Overview
Introduction
Symptom relief should match the child’s goals of care and the likely cause of distress.
Symptom relief should match the child’s goals of care and the likely cause of distress. Nonpharmacologic measures often reduce suffering and may decrease the medication needed. Offer a familiar caregiver’s presence, quiet surroundings, favourite music, comfort objects, gentle positioning, clustered care, mouth care, and choices that preserve the child’s sense of control. For pain, determine whether the pattern is constant, episodic, movement-related, procedure-related, or neuropathic. A child with predictable pain during turning or personal care may benefit from planned comfort measures and prescribed analgesia before the activity rather than waiting until distress escalates. Reassess after intervention and document whether the child became more settled, slept, interacted, or tolerated care more easily. Dyspnea is the subjective experience of difficult breathing. Oxygen saturation may be low, normal, or unavailable; the child’s observed distress and reported air hunger guide the urgency of comfort measures. Sit the child upright if tolerated, reduce exertion, loosen restrictive clothing, use calm coaching, and involve the caregiver. Administer prescribed symptom medication as ordered and reassess respiratory effort, sedation, and comfort. Oxygen may be used when prescribed or when...