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eMediNexus 02 August 2018
A new study published in The American Journal of Nursing aimed to diagnose the sources of pain in children medical complexity; to describe the signs and symptoms parents of nonverbal children with medical complexity found worrisome; and to describe nursing pain assessment practices in this population. In this study, retrospective chart review was used to identify the initial presenting symptoms, sources of pain, and nursing documentation for 46 children with medical complexity who were admitted with a chief complaint of pain to a pediatric hospital in the United States. The findings revealed that irritability, pain, feeding intolerance, and abnormal behavior were common parent-reported symptoms. On an average, five diagnostic tests were employed to identify the source of pain while four specialty services were consulted during the admission. Nursing assessments of pain were documented approximately every three hours. While the mean pain intensity score recorded was 1.1 out of 10. Furthermore, discharge diagnoses included infection (including urinary tract infection), seizures, constipation, chronic pain, failure to thrive, dehydration, and subdural hematoma. The results indicated that a systematic approach to pain evaluation could help in ensuring a thorough and efficient diagnostic process. It was also stated that common childhood ailments such as constipation or urinary tract infection, as well as other causes must be considered when diagnosing pain in this population. It was suggested that pediatricians should consult parents of nonverbal children regarding changes in the childs behavior.
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