Exam 1: Chapter 9 - Pain management

Question 1

Define atraumatic care

Answer 1

The use of interventions that minimize or eliminate physical and psychological distress

Question 2

What are 3 ways that pain can be managed by?

Answer 2

Atraumatic, nompharmalogical, and pharmacological interventions

Question 3

What are expected findings in young infants who are in pain?

Answer 3

Loud cry, rigid body or thrashing, reflex withdrawn from painful stimuli, expression of pain lack of association between stimulus and pain

Question 4

What are expected findings in older infants who are in pain?

Answer 4

Love cry, withdraws from pain, facial expressions of pain

Question 5

What are expected findings in toddlers who are in pain?

Answer 5

Loud cry or screaming, verbal expressions of pain, thrashing of extremities attemp to push away o avoid stimuli, noncooperation, clinging to a significant person requests physical comfort

Question 6

What are expected findings in school-aged children who are in pain?

Answer 6

Stalling behavior, muscular rigidity, more intense toddler behavior during painful stimulus

Question 7

What are expected findings in adolescents who are in pain?

Answer 7

Verbal expressions of pain with less protest, muscle tension with body control

Question 8

What is the age requirement for a child to be able to self report their pain?

Answer 8

4 years or older

Question 9

Using play therapy to explain procedures and allowing the child to perform the procedure on a doll or try is using what type at pain management technique?

Answer 9

Atraumatic measures

Question 10

True or false: all procedures should be performed in a treatment room and never in a child’s “safe space” like the play room or their bed if able to be avoided

Answer 10

True

Question 11

Offering choices to the child is using what type of pain management technique?

Answer 11

Atraumatic measures

Question 12

The World Health Organization (2012) recommends a 2-step approach for medication management of pain for children. What are these 2 steps?

Answer 12

1. For children above 3 months of age with mild pain, first administer a non-opioid like an NSAID
2. For milaren with moderate to severe pain, administer a strong opidia like morphine

Question 13

How should medications for pain be given to optimize relief when pain is expected to last for an extended period of time?

Answer 13

Routinely not PRN

Question 14

Why is providing an opioid with a non- opioid beneficial for treating pain?

Answer 14

It treats pain peripherally and centrally which provides analgesia with fewer adverse effects ( respiratory depression, constipation, nausea)

Question 15

What route of medication administration is not recommended for pain control in children?

Answer 15

IM injections, intranasal medications for <18 years

Question 16

What age group is the FLACC pain scale used for?

Answer 16

2 mouths to 7 years

Question 17

What age group is the FACES pain scale used for?

Answer 17

3 years or older

Question 18

What age group is the oucher pain scale usually used for?

Answer 18

3 to 13 years

Question 19

What medication administration route is preferred due to convenience post, and ability to maintain steady blood levels?

Answer 19

Oral

Question 20

How long does it take for oral medication to reach peak analgesic effect?

Answer 20

1-2 hours

Question 21

What are common topical/transdermal medications to treat pain in children?

Answer 21

Lidocaine, prilocaine, fentanyl

Question 22

When using fentanyl, what should you use to treat respiratory depression?

Answer 22

Naloxone

Question 23

How old does the child need to be to have fentanyl?

Answer 23

12 years at age

Question 24

What are the three types of intravenous medication administration methods to treat pain in children?

Answer 24

Bolus, patient-controlled analgesia, family controlled analgesia

Question 25

What are nonpharmalogical measures to central pain in children?

Answer 25

-Distraction
- relaxation
- guided imagery
- positive self talk
-Behavioral contracting
-Containment
- nonnutritive sucking
-Kangaroo care
- complementary or alternative medicine

Question 26

What is an example of using distraction?

Answer 26

Play, radio, a computer game, movie, jokes or stories

Question 27

What is an example of using relaxation to treat pain in children?

Answer 27

Holding or rocking infant or young child, assisting older children into a comfortable position, assist with breathing techniques

Question 28

What is an example of using guided imagery to treat pain in children?

Answer 28

Assist the child in an imaginary experience, have the child describe the details

Question 29

What is an example of using positive self talk to treat pain in children?

Answer 29

Have the child say positive things during a procedure or painful episode

Question 30

What is an example of using behavioral contracting to treat pain in children?

Answer 30

Use stickers or tokens as rewards, give time limits for the child to cooperate, reinforce cooperation with reward

Question 31

What is an example of using containment to treat pain in children?

Answer 31

Swaddle the infant, place rolled blankets around the child, maintain proper positioning

Question 32

What is an example of using nonnutritive sucking to treat pain in children?

Answer 32

Offer pacifier with sucrose before, during, and after painful procedures

Question 33

What is an example of using kangaroo care to treat pain in children?

Answer 33

Skin-to-skin contact between infants and parents

Question 34

What is an example of using complementary and alternative medicine to treat pain in children?

Answer 34

-Offer foods, vitamins, supplements
- Offer massage or chiropractic options
- review energy-based treatments (magnets)
- discuss mind-body techniques (hypnosis, homeopathy or naturopathy )

Question 35

What is the main complication for children who have poorly controlled pain?

Answer 35

Chronic pain syndrome