The effect of nonnutritive sucking on bottle-feeding stress in preterm infants.

OBJECTIVE: To examine the effects of nonnutritive sucking on the physiologic and behavioral stress reactions of preterm infants at early bottle feedings and to examine the effect of nonnutritive sucking on the feeding performance of preterm infants at early bottle feedings. DESIGN: Quasi-experimental with a matched sample. SETTING: A level III neonatal intensive-care unit in a large medical center. PARTICIPANTS: Twenty preterm infants whose gestational ages at birth ranged from 26 to 34 weeks. INTERVENTIONS: Ten infants were provided nonnutritive sucking for 5 minutes before and 5 minutes after an early bottle feeding. Ten infants served as controls. MAIN OUTCOME MEASURES: Physiologic stress was measured by heart rate and oxygen saturation rate. Behavioral stress was measured by observation of behavioral state. Feeding performance was measured by duration, percentage of formula taken by bottle, and behavioral state after feeding. RESULTS/CONCLUSIONS: Infants who received nonnutritive sucking before and after bottle feedings were more likely to be in a quiescent behavior state 5 minutes after the feeding (p = .01) and had higher feeding performance scores (p = .01) than infants who did not receive nonnutritive sucking.

Case management in inpatient pediatric nursing.

Case managed family-centered hospital care can prepare a child and family for transition/continuity to quality home care. One child with complex, chronic, and expensive health care and his family illustrate how this idea can be made a reality.

Critical care nurse model.

An innovative organizational framework is proposed in which professional group practices provide health care services by contract to hospitals and nurses and other health care providers have equal authority and power. Using this model, nurses can form group practices and contract with hospitals to provide total critical care nursing services to patients in hospital units.

Factors affecting nurses' decisions to administer PRN analgesic medication to children after surgery: an analog investigation.

Investigated postoperative PRN analgesic medication decisions regarding children in 113 hospital nurses, using analog stimuli. Nurses with greater narcotics knowledge and comfort indicated they would provide significantly more medication. Nurses provided more analgesics to children showing higher pain, and on the first than on the third postoperative day. Seriousness of child's condition also affected medication decisions. On the first day, nurses gave less medication to the child with than without permanent sequelae, whereas on the third postoperative day nurses provided more analgesics to the child with than without sequelae. These findings were consistent across high and low pain conditions. Nurses' ratings of children's pain were also affected by seriousness and time since surgery. Findings are discussed with reference to problems of undermanagement of children's pain.

Preparing children for endoscopy and manometry.

Properly preparing children for endoscopy and manometry contributes to the child's ability to cope and to the nurse's efficiency and effectiveness. Therapeutic play has been documented as the ideal way to prepare children for procedures. Because of time limitations, therapeutic play is not always an alternative in the endoscopy unit. Knowledge of the different developmental stages of childhood is helpful in preparing children for procedures. The nurse's approach and preparation of the child are based on her assessment of the child's developmental age, cognitive level, past experiences and coping skills. Using her assessment of the child, the nurse establishes trust with the child and the parent prior to beginning preparation of the child. A brief overview of the abilities and needs of the infant, toddler, preschooler and school age child is presented. Suggestions are made for nursing intervention before and during the endoscopic procedure or esophageal manometry.

One latency-age child's coping with hospitalization.

The hospitalized, chronically ill child in this study was able to secure gratification and emotional support from her environment, was able to use her cognitive ability to solve problems and gather needed information, and was able to utilize defense mechanisms to ward off anxiety until she could develop her coping strategy. The successful application of her coping strategy enabled her to achieve a degree of mastery in some of the hospitalization experiences. Throughout the hospitalization and treatment of this child there was no day during which she used her coping methods in the same sequential pattern. Instead, the coping methods varied with the stressful situation. The variety of coping methods used, the flexibility exercised, and ability to secure gratification assisted this child in coping and achieving mastery.