ATI 9 - Pain MGMT Flashcards
factors that influence pain perception
- age
- dvlptmtl age
- chrnc or acute disease
- prior hx w pain
- personality
- family dynamics
- culture
- socioeconomic status
expected pain signs
YOUNG INFANT
- loud cry
- rigid body or thrashing
- local reflex withdrawal
- expressions of pain (tight eyes, mouth open in square shape, brows lowered + drawn together)
- lack of assoc bw stimuli + pain
expected pain signs
OLDER INFANT
- loud cry
- deliberate withdrawal fr pain
- facial expression of pain
expected pain signs
TODDLER
- loud cry or screaming
- verbal expression of pain
- thrashing
- attempt to push away fr stimulus
- NONCOOPERATION
- clinging to person
- behavior occurs in ANTICIPATION
- requests physical comfort
expected pain signs
SCHOOL-AGED CHILD
- stalling behavior
- muscular rigidity
- any behavior of toddler, but less intense
expected pain signs
ADOLESCENT
- more verbal expression w less protest
- muscle tension w body control
self report of pain intensity is used for…
children 4 yo + older
atraumatic measures
- use tx room for painful procedures
- avoid procedures in “safe” places (playroom, child’s bed)
- use approp terminology
- offer choices to child
- allow parents to stay w kid
- use play therapy to explain procedure
W.H.O. recommends 2-step approach for pharm mgmt
step 1 is for 3 mo + older w mild pain: admin non-opioid like NSAID
step 2 is for mod-severe pain: admin strong opioid like MORPHINE
T/F give pain med PRN
FALSE
-give routinely esp in pain that is expected to last for an extended period of time
combining ___ + ___ treats pain peripherally + centrally
non opioid w opioid
___ are not recommended for pain control in children, + ___ are not recommended for children younger than 18yo
IM injections
intranasal med
fentanyl
- for kids older than 12 yo
- continuous pain control
- –onset 12-24 hr, duration 72hr
IV bolus
-rapid pain control in 5 min
nonpharmacological measures [9]
- distraction
- relaxation
- guided imagery
- positive self talk
- behavioral contracting
- containment
- nonnutritive sucking
- kangaroo care
- complementary + alternative med
distraction
- use play, radio, computer game, or movie
- tell jokes or a story to child
relaxation
- hold or rock infant/young child
- assist older children into comfortable position
- assist w breathing techniques
guided imagery
- assist w imaginary experience
- have child describe the details
positive self talk
-have child say positive things during a procedure or painful episode
behavioral contracting
- use stickers or tokens as rewards
- give time limits for the child to cooperate
- reinforce cooperation w a reward
containment
- swaddle infant
- place rolled blankets around child
- maintain proper positioning
nonnutritive sucking
-offer pacifier w sucrose before, during, + after
kangaroo care
skin to skin contact
complementary + alternative medicine
- offer food, vitamins, + supplements
- massage or chiro
- review energy based tx like magnets
- mind body techniques like hypnosis, homeopathy, neuropathy
FLACC age
2 mo - 7 yo
FLACC
face (0=smile/no expression, 2 constant frown, clenched jaw) legs (0=relaxed, 2=kicking) activity cry consolability
NUMERIC SCALE age
5yo + older
FACES age
3yo + older
-similar to pain scale but w faces
OUCHER age
3-13 yo
OUCHER
pain rate don scale using 6 pics
-organize pics in order of no pain to worst pain
>then have them choose how theyre feeling
NON-COMMUNICATING CHILDREN’S PAIN CHECKLIST
age
3yo + older
NON-COMMUNICATING CHILDREN’S PAIN CHECKLIST
-behavior observed for 10 min
6 subcategories are scored on scale of 0-3 (0=not at all, 1=a little, 3=very often)
NON-COMMUNICATING CHILDREN’S PAIN CHECKLIST
subcategories
- facial
- limbs + body
- activity
- vocal
- social
- physiological
