Lea detenidamente el texto adjunto sobre MANEJO DEL DOLOR EN PACIENTES PEDIÁTRICOS y marque la

parte del texto donde se encuentra la respuesta a las siguientes preguntas. Luego transcríbala en forma breve
y precisa en español en el espacio dado utilizando únicamente la información que proporciona el texto.

1. ¿Cómo expresaría el título y subtítulo de este artículo en español?

2. Enumere las dos soluciones que menciona este texto para el manejo del dolor. ¿Cuál da mejores
resultados en pacientes pediátricos?

3. ¿Qué recomienda el Hospital Infantil de Texas para aliviar el dolor post-quirúrgico de los pacientes
pediátricos además de la medicación? Mencione al menos 3 opciones

4. ¿Cuál es el rol de los padres?

5. ¿Qué técnicas utilizan los siguientes profesionales de la salud para manejar el dolor en pacientes
pediátricos?
a. Patricia “Trish” Riggers?
b. El personal de Servicios de Emergencias Médicas del Condado de Austin/Travis?
c. Beverly Dunn?

TEXTO

No More Tears
Pediatric caregivers create drug-free techniques to reduce the ‘ouch factor’ for kids before, during, and after
surgery

By Janet Kilgore. November 15, 2004

A child in pain is a common sight for health care professionals. Medications bring relief, but in the last decade,
pain management has come into its own. Analgesics are no longer the only solution for pediatric patients.

Despite a lack of scientific studies, innovative alternatives were developed. Many hospitals initiated pain
management programs to train staff in relief-giving techniques. In the past 15 years, programs to manage
pediatric patients’ pain have sprung up throughout Texas. Analgesics were not replaced; rather, a combination
of pain medication and distraction techniques proved most effective.

Case Western Reserve University in Cleveland recently released a study demonstrating a reduction in
children’s postoperative pain and anxiety. Findings show that the use of medicine and imagery tools can help
reduce pain for some children. Videos, audiotapes, booklets, deep breathing, and relaxation and imagery
techniques were used before and after day surgery and at home. According to the study, children receiving
these techniques and adequate pain medication experienced significantly less pain and anxiety than the
control group, which received only attention and medication.

Since 1995, Texas Children’s Hospital in Houston has worked with psychologists to find ways to help children
cope with surgery and postoperative pain. In addition to properly managed medication, they recommend
distraction, soothing techniques, and reducing anxiety through thorough preparation. Distraction techniques
include blowing bubbles, listening to stories, watching videos, or playing video games. Soothing the senses
uses anything from an infant pacifier to gentle massage. Taking time to explain what to expect before a
procedure can control or reduce anxiety. Choices, such as choosing a bandage color, often give the child a
sense of control.

The patient’s family plays a vital role in these treatments. “The family has to believe it can help and work with
the child. We spend a lot of time preparing the parents,” says Nancy Glass, MD, of TCH. Although success
depends partially on the severity and acuity of the pain, Glass notes it is important for treatment to initiate
immediately and continue through recovery. She adds, “Benefits increase with time, practice, and with the
parents’ level of acceptance of the alternate methods.”

Children’s Medical Center in Dallas created its Pain Resource Nurse Program two years ago. Patricia “Trish”
Rittgers, RN, was one of the first nurses to receive the training, which included drug and nondrug interventions.
In addition to pain management for inpatients, Rittgers uses relaxation techniques in the outpatient clinic, too.
Referring to the “cold spray” she uses for immunizations and lab draws, Rittgers says, “I refer to it as magic
cream. Some pain management is mind over matter.”

Austin/Travis County Emergency Medical Services personnel in Central Texas have used teddy bears, raised
from donations from local organizations, to comfort injured children since 1988. “The toys help calm and
distract the children, something familiar in an unfamiliar situation,” says Director Richard Herrington.

Collected through the EMS’ annual Teddy Bear Picnic, the “fist-sized bears work best. They’re easier to store
in the vehicles and don’t hamper treatment,” says Warren Hassinger of the Austin/Travis County EMS. Kept
clean in plastic bags in EMS trucks and Starflight helicopters, the little bears are ready to be hugged by a
frightened child. They go with the patient into the emergency department, too. The bears reduce stress and
trauma, which means a greater ability to cope with pain and shock.

When Children’s Hospital in Austin lost funding for her program, music therapist Beverly Dunn acquired a
$10,000 grant from the Scanlan Foundation. She provides support to patients and families and gives them
skills to use when she and her music cart move on. Her ideas are spreading, too. “I’ve had many nurses and
some doctors sing with me to patients before, during, and after treatment,” Dunn says.

Dunn’s version of an American Indian rain stick, made of clear plastic and filled with colorful beads, may not
summon showers, but the sounds and colors are part of the musical magic she brings to pediatric patients. She
and her guitar are welcome visitors. “A baby smiled for the first time in three days when I played my guitar for
him. His mother burst into tears,” Dunn says. “And a young oncology patient has started writing his own
songs. It’s an emotional outlet.”

Whatever the method — rain sticks, video games, or gentle massage — today’s pediatric caregivers use
innovative techniques to relieve pain in their young patients.

TEXTO

Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may
attain, maintain, or recover optimal health and quality of life from conception to death. Nurses work in a large
variety of specialties where they work independently and as part of a team to assess, plan, implement and
evaluate care. Nursing Science is a field of knowledge based on the contributions of nursing scientist through
peer-reviewed scholarly journals and evidenced-based practice. Nurses practice in a wide range of settings,
from hospitals to visiting people in their homes and caring for them in schools to research in pharmaceutical
companies. Nurses work in occupational health settings (also called industrial health settings), free-standing
clinics and physician offices, nurse-led clinics, long-term care facilities and camps. They also work on cruise
ships and in military service. Nurses act as advisers and consultants to the health care and insurance
industries. Many nurses also work in the health advocacy and patient advocacy fields at companies such as
Health Advocate, Inc. helping in a variety of clinical and administrative issues. Some are attorneys and others
work with attorneys as legal nurse consultants, reviewing patient records to assure that adequate care was
provided and testifying in court. Nurses can work on a temporary basis, which involves doing shifts without a
contract in a variety of settings, sometimes known as per diem nursing, agency nursing or travel nursing.
Nurses work as researchers in laboratories, universities, and research institutions. Nurses have also been
delving into the world of informatics, acting as consultants to the creation of computerized charting programs
and other software. Internationally, there is a serious shortage of nurses. One reason for this shortage is due
to the work environment in which nurses practice. In a recent review of the empirical human factors and
ergonomic literature specific to nursing performance, nurses were found to work in generally poor
environmental conditions. DeLucia, Ott, & Palmieri (2009) concluded, "the profession of nursing as a whole is
overloaded because there is a nursing shortage. Individual nurses are overloaded. They are overloaded by the
number of patients they oversee. They are overloaded by the number of tasks they perform. They work under
cognitive overload, engaging in multitasking and encountering frequent interruptions. They work under
perceptual overload due to medical devices that do not meet perceptual requirements (Morrow et al., 2005),
insufficient lighting, illegible handwriting, and poor labeling designs. They work under physical overload due to
long work hours and patient handling demands which leads to a high incidence of MSDs. In short, the nursing
work system often exceeds the limits and capabilities of human performance. HF/E research should be
conducted to determine how these overloads can be reduced and how the limits and capabilities of
performance can be accommodated. Ironically, the literature shows that there are studies to determine
whether nurses can effectively perform tasks ordinarily performed by physicians. Results indicate that nurses
can perform such tasks effectively. Nevertheless, already overloaded nurses should not be given more tasks to
perform. When reducing the overload, it should be kept in mind that underloads also can be detrimental to
performance (Mackworth, 1948). Both overloads and underloads are important to consider for improving
performance." Each county/ state in which a nurse is licenced has laws concerning how many patients one
nurse can attend to (depending on the accuity of the patients needs).

1. Traducir las siguientes frases nominales extraídas del texto teniendo en cuenta el contexto:

1. evidenced-based practice:
2. occupational health settings:
3. long-term care facilities and camps:
4. generally poor environmental conditions:

2. Marcar con un círculo la opción correcta y corregir las oraciones que no sean correctas:

a. True - False Los enfermeros solo trabajan en equipo, no pueden trabajar individualmente.

b. True - False Los enfermeros ejercen su profesión en los hospitales.

c. True - False No hay suficientes enfermeros en el mundo debido al ambiente en el que trabajan.

d. True - False Los enfermeros no tienen mucho trabajo.

e. True - False La letra ilegible es uno de los problemas que tienen los enfermeros en su trabajo cotidiano.

2. Subrayar las ideas principales en el texto y dar un título representativo a cada párrafo. Además, dar un título
general al texto.

Título general: _____________________________________________________________________

Párrafo 1 ________________________________________________________________________

Párrafo 2 ________________________________________________________________________

Párrafo 3 ________________________________________________________________________