Schaum's Outline of Pediatric Nursing (Schaum's Outlines by Mary Ann Cantrell

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9. ) School-Age Child 1. , taking cookies without parents’ permission) 2. Magical thinking 3. Beginning concept of time 4. Bodily mutilation 5. More blood equals more injury 6. Does better with manipulation of equipment Adolescent 1. 2. 3. 4. 10 Pain Assessment There are three types of measure for pain: 1. Behavioral 2. Physiologic 3. Self-report Note: The use of these types in the measurement of a child’s pain is dependent upon the child’s cognitive and verbal abilities. Behavioral Measures of Pain       Useful for measuring pain in infants and preverbal children Add to important data in the assessment of a child’s pain in all stages of childhood Might be time consuming to use Require a trained observer to watch, record, and rate a child’s behaviors Behaviors are scored from 0 to 4 and then added together to determine the pain score Most reliable when measuring short, sharp procedural pain such as experienced during a spinal tap or injections CHAPTER 2 35 Hospitalized Child and Family Four Commonly Used Behavioral Pain Assessment Scales     FLACC: Face, Legs Activity, Cry, Consolability CHEOPS: Children’s Hospital of Eastern Ontario Pain Scale TPPS: Toddler-Preschooler Postoperative Pain Scale PPPRS: Parent’s Postoperative Pain Rating Scale Physiologic Measures    Include heart rate, blood pressure, palmar sweating, cortisone levels, oxygen saturation, vagal tone, and endorphin concentration, all of which reflect a generalized, complex response to stress and cannot distinguish between pain and other forms of stress to the body Provide indirect estimates of pain Provide useful information about general distress levels in children Self-Report Measures: Preschool Child Self-report measures of pain can begin in the preschool child, ages 4 to 5 years.

A child’s weight increases by 5 to 6 pounds yearly and height increases by 2 inches per year. Average weight for a male is 45 pounds and average height is 45 inches. For females the average weight at 6 years is 43 pounds and an average height is 45 inches. M. M. Play becomes more competitive and complex throughout the school-age period. Team sports, formal social organizations (Girl Scouts and Boy Scouts), board games, reading, video games, hiking, listeningtomusic. (continued ) 22 CHAPTER 1 Pediatric Nursing School Age (6 to 12 years) (continued ) Age in Years Psychosocial Development  7    8–9 years   Has difficulty in assuming responsibility for misbehavior Becoming a family member Prefers same-sex friends May steal Dramatic Enjoys rewards Cognitive Development Play/Toys  Can tell time   Understands concepts of reversibility, space, cause and effect, and conservation Describes common objects in detail; understands parts and wholes Reads for information and enjoyment  10–12 years     Friends gain increased importance; becomes selective about friends Likes his/her family Respects parents Writes stories and letters  Enjoys group play as well as spending time alone Adolescence (12 to 21 years) Stage Early 12–14 years Physical Growth and Developmental Changes Psychosocial and Cognitive Development   At 12 years of age the average weight for a male is 88 pounds and the average height is 59 inches.

4. Teach parents how to assess the child for stress so that they can comfort the child. 5. Follow the home routine as much as possible. 6. Plan time for the child to spend in the playroom. 7. Utilize medical play that involves the use of puppets or dolls. 8. Expect regression behaviors. To decrease anxiety and loss of control in the preschooler include the same interventions as for toddlers plus the following: 1. Offer choices and encourage participation. 2. Plan time for the child to spend in the playroom.