Class 4 Chronic Illness and pain

Question 1

What are the presenting symptoms of type 1 diabetes

Answer 1

-Hyperglycemia
-polyphagia (constantly hungry)
-Polydipsia (constantly thirsty)
-polyuria (excessive peeing)

Question 2

what is a primary test that can be used to confirm the presence of diabetes

Answer 2

Elevated fasting blood glucose levels

Question 3

What does a glucose tolerance test assess for

Answer 3

assessed insulin response to glucose

Question 4

typically how old does a child have to be before they can start using an insulin pump

Answer 4

usually have to be 7 and older

Question 5

What can cause DKA

Answer 5

-Inadequate insulin
-Excess CHO intake

Question 6

What are some signs and symptoms of DKA

Answer 6

-BG levels above 11
-The three P’s
-Abdo pain
-Change in LOC
-Fruity odor to breath
-Kussmaul’s respirations

Question 7

What is the biggest indicator of DKA

Answer 7

Decreased LOC

Question 8

what lab values would indicate DKA

Answer 8

-Hyperglycemia
-Ketonuria
-Low serum Bicarb
-Decreased CO2
-Low PH
-hypertonic dehydration

Question 9

what are the general principles of palliative care for children

Answer 9

-Simultaneous care (Curative and palliative care)
-Family centered approach
-Interdisciplinary team
-Ongoing assessment

Question 10

what is the role of the nurse in pediatric palliative care

Answer 10

-Recognizing child’s needs
-Emotional spiritual support
-Facilitate advanced planning
-pain and symptom management

Question 11

what are the main systems/organs that pain can negatively effect

Answer 11

-Endocrine system
-Immune system
-Pulmonary expansion and atelectasis
-Cardio system (elevated heart rate BP and O2 consumption)

Question 12

when do children start to be able to locate pain sites

Answer 12

at around 3 years and older

Question 13

What are the principles of a pediatric pain assessment

Answer 13

-Question the child (ask in an age appropriate way about pain)
-Use a pain rating scale
-Evaluate behaviour and physiological changes
-Secure parents involvement
-Take cause of pain into account
-Take action and evaluate results

Question 14

How do infants show that they are in pain

Answer 14

-Crying
-grimacing
-Increased muscle tone
-poor feeding
-Sleep disturbances

Question 15

what is one reason it is hard to access pain in toddlers

Answer 15

they tend to exhibit the same reaction regardless of the severity of the pain

Question 16

which age group might blame themselves for pain because of their concrete way of thinking

Answer 16

School aged children

Question 17

which age group might downplay their pain due to concerns about appearing week or different

Answer 17

Adolescents

Question 18

when can children typically start using numeric pain scales

Answer 18

around 8 (school age)

Question 19

what aspects do you have to access before you can use a numeric pain scale

Answer 19

-Language skills
-Sequencing ability
-Ability to follow directions
-Ability to answer and understand questions

Question 20

What does FLACC stand for

Answer 20

Face, Legs, Activity, Crying, Consolability

Question 21

What is the FLACC scale and what age is it used for

Answer 21

2 months-7 years of age or older if they are developmentally delayed

Question 22

What age can utilize the wong baker faces scale

Answer 22

children 3 years and older that can communicate pain levels visually

Question 23

what age uses the NIPS pain scale

Answer 23

from birth to 1 year of age

Question 24

what age is the OUCHER pain scale used for

Answer 24

usually for children 3-12

Question 25

what is the NIPS pain scale

Answer 25

Neonatal infant pain scale and is an observational behavioural pain assessment

Question 26

What 6 things does the NIPS scale include

Answer 26

-Facial expressions
-Crying
-breathing
-arms
-legs
-state of arousal

Question 27

what is the FLACC scoring rance

Answer 27

Each category is 0-2 with a total score of 10

Question 28

WHat opioid is never recommended to use in children

Answer 28

Codeine since the rate at which it is metabolized varies greatly between kids

Question 29

how long before a procedure would you apply a topical anesthetic

Answer 29

30-60 minutes

Question 30

What organ do you have to monitor closely when a child is on acetaminophen

Answer 30

monitor the liver

Question 31

What are the common NSAIDS

Answer 31

ASA
Ibuprofen
Naproxen

Question 32

What is ketorolac

Answer 32

an NSAID but used for moderate to severe pain usually after a procedure

Question 33

What organs are NSAIDS particularly hard on

Answer 33

GI and Kidneys

Question 34

what is one of the most important things to integrate into a pediatrics patients pain management strategy

Answer 34

A multimodal approach that combines pharmacological and non pharmalogical

Question 35

what are the three different types of pain

Answer 35

-Acute
-Chronic
-Recurring

Question 36

is smoking a risk factor for type 2 diabetes

Answer 36

no