatric pain management is measured subjectively because it is based off of what the patient says or how the nurse interprets the pain scale. Pain is rated using different scales, unfortunately these different scales could yield different results. Nurses are trained to use pediatric pain scales to analyze and treat pain but parents are not supplied with the tools to manage pain when the patient goes home. With 84% of all pediatric surgical procedures performed on an outpatient basis, the importance of teaching parents how to assess for and manage pain has become more important than ever (Rony, Fortier, Chorney, Perret, & Kain, 2010). According to Rony’s et al. (2010) study, it is apparent that pediatric pain is not being treated effectively. The study showed that 58.8% of children were receiving less than the daily recommended does prescribed by the pediatrician (p.1). Results of the study also showed that parents had false assessments on if their child was actually in pain. 36% of parents believed that if their child was in pain, they would cry out for the parent , 30% agreed that their child would always tell them if they are in pain, while 22% said that the child would report their pain immediately (Rony, Fortier, Chorney, Perret, & Kain, 2010, ). Children do not always verbalize when they are in pain. Sometimes the pain can be so intense that a child is unable to talk. If the child catches on to the parents negative perception of pain medications, the child may not

The author deduces that neonates feel more pain than older children and adults based on the pain physiology of neonates’ immature dorsal horns to block or inhibit descending pain pathway leading to a poor inhibitory coping mechanism. If this pain is not treated instantly, it can lead to lowering the pain threshold. As the child grows up, he\she is likely to feel more pain than those children that have not been exposed to noxious stimuli at an early age. Children experience pain from a variety of sources: injuries, traumas, surgeries, illness such as pharyngitis and otitis media, heel sticks, immunizations, vein and lumbar punctures. Children are not excluded from chronic pain which may result from repeated surgery exposure, procedural episodes,