ELNEC Pediatric Module 7: Symptom Management

ELNEC Pediatric Module 7: Symptom Management 

Symptom management in pediatric palliative care involves more than the management of pain. In this course, you will learn how you can address other symptoms commonly encountered in children with life-threatening illnesses. DSM™ and DSM-5™ are registered trademarks of the American Psychiatric Association. The American Psychiatric Association is not affiliated with nor endorses this course.


Hours: 1.00


Certificates provided by accrediting body (7 Match)

California Board of Registered Nursing


Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.00 contact hours for participating in this course.

District of Columbia Board of Nursing


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.00 contact hours for participating in this course.

Florida Board of Nursing


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

American Nurses Credentialing Center


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.00 contact hours for participating in this course.

Georgia Board of Nursing


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

South Carolina Board of Nursing


This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

West Virginia Board of Registered Nursing


Course Details

Course Code: REL-PAL-ELNEC-PED7-V2
Hours: 1
Type: Online Course
Content Expiration Date: 11/30/2021
Learning Objectives:
Identify common symptoms in children with life-threatening illnesses.
Identify potential causes of symptoms.
Describe assessment of these symptoms.
Describe interventions that can prevent or diminish symptoms.


Section 1: Introduction

About This Course

Learning Objectives

Section 2: Chronic Conditions and Common Symptoms

Chronic Conditions

Symptom Management

General Principles

Addressing Symptoms in End-of-Life/Palliative Care

Goals of Care

Anticipate Symptoms

Understanding Family-Centered Care

Impact on the Child and the Family

Symptoms and Suffering

Key Nursing Roles

Assessment and Management



Section 3: Neurological and Respiratory Symptoms

Neurological Symptoms

Autonomic Dysfunction or Dysautonomia





Respiratory Symptoms


Dyspnea: Causes

Dyspnea: Assessment

Dyspnea: Treatment

Terminal Respirations



Section 4: GI Symptoms

Gastrointestinal Symptoms

Anorexia and Cachexia

Anorexia and Cachexia: Assessment

Anorexia and Cachexia: Treatment

Feeding at End of Life


Constipation: Causes

Constipation: Assessment

Constipation: Treatment

Nausea and Vomiting

Nausea and Vomiting: Assessment

Nausea and Vomiting: Pharmacologic Treatment

Nausea and Vomiting: Non-Drug Treatment



Section 5: Fatigue and Psychological Symptoms


Fatigue: Causes

Fatigue: Assessment

Fatigue: Treatment


Depression: Risk Factors

Depression: Clinical Manifestations

Depression: Causes

Depression: Treatment


Anxiety: Assessment

Anxiety: Treatment



Section 6: Conclusion


Course Contributors




Instructor: The National ELNEC Project - 2018 Pediatric (modules 1, 3, 4, 6, 7, and 8)

The ELNEC Project, which began in 2000, is a partnership between the American Association of Colleges of Nursing (AACN), Washington, DC and the City of Hope, Duarte, CA. For more information about ELNEC, go to www.aacnnursing.org/ELNEC.

The content for this course was created or revised by:

Amy Haskamp, MSN, PCNS-BC, CPON, CHPPN is a Pediatric Clinical Nurse Specialist for the Pediatric Palliative Care Team (PACT) at Riley Hospital for Children at Indiana University Health Hospital.  She has over 16 years of experience caring for children with cancer before joining PACT in 2014.  Working with the oncology population, she became interested in pain management, psychosocial support, and pediatric palliative care.  She lectures and teaches at the local, national, and international level, and has been a member of the ELNEC pediatric faculty since 2011.  Ms. Haskamp is an active reviewer for pediatric palliative care education, and has co-authored a book chapter and several articles on various aspects of pediatric palliative care. She earned her bachelor's degree from Purdue University and master's degree from Indiana University. She is an active nursing alumnus of Purdue University providing multiple guest lectures on pediatric oncology and palliative care.  Amy remains very committed to the Association of Pediatric Hematology-Oncology Nurses (APHON) and was the 2017 recipient of the Dr. Patricia Greene Leadership Award.

Cheryl Ann Thaxton, DNP, RN, CPNP, FNP-BC, CHPPN has enjoyed over 25 years of experience in nursing. She is both an ELNEC-Core and ELNEC-Pediatric Palliative Care trainer, and she also helped to develop portions of the ELNEC-APRN curriculum.   She is currently working as an Advanced Practice Nurse for The University of Texas Southwestern Medical Center in Dallas, Texas, Palliative Care Team. Dr. Thaxton worked several years as the Program Coordinator for the Pediatric Quality-of-Life Program at Duke Children's Hospital and Health Center in Durham, North Carolina. Prior to Duke Children's Hospital, she had several years of experience working with pediatric cardiac intensive care, primary care, and neonatal intensive care patients. She has provided several course lectures to ABSN and APRN students as well as medical students. Dr. Thaxton was selected to serve on the Pediatric Examination Development Committee for the Hospice and Palliative Credentialing Center (formerly known as the National Board for Certification of Hospice and Palliative Nurses) which is the only nursing specialty organization to offer certification to all members of the nursing team (APRN, RN, pediatric RN, LP/VN, NA) as well as administrators and perinatal loss care professionals. She has co-authored several publications related to pediatric palliative care and the needs of children with life‐limiting illnesses.  Dr. Thaxton's overall interest in caring for children with chronic pain and life-limiting illness is driven by her passion to serve pediatric and neonatal patients and their families. Her desire to promote the implementation of culturally sensitive initiatives has helped to develop strategic models of care through education and curriculum development. In 2014, Dr. Thaxton received an award for being one of the Great 100 Nurses of North Carolina.

Vanessa Battista, MS, RN, CPNP is a board certified Pediatric Nurse Practitioner (PNP) and is currently a member of the Pediatric Advanced Care Team (PACT) at The Children's Hospital of Philadelphia. Ms. Battista initially worked as a clinical research coordinator/nurse overseeing all aspects of clinical research trials for patients with a variety of neuromuscular diseases. She then practiced as an advanced practice nurse at the neuromuscular centers at both The Columbia University Medical Center and The Children's Hospital of Boston, before being recruited to The Boston College Connell School of Nursing to develop the Pediatric Palliative Care Masters subspecialty program. Ms. Battista then relocated to Philadelphia to serve in her current role. She also serves as a board member and consultant for various organizations that provide services for patients and families living with life-threatening diseases. She lectures and teaches at the local, national, and international level, and is a member of the ELNEC pediatric faculty.  Ms. Battista is an active reviewer for publications and grants, and has co-authored several book chapters and articles on various aspects of pediatric palliative care. She earned her bachelor's degree from Boston College in psychology, with minors in health sciences and faith, peace, and justice studies; her nursing degree and master's degree from Columbia University School of Nursing; and completed a certificate in Pastoral Ministry at the Boston College School of Theology and Ministry. Ms. Battista was the recipient of the ELNEC Award for Excellence and the Distinguished Young Alumni Award from Columbia University.

This course was reviewed by:
Pam Malloy, MN, RN, FPCN, FAAN is an oncology clinical nurse specialist with over 40 years of experience in clinical oncology and palliative care nursing, staff development, education, program development, and administration. Ms. Malloy is currently the national Director and Co-Investigator of the End-of-Life Nursing Education Consortium (ELNEC) Project and Special Advisor on Global Initiatives at the American Association of Colleges of Nursing (AACN) in Washington, DC. She serves as faculty for all the national ELNEC courses and has presented ELNEC in 12 international countries. In addition, she has developed palliative care nursing leadership curricula, taught, and mentored current and future nursing and physician leaders throughout Eastern Europe, Kenya, and Asia. Ms. Malloy directed the California Endowment project for AACN on developing cultural competencies for undergraduate and graduate nursing students. In addition, she collaborated with the US Department of Veterans Affairs to develop the ELNEC-For Veterans curriculum, which was presented to over 500 nurses, representing every VA hospital across the nation. Ms. Malloy serves on the Board of Directors of Living Room International—which provides hospice/palliative care services in Kipkaren, Kenya. She has also served on the Board of Directors for the Leukemia, Lymphoma Society/Washington, DC Chapter and the Hospice and Palliative Nurses Foundation (HPNF). Ms. Malloy is a Florence Wald Fellow, a Fellow in Palliative Care Nursing (FPCN), and the American Academy of Nursing (FAAN). She has written and had published numerous articles in peer-reviewed journals, has written chapters for various textbooks, and currently consults on three palliative care grants. She was recently presented with a Lifetime Achievement Award from the MD Anderson Cancer Center.

Disclosure: The National ELNEC Project - 2018 Pediatric (modules 1, 3, 4, 6, 7, and 8) has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Nurses; in the following settings: Hospice, Palliative Care.
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Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
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