Paediatric Assessment, Hospitalization & Pain - Concept Map
Comprehensive Paediatric Nursing Care: Age-Appropriate Assessment, Safe Hospitalization, and Effective Pain Management
Related concepts
Principles of Paediatric Physical Assessment
Sub concepts
- Least-to-most invasive sequencing
- Building trust before touching
- Position of comfort (parent's lap)
- Equipment familiarisation
- Developmental modifications
Relationship to central
Foundation for all paediatric nursing practice; guides how nurses safely and effectively examine children across developmental stages
Age-Specific Vital Signs & Techniques
Sub concepts
- Apical pulse counting (full minute in infants)
- Abdominal respirations in infants
- Blood pressure cuff sizing
- Temperature measurement routes
- Vital sign trend interpretation
Relationship to central
Critical for accurate assessment and early detection of complications; normal ranges differ significantly by age
Developmental Communication Strategies
Sub concepts
- Infant: soft voice, holding, primary caregiver presence
- Toddler: concrete language, preparation timing, choices, rituals
- Preschooler: simple words, non-threatening language, reassurance
- School-age: explanations, honesty, privacy, involvement
- Adolescent: respect, honesty, privacy, control, confidentiality
Relationship to central
Enables effective therapeutic interaction and reduces fear/anxiety; improves child cooperation and coping
Child's Response to Hospitalization
Sub concepts
- Separation anxiety (toddlers): Protest → Despair → Detachment
- Loss of control (all ages)
- Fear of bodily injury/mutilation (preschoolers)
- Regression behaviours (normal response)
- Nursing management strategies
Relationship to central
Major source of psychological distress; requires nursing interventions aligned with developmental stage and stressors
Paediatric Pain Assessment
Sub concepts
- FLACC scale (infants/non-verbal)
- FACES/Wong-Baker scale (≥3 years)
- Numeric rating scale (≥7–8 years)
- Neonatal scales (NIPS, CRIES)
- Behavioural and physiologic cues
- Misconceptions about paediatric pain
Relationship to central
Pain is the fifth vital sign; accurate assessment is foundational to safe and effective pain management
Paediatric Pain Management
Sub concepts
- Non-pharmacologic measures: distraction, positioning, cuddling, sucrose
- Topical anaesthetics (EMLA)
- Paracetamol: 10–15 mg/kg/dose q4–6h (safest first-line)
- Ibuprofen: 5–10 mg/kg/dose q6–8h with food
- Opioid management and monitoring
- Aspirin contraindication in viral illness
- Pain reassessment protocols
Relationship to central
Comprehensive approach balancing non-pharmacologic and pharmacologic strategies; weight-based dosing is critical
Atraumatic Care Principles
Sub concepts
- Prevention/reduction of separation
- Promotion of control and autonomy
- Minimisation of pain and fear
- Use of treatment rooms (not bedside)
- Therapeutic holding vs. forced restraint
- Preservation of safe spaces (bed, playroom)
Relationship to central
Overarching framework minimising physical and psychological distress; guides all paediatric nursing interventions
Safe Medication Administration in Children
Sub concepts
- IM injection sites: vastus lateralis preferred (infants)
- Ventrogluteal and deltoid sites (older children)
- Contraindication of dorsogluteal site (young children)
- Oral medication administration technique
- Weight-based dose verification
- Avoiding medication hiding in formula
Relationship to central
Critical skill requiring age-specific techniques and weight-based dosing to prevent medication errors
Concept connections
- Principles of Paediatric Physical AssessmentAge-Specific Vital Signs & TechniquesAssessment principles guide HOW to obtain vital signs; technique must match developmental stage for accuracy
- Developmental Communication StrategiesPrinciples of Paediatric Physical AssessmentCommunication prepares the child for assessment; reduces anxiety and improves cooperation during physical exam
- Child's Response to HospitalizationDevelopmental Communication StrategiesUnderstanding developmental responses guides communication approach; prevents separation anxiety through appropriate interaction
- Paediatric Pain AssessmentPaediatric Pain ManagementAccurate pain assessment using age-appropriate tools is the foundation for effective pain management planning
- Atraumatic Care PrinciplesPaediatric Pain ManagementAtraumatic care framework guides pain management to minimise physical and psychological distress
- Atraumatic Care PrinciplesChild's Response to HospitalizationAtraumatic care strategies directly address hospitalization stressors (separation, loss of control, fear) and promote coping
- Safe Medication Administration in ChildrenPrinciples of Paediatric Physical AssessmentIM administration technique must follow assessment principles; use correct site based on developmental stage
- Paediatric Pain ManagementSafe Medication Administration in ChildrenMany pain medications (analgesics) are administered via IM or other routes; dosing must be weight-based and age-appropriate
- Age-Specific Vital Signs & TechniquesChild's Response to HospitalizationAbnormal vital signs (tachycardia, tachypnoea) may reflect anxiety/fear related to hospitalization; interpret in context
- Paediatric Pain AssessmentDevelopmental Communication StrategiesPain assessment tool selection depends on child's developmental stage and communication abilities
- Atraumatic Care PrinciplesPrinciples of Paediatric Physical AssessmentLeast-to-most invasive sequencing and position of comfort are core atraumatic care strategies implemented during assessment
- Child's Response to HospitalizationAtraumatic Care PrinciplesUnderstanding separation anxiety, loss of control, and regression guides implementation of atraumatic care interventions
- Developmental Communication StrategiesPaediatric Pain AssessmentAge-appropriate communication explains pain assessment process; helps child cooperate with tool administration
- Age-Specific Vital Signs & TechniquesPaediatric Pain AssessmentPhysiologic vital sign changes (↑HR, ↑BP, ↑RR) are indicators used in pain assessment, especially in non-verbal children
- Safe Medication Administration in ChildrenAtraumatic Care PrinciplesCorrect technique (site selection, position of comfort, minimal distress) is essential atraumatic care during medication administration
Diagrams
Comprehensive Paediatric Assessment, Hospitalization & Pain Management
Comprehensive mind map showing the hierarchical relationships between all major concepts in paediatric assessment, hospitalization, and pain management. This central visual organizes the chapter into eight main branches (Physical Assessment, Vital Signs, Communication, Hospitalization Response, Pain Assessment, Pain Management, Atraumatic Care, and Medication Administration), each with specific sub-concepts and clinical details essential for NLE preparation.
Paediatric Physical Assessment Sequence (Least-to-Most Invasive)
Flowchart illustrating the critical principle of least-to-most invasive sequencing in paediatric physical examination. Green indicates initial non-distressing procedures (observation and auscultation); yellow shows intermediate procedures (palpation and percussion); red highlights the most distressing procedures (eyes, ears, throat) performed last. This sequence is essential to obtain accurate vital signs before the child cries and becomes upset.
Separation Anxiety in Hospitalized Toddlers: Three Stages & Nursing Response
Sequential flowchart showing the three classic stages of separation anxiety in hospitalized toddlers (Protest → Despair → Detachment) and the corresponding nursing interventions. The diagram emphasizes that detachment (Stage 3) is the most serious stage and appears as adjustment but represents resignation. Color-coded stages show severity; green branch shows nursing interventions (rooming-in, consistent caregivers, comfort objects) that prevent progression to detachment and promote healthy coping.
Paediatric Pain Assessment: Age-Appropriate Tool Selection
Decision tree flowchart for selecting the appropriate paediatric pain assessment tool based on the child's age. Neonates (0–2 months) use observational/physiologic scales (NIPS, CRIES); infants and non-verbal children (2 mo–7 yr) use FLACC (Face, Legs, Activity, Cry, Consolability); preschoolers (3–7 yr) use FACES/Wong-Baker; school-age and older (≥7–8 yr) use numeric 0–10 rating. Each pathway shows the specific assessment parameters and scoring method appropriate for that developmental stage.
Weight-Based Paediatric Analgesic Dosing Guide
Comprehensive flowchart for weight-based paediatric analgesic dosing and administration. Shows first-line agents (paracetamol 10–15 mg/kg q4–6h and ibuprofen 5–10 mg/kg q6–8h with food for ≥6 months), dosing parameters, routes, and special considerations (no aspirin with viral illness due to Reye syndrome risk). Includes topical anaesthetic use (EMLA cream 60 minutes before procedures) and mandatory reassessment after intervention. Colour-coded by analgesic class and severity of pain.
Developmental Communication Strategy by Age Group
Developmental communication flowchart showing age-specific strategies for therapeutic interaction with paediatric patients. Displays five developmental stages (Infant, Toddler, Preschool, School-Age, Adolescent) with specific communication approaches tailored to cognitive and emotional development. Emphasizes universal principles applicable across all ages: truth-telling, eye-level communication, use of child's name, and timing of preparation (younger children prepared closer to the event to reduce anxiety). This framework is essential for obtaining cooperation and reducing fear.
Vital Sign Trends Across Paediatric Age Groups
State diagram illustrating the progressive changes in vital signs across paediatric age groups from newborn through adolescent. Shows the critical trend that heart rate and respiratory rate DECREASE as the child grows, while blood pressure INCREASES. Newborns have high HR (110–160) and RR (30–60) with low BP (~60–90); adolescents approach adult values (HR 60–100, RR 12–20, BP ~95–120). This visualization emphasizes why memorizing age-specific ranges is essential for accurate assessment and recognition of abnormal vital signs.
Safe Medication Administration in Paediatrics: IM Injection Site Selection
Decision flowchart for safe IM injection site selection in paediatric patients. Vastus lateralis (anterolateral thigh) is the PREFERRED and SAFEST site for infants and young children (under 3 years or not walking well) due to its large muscle mass and absence of major nerves and vessels. Ventrogluteal site is safe for children walking well and aged 3+ years. Dorsogluteal site is CONTRAINDICATED in young children due to sciatic nerve proximity and small muscle mass. Deltoid is acceptable for small-volume injections and vaccines in older children. Emphasizes documentation and site rotation to prevent complications.