...Abstract The specific aim of this paper is to identify the effect of swaddled infants in the management of symptoms during painful procedures. A broad research for five scholarly articles began with an on-line search of State College of Florida’s library, where links to Cochrane, Ebsco, Google Scholar and PubMed were accessed. A Boolean search began with infants, swaddling and pain, with filters that included full-text, in English, free articles, and articles less than five years. Key words included swaddling, infant pain, heel sticks, painful procedures, neonates, facilitated tucking and infant care during painful procedures. Many of the articles required a fee to access the article. Continual searches on Google Scholar finally obtained five scholarly articles. The ancestral search proved the most fruitful in obtaining five strong sources of research, each rated at an evidence level of one. Overall, the studies used in this paper supported the theory and PICO question that swaddling infants during painful procedures manages symptoms and even decreases infants’ pain. Even more favorable is that swaddling (for infants less than three months of age) is recommended for clinical practice as a cost-effective, non-pharmacological, non-invasive, evidence-based method that is easy to teach and implement and offers comfort to tiny infants! Introduction Swaddling, also known as infant-wrapping, binding, bundling or facilitated tucking, is a customary newborn technique that is utilized...
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...Pain Assessment and Management G u i d e l i n e f o r Marlene Walden, PhD RNC NNP CCNS Sharyn Gibbins, PhD RN NNP P r a c t i c e , 2 n d E d i t i o n Pain Assessment and Management Guideline for Practice, 2nd Edition This guideline is an outline of the pain assessment and management practices that currently are accepted and documented by experts in the field of neonatal care. In addition, it summarizes and recommends pain assessment and management practices based on the best evidence for the nursing care of infants. This guideline does not preclude the use of manufacturers’ recommendations or other acceptable methods of assessing and managing pain in infants. The use of other practices known to improve the quality of neonatal care is encouraged and not restricted by this document. The National Association of Neonatal Nurses (NANN) developed this guideline in response to members’ requests. Broad in scope, it can provide a foundation for specific nursing protocols, policies, and procedures developed by individual institutions. Authors Marlene Walden, PhD RNC NNP CCNS Sharyn Gibbins, PhD RN NNP Reviewers Daniel Batton, MD, American Academy of Pediatrics Sandra Sundquist Beauman, MSN RNC Jim Couto, MA, American Academy of Pediatrics Mary Ann Gibbons, BSN RN Melinda Porter, RNC CNS NNP Ann Stark, MD FAAP, Chair of AAP Committee on Fetus and Newborn Carol Wallman, RNC NNP MS, NANN/AWHONN Liaison to AAP Committee on Fetus and...
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...Visual Analog Scale (VAS) was shown to be an accurate and reliable scale for pain measurement. The statistical findings of this scale were as follows: Intra- and inter-rater reliability (ICC: 0.69-0.91; 0.55-0.97) and criterion validity (p: 0.81-0.94) Pain expression. (McCall, DeCristofaro, & Elliott, 2013). When these scales were utilized they were shown to be effective and demonstrated significant reduction in measurements when sucrose was utilized. In the studies that did not use these formal pain scales the measurement most commonly used was the presence of cry, total crying time, and/or the percent of total crying time. Some studies found that an excellent predictor of infant pain was crying. McCall, DeCristofaro, & Elliott, (2013) continues with the statement, “this is the first report of these specific measures of crying and a consistent relation to an independent measure of the infant pain and arousal” (p. 249)....
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...intussusception. Intussusception is the main cause of intestinal obstruction in infants and toddlers and is seen when one portion of the small intestine segment slips into another segment (Fotso Kamdem et al., 2017). My primary reason for choosing intussusception was the symptoms are similar to J. T. symptoms. It affects infants and toddlers and the classic symptoms are colicky, vomiting abdominal pain and at times bloody stools (Reust, & Williams, 2016). According to (Reust, & Williams (2016), children with intussusception often times has a palpable sausage-shaped mass in their abdomen. The pertinent positives were abdominal pain, sausage-like mass in the right quad, bloody stools, and vomiting. Intussusception is diagnosed by doing an abdominal ultrasound, which is considered the most reliable tool for diagnosing (Lim et al., 2015). The treatment for intussusception should not be delayed. As per Yushui, Zhengyin, & Kai (2017), based on clinical practice, the success rate with the use of guided hydrostatic reposition was 90% in the treatment of intussusception in three months to two years old. (2) Malrotation ICD 10 - Q43.3...
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...End of Life Care for the Newborn Ashley Altendahl Author Note This research is being submitted on November 18th, 2010, for Kristy Reinke’s PN 130 Maternal-Child Nursing course at Rasmussen College by Ashley Altendahl. 1) Article: The Dying Neonate: Family-Centered End-of-Life Care Author: Lisle-Porter, M., & Podruchny, A. This article discusses the importance of proper end of life care for dying infant and their family. They discuss three main goals: pain and comfort management, assisting with end of life decision making, and bereavement support. They believe the most important aspect of care, is to keep the newborn as comfortable and pain free as possible. It is also important to involve the family in end of life decision making, such as when to withdraw life support, whether to bless or baptize the child, and what to do after death. The article also stresses the importance of active listening and encouraging the family to discuss their thoughts and concerns. They also find it very crucial for the family to bond with their child during this time, which will help with the grieving process. It is also encouraged that they hold and bathe the child, as well as collect any mementos to remind them of the child they lost. 2) Article: ‘We baptized him with our tears’: A family is forced to say goodbye Author: Kris Berggren In this article, a woman discusses a loss of her sister in law’s baby, her children’s very first cousin. The one day they received a call stating...
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...Long Lasting Effects of Preterm Birth Angel McClucas Psychology 221 The National Institute for Child Health and Development (NICHD) published an article about long lasting effects of preterm birth. NICHD performed several research studies that shows preterm birth leads to different long term challenges after birth. The researchers explained that infants born 32 weeks of gestation or less are considered preterm, with being born early their brain and other organs are not fully developed as they would be if the infant was born after 32 weeks. NICHD continued to explain that preterm infants, most times, require life-saving medical treatments to survive. These treatments can cause pain and stress that is unwanted for the infant. The pain and stress during these critical development periods can cause problems long term. Some challenges for these infants long term can consist of visual memory, poor planning skills, and symptoms of anxiety and depression. Several studies have been done by The Institute to understand how these stressors affect the brain development and to help find ways to make their first weeks after birth easier. NICHD is also hoping to promote healthy development with these studies. In one study the researchers measured the cortisol level in the children’s saliva before, during and after the children performed simple tests. The study showed the children who were born extremely preterm did worse than the children born preterm and full term. ...
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...Journal of Neonatal-Perinatal Medicine 3 (2010) 325–331 DOI 10.3233/NPM-2010-0132 IOS Press 325 Sucrose as an analgesic in relieving procedural pain in neonates Srijana Basnet∗, Laxman Shrestha and Prakash Sundar Shrestha Department of Pediatrics, Institute of Medicine, Kathmandu, Nepal Received 1 January 2010 Revised 29 June 2010 Accepted 27 July 2010 Abstract. Objective: This study was undertaken to study physiological and behavioral pain responses of neonates and to assess the analgesic effect of orally administered sucrose as assessed by the behavioral pain rating scale [DAN (Douleur Aigu¨ du e Nouveau-n´ ) score] during venepuncture in neonates. e Method: In 50 healthy neonates requiring bilirubin estimation, blood sugar was randomly assigned to receive 2ml of 30% sucrose two minutes before the venepuncture (intervention) in comparison to a group not receiving sucrose (control). During the procedure, pain was assessed by behavioral pain rating scale [Douleur Aigu¨ Nouveau-n´ (DAN) scale]. The heart rate, oxygen e e saturation before, during and after procedure as well as crying time was noted. Results: There was significantly lower pain (DAN) score in the intervention group compared to control group. Median (interquartile) DAN score in the group receiving sucrose was 3 (1.5–5.5) compared to 7 (5–9.5) in control group. The difference in median DAN score between two groups was statistically significant (p = 0.0001). There was a significant increase in heart rate...
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...Postpartum Case Study May 26, 2016 Postpartum Case Study Admission Assessment J.B. a 38-year-old female, G5, P3 (SAB 2, L3) admitted on 5/09/16 at 0930 for a scheduled repeat cesarean section. The patient’s chief complaint is minor contractions and concern from previous SAB (Spontaneous Abortions). J.B’s 1st pregnancy ended at 13 weeks with a SAB. 2nd pregnancy ended by C-section at 37 weeks due fetal intolerance. Her 3rd pregnancy ended at 38 weeks with a repeat C-section and her 4th pregnancy ended at 11 weeks with a SAB. Bringing us to this pregnancy number 5. J.B. chose to have a repeat C-section, because her physician recommended it due to a prior C-section. Multiple scars on uterus increase the risk for several serious problems for women and fetus. These risks include: scar rupture, placenta previa, placental abruption, and placenta accrete (Tobah, 2015). A high-risk pregnancy involves at least one of the following; the woman or baby is more likely to become ill or die more than usual. Complications before or after delivery are more likely to occur than usual. High-risk pregnancies must be closely monitored. Some risk factors are present before women become pregnant. These risk factors include certain physical and social characteristics of women, problems that have occurred in previous pregnancies, and certain disorders women already have. In J.B.’s case she had a high-risk pregnancy due to several reasons, she has advanced maternal age > 35, prior miscarriages...
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...Suppose that there is man named Bill who feels no pleasure nor pain of any kind under any circumstances. Bill finds himself part of a sadistic gameshow involving three infants, all restrained, and a gameshow host. The host, like Bill, is capable of feeling neither pleasure nor pain. There are no noticeable differences between the three infants. The gameshow host presents Bill with 2 options. Option 1 is that Bill tortures one of the infants for one hour using specific methods that the gameshow host provides. Option 2 is that Bill does not torture any of the infants, in which case the gameshow host himself will torture two of the infants for one hour each (using the same specific methods that he would have provided to Bill in Option 1). In...
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...second-line strategies for healthy term infants in the first week postpartum Introduction Breastfeeding has numerous well-known health benefits (Alexander et al. 2010, Wojcicki et al. 2010).It protects both baby and mother from many diseases (Steube 2009). Breastfeeding self-efficacy (BFSE) supports breastfeeding initiation and duration. Many studies have reported the benefits of prolonged breastfeeding for mother and infant health, but the rate of breastfeeding is still decreasing during the first week postpartum. Mothers who discontinue breastfeeding early are more likely to report nipple pain, birth related pain, insufficient milk supply, and engorgement and fatigue in the early postpartum period. This study informs readers that Breastfeeding self-efficacy of women using second-line strategies for healthy term infants in the first week postpartum can improve the confidence of mothers in their ability both to breastfeed and to persevere in establishing breastfeeding when difficulties are encountered. Background of study The study describes the breastfeeding problems during the first week postpartum are nipple pain, birth related pain, insufficient milk supply, and engorgement and fatigue and informs the readers that First-line strategies such as Skin to skin and Second-line strategies such as cup feeding, syringe feeding, finger feeding, supply lines, bottles with teats, and nipple shields can be used to overcome this problems and to maintain infant nutrition and hydration temporarily...
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...are not responding to antibiotics or other medical treatment (“Myringotomy Information”). Common reasons for persistent nocturnal wheezing and coughing and noisy breathing in infants include inflammation,...
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...Reason for choosing disease The reason why I chose this disease for further research, is because of an infant in San Joaquin County that had died on the fifth of this month and year. The infant was three weeks old and is the county’s first death from this particular disease. So this incident intrigue me to learn and do more research on this disease. The name of the disease and the etiology The name of this disease is Pertussis and also known as the Whooping cough. According to the CDC website, the etiology of this disease is caused by a type of bacteria called Bordetella pertussis. These bacteria attach to the cilia (tiny, hair-like extensions) that line part of the upper respiratory system. The bacteria release toxins, which damage the cilia and cause inflammation (swelling) (Pertussis, 2014)....
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...is there to support skin-to-skin and kangaroo mother care, many hospitals still do not encourage it, or mothers do not wish to provide this care to their baby. This is an issue because kangaroo mother care and skin-to-skin contact has shown to provide many benefits to the baby as well as the mother, such as early bonding between the mother and baby and treatment of pain for an infant that has experienced a painful procedure (Haixia et al., 2015). Pain can cause stress on the baby, even more so if the painful procedures are recurring. Repeated heel sticks are a common example of a repeated painful procedure that an infant may experience. Pain related stress is important to keep under control for the infant because of the potential effects that the baby can experience due to the stress, such as decreased brain development (Haixia et al., 2015). A study has shown that kangaroo mother care provided to the infant following repeated painful procedures allows the infant to recover quicker and cry for a significantly less amount of time (Haixia et al., 2015). A current issue in postpartum nursing care is that not all infants receive kangaroo mother care. This issue is important to correct in order to provide the best care to patients. Whenever a mother is present and able, it is important to encourage the mother to provide her baby with kangaroo mother...
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...of reasons why a mother would not choose breastfeed their infant. Most women in the United States know that breastfeeding is best for their infant but are unaware of the specific health benefits and risks associated with it. According to Moore, Anderson, and Bergman (2007) “research has shown that obstetricians rarely provide information about breastfeeding and formula feeding during prenatal visits”. Mother’s often rely on education about breastfeeding on pamphlets, leaflets, and other written materials as their source of information but are highly ineffective. Breastfeeding is perceived as a natural act but women are often surprised at the difficulty of performing it. The skills to breastfeed are not provided to...
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...debate, extending to such issues as physician responsibility, duty of care, extent of individual responsibility, and personal integrity, to name just a few. This paper considers aspects of euthanasia and the moral factors that pertain. At the conclusion, this paper will recommend that certain types of euthanasia be permitted under the general supervision of a trained physician. EUTHANASIA AND PHYSICIAN-ASSISTED SUICIDE Physician-assisted suicide (PAS), like euthanasia, has been forbidden since the creation of the Hippocratic Oath. However, as a practical matter, physicians have had a measure of latitude in the specific application. For example, a fatal dose of an opium based drug might be administered to counteract intractable pain in a terminal patient, with an expected resulting death. Unlike euthanasia, PAS involves the physician as a facilitator of patient termination, one in which the patient still participates, in a limited fashion, as an active participant. In much of northern Europe PAS has been legislated with varying limitations on both...
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