Pain Management in Children Cindy Lizzo is a 10-year-old who was playing at the playground at school

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Pain Management in Children

Cindy Lizzo is a 10-year-old who was playing at the playground at school and fell from the monkey bars.  She held her left leg and began to scream uncontrollably. EMS and her mother were called. She was taken to the local hospital.

Cindy lives with her mother and two siblings, 6-year-old Roger and 12-year-old Betty. Her father died in car accident a few years ago. Her mother works as a receptionist in a law office. Her family is now at the hospital. Cindy undergoes an open reduction and internal fixation of tibial fracture. She has been in the post anaesthesia unit for approximately 45 minutes. As she arouses from sleep, she begins to moan and call for her mother, “I want my mom! Where is she?”.

Her vital signs are “HR: 115 beats/minute; T: 37.4 C oral; BP: 122/74 mm Hg; RR: 25 breaths/minutes with oxygen saturation of 94% on room air.

1.  What signs indicate that Cindy may be in pain?

2.  What are the effects of hospitalization for Cindy and her family? Consider implementing atraumatic/trauma informed care.

3.  What pharmacologic and non-pharmacologic therapies would you expect to be used to manage Cindy’s pain? What are the implications of unmanaged pain?

4.  As Cindy’s primary nurse what assessments and interventions do you expect to perform? How will you collaborate with the interdisciplinary team?




Diabetic Ketoacidosis and Viral Pneumonia

Rita Rodrigues is a six-year-old girl who presents to the Emergency Department (ED) fever and cough for the past two days. Her mother states that Rita’s appetite has been poor over the past two days, and she hasn’t eaten or drank anything since yesterday; Rita is less active today Her mother has been administering Ibuprofen and Benylin cough for children.

Rita was diagnosed with Type 1 Diabetes Mellitus at age five years old. On further questioning, the mother reports, “I don’t know what her blood sugar is because her monitor broke a couple weeks ago, and I haven’t been able get a new one yet. And I didn’t give her any insulin for the past two days either because she barely ate anything; the peanut butter & jelly sandwich and the bag of chips from lunch yesterday are still uneaten.”

Rita presents with a fruity odor to her breath and the following vital signs: HR 125 beats/minute, BP 84/56 mm Hg, RR 34 breaths/minute, temperature of 37.8 C oral and oxygen saturation of 88% on room air. The point of care glucose reading reveals capillary blood glucose of 18 mmol/L.


1.  Based on the presenting information what concerns do you have for Rita?

2.  What do you anticipate your immediate nursing assessment and interventions would be based on priority of the concerns identified? Refer to therapeutic management of the presenting problem(s).

3.  How might Rita experience hospitalization? What about Rita’s mother?

4.  Explain three (3) areas that you will include in the education session when providing education to the patient and family. How will you collaborate with the interprofessional team to address identified needs?


NURS 4910L


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