4 Dying Child Nursing Care Plans

Acute Pain

Acute pain for a dying child can occur due to a variety of reasons, including the underlying illness or condition causing the child’s death. The pain may be a result of treatments or procedures meant to prolong the child’s life, such as surgeries or chemotherapy. Additionally, the emotional distress and anxiety experienced by the child and their loved ones during this difficult time can also contribute to the child’s pain.

Nursing Diagnosis

• Acute Pain

May be related to

• Underlying illness
• Biologic, physical, and 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
• Withdrawal
• Increase in heart rate, breathing rate, and blood pressure
• Irritability, restlessness
• Tension or flexion of muscles

Desired Outcomes

• The child will appear relaxed and is not crying, grimacing, or moaning.
• The child will experience less pain.

Nursing Assessment and Rationales

1. Assess the intensity of pain, fear of receiving pain medication, anxiety and coping mechanisms related to pain, and ability to rest and sleep.
Assessing the intensity of pain, fear of receiving pain medication, anxiety, and coping mechanisms related to pain, as well as the ability to rest and sleep, is essential for effective pain management. This information serves as a basis for determining appropriate analgesic administration and developing tailored care plans that meet the unique needs of each child. Developmentally-based pain scales provide a reliable and accurate assessment of a child’s discomfort, enabling healthcare providers to identify pain patterns and adjust treatment plans accordingly.

Nursing Interventions and Rationales

1. Educate the child and parents on the route of medication administration and expected side effects; 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.

2. Support the coping mechanisms of the child and family and modify analgesics accordingly, with input from the child, parents, and physician.
Promotes the child’s comfort supports coping abilities and includes parents and child in decision-making regarding care.

3. Provide familiar toys/blankets to the child; Encourage parents and significant others to stay with the child at all times.
Providing familiar toys, blankets, and other comforting items to children can significantly reduce fear and anxiety during hospitalization. These items provide a sense of security and familiarity, which can help children cope with the stress of being in an unfamiliar environment. Encouraging parents and significant others to stay with the child at all times can also provide a source of comfort and support. This can be particularly important for young children who may feel scared or alone in the hospital.

4. 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.

5. Dim lights, avoid noise, maintain a clean, comfortable bed with loose sheets and clothing, and disturb for care only when needed to promote comfort.
Provides an environment free of stimuli that increase anxiety and pain.

6. Assist with position changes as tolerated, use pillows to support position, move slowly with gentle handling, and give a back rub.
A nonpharmacologic measure to reduce pain.

7. Discuss with the 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.

8. Administer intermittent or continuous analgesic as prescribed based on the severity of the pain, and administer it prior to any painful procedure or care being performed.
Provides coverage of pain medications to guarantee freedom from any type of pain and discomfort including administration of analgesics for quick relief if given intermittently.

9. Educate parents and the child that care and treatment will only be palliative.
Lessens anxiety and stress caused by apprehension of painful interventions.