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Flashcards in Chapter 10 Deck (15):
0

Preparing child and patient

-calm confident approach

-correctly identify the patient by using at least two patient identifiers

-find out about child's past experience with blood collections

-develop a plan

-place yourself at child's eye level to explain and demonstrate procedure

-establish guidelines

-be honest when child asks whether the puncture will hurt

-encourage parent involvement

1

Children 1 to 2 years of age

May react extremely to painless procedures

Example taking a temperature

2

Children 3 to 5 years of age

Perceive pain as a punishment for bad behavior they may react aggressively

3

Children 6 to 12 years of age

More likely to relate pain to past experiences

Example may perceive that a shot or needle hurts more than anything that ever happened to them

4

Children 13 to 17 years of age

More independent and may be embarrassed to show fear

Example usually need privacy and may react hostile to mask fear

5

With proper preparation the child and patent

Develop coping skills to help lessen the fear and diminish the hurt

6

Parenting behaviors and examples have positive effect on relieving child distress

Behaviors- distraction (look at mommy tell us about your doll)

Emotional support- hugging stoking hair paying and talking in a soothing voice

Explanation- we need to take a tiny bit of blood from finger you will feel a little prick

Positive enforcement - you did a great job holding your a still

7

Distraction techniques

Older than 3 years respond well. Helps refocus on a more pleasant experience.

Examples-
blow bubbles,pinwheels , counting,reading book,video,music,singing,talk gentle voice

8

Topical anesthetic ( pain reliever ) EMLA(eutectic mixture of local anesthetic) rubbed on skin when needle stick used for venipuncture on a child doesn't require a needle.

Applies to skin as patch or cream coverered with transparent dressing

Optimal anesthesia occurs after 45 to 60 minutes lasts 2 to 3 hrs

Drawbacks are the cost, need to apply 60 minutes before procedure, know in advance the location of vein to be used

Sucrose (a sugar ) effective in reducing pain in crying time for an infant up to 6 months old

25% solution mixing 4 teaspoons of water with 1 tablespoon of sugar

Administers by oral syringe,dropper,nipple,pacifier

Sucrose nipple or pacifier given 2 minutes before heelsticks lasts about 5 minutes

9

Which of the following is the specimen of choice for testing the ph,po2,and pcO2 of the blood

Arterial blood

10

Which of the following supplies is needed to collect blood for capillary blood gases from a newborn infant

Metal filling

11

Which of the following supplies is needed to collect blood for a pediatric venipuncture

Safety winged infusion set

12

Blood spot testing for neonatal screening disorders should be performed before the newborn is

72 hrs old

13

Venipunctures in an infant or toddler is recommended for which of the following blood tests

Blood cultures

14

When a skin puncture is performed on an infant which of the following Soecimens is collected first

Hematology specimens