Meeting the physical, emotional, and psychosocial need of a dying child is important to support the totally dependent child and grieving family in experiencing the best quality of life possible. The child’s terminal illness and care can affect the whole family, hence, the nurse initial role is to establish rapport in order to build and develop effective communication that assists in alleviating unnecessary fears and anxiety about impending death and supporting anticipatory grieving.
Nursing Care Plans
Nursing care plan for a dying child involves providing substantial and appropriate age-related information about death and dying to allay anxiety, providing optimal pain relief through pharmacological and non-pharmacological methods, assisting the child to move through the stages of awareness and acceptance, and helping the family cope through the stages of grieving.
Here are four (4) nursing care plans (NCP) for a dying child:
Acute Pain: Unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage; sudden or slow onset of any intensity from mild to severe with anticipated or predictable end and a duration of <6 months.
May be related to
- Biologic, physical, psychological injuring agents
Possibly evidenced by
- Communication [verbal or coded] of pain descriptors
- Age-related expression of pain behaviors
- Crying, moaning
- Facial grimacing
- Guarding, protective behavior
- Increase in heart rate, breathing rate, and blood pressure
- Irritability, restlessness
- Tension or flexion of muscles
- Child will appear relaxed and is not crying, grimacing, and moaning.
- Child will experience less pain.
|Assess intensity of pain, fear of receiving pain medication, anxiety and coping mechanisms related to pain, ability to rest and sleep.||Provides information as a basis for analgesic administration. Developmentally-based pain scales provide an accurate assessment of child’s discomfort.|
|Administer intermittent or continuous analgesic as prescribed based on the severity of the pain, and administer prior any painful procedure or care is performed.||Provides coverage of pain medications to guarantee freedom from any type of pain and discomfort including administration of analgesic for quick relief if given
|Educate child and parents of the route of
medication administration and expected side effect; that pain will be monitored continuously and medication adjusted as needed to control pain.
|Provides assurance that pain will be controlled continuously whether or not the child is able to express pain.|
|Support coping mechanisms of child and family and modify analgesic accordingly, with input from child, parents, and physician.||Promotes child’s comfort, supports coping abilities and includes parents and child in decision making regarding care.|
|Provide familiar toys/blankets to the child; Encourage parents and significant others to stay with the child at all times.||Reduces fear and supports comfort of the child.|
|Provide nonpharmacologic pain management strategies: therapeutic touch, soothing baths; massage therapy to painful areas; distraction techniques (e.g., guided imagery, hypnosis, biofeedback, breathing techniques, music, reading, journal writing, gentle movement, aroma, humor, prayer,, hypnosis, relaxation techniques).||Reduces pain perceptions and may foster a sense of control.|
|Dim lights, avoid noise, maintain clean, comfortable bed with loose sheets and clothing, disturb for care only when needed to promote comfort.||Provides an environment free of stimuli that increase anxiety and pain.|
|Assist with position changes as tolerated,
use pillows to support position, move slowly with gentle handling, give a backrub.
|A nonpharmacologic measure to reduce the pain.|
|Discuss with child and parents that verbalizing fear and feelings about pain and its control is common.||Decreases anxiety by recognizing fear of pain and encouraging to express feelings and concerns about methods of control.|
|Educate parents and child that care and treatment will only be palliative.||Lessens anxiety and stress caused by apprehension of painful interventions.|
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Pediatric Nursing Care Plans
Nursing care plans for pediatric conditions and diseases:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Apnea | 4 Care Plans
- Brain Tumor | 3 Care Plans
- Bronchiolitis | 5 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cerebral Palsy | 7 Care Plans
- Child Abuse | 4 Care Plans
- Cleft Lip and Cleft Palate | 6 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Croup Syndrome | 5 Care Plans
- Cryptorchidism (Undescended Testes) | 3 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Dying Child | 4 Care Plans
- Epiglottitis | 5 Care Plans
- Febrile Seizure | 4 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Hospitalized Child | 5 Care Plans
- Hydrocephalus | 5 Care Plans
- Hypospadias and Epispadias | 4 Care Plans
- Intussusception | 3 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Kawasaki Disease | 6 Care Plans
- Meningitis | 7 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Osteogenic Sarcoma (Osteosarcoma) | 4 Care Plans
- Otitis Media | 4 Care Plans
- Scoliosis | 4 Care Plans
- Spina Bifida | 7 Care Plans
- Tonsillitis and Adenoiditis | 4 Care Plans
- Umbilical and Inguinal Hernia | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
- Wilms Tumor (Nephroblastoma) | 4 Care Plans
Recommended books and resources:
- Nursing Care Plans: Diagnoses, Interventions, and Outcomes
- Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
- Nursing Diagnoses 2015-17: Definitions and Classification
- Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
- Manual of Psychiatric Nursing Care Planning
- Maternal Newborn Nursing Care Plans
- Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
- Maternal Newborn Nursing Care Plans