Pain Flashcards
What age group typically sees their pain as a punishment, and it is important we reassure this age group that the illness/injury is not their fault.
preschool: guilt vs initiative
What are some physical and behavioral changes that we need to keep track of when assessing pain?
Restlessness, VS changes, grimacing, mood change, pain thresholds vary
What are 2 behavioral measures and scales used to assess pain in infants, toddlers and children who are nonverbal–not used in acute care settings.
CRIES -crying -requires SpO2 >95% -increased vital signs -expression -sleeplessness (0-2 scale) NIPS -facial expression -cry -breathing pattern -arms -legs -state of arousal -HR -O2 Sat (a score greater than 3 indicates pain)
What self report scale is used in ages 4-8 years old?
FACES
What self report scale is used by older children?
numeric scale
-Types of Pain-
Acute pain and example?
last less than 2 weeks
Example: post operative
-Types of Pain-
Chronic pain and example?
at least 3 months- can be constant or transient
Example: back injury
-Types of Pain-
Recurrent pain and example?
episodic, comes along more frequently
example: migraine, sickle cell pain
-Managing Pain-
mild to moderate?
acetaminophen (0-6 months would ONLY get this medication) or NSAIDs
-Managing Pain-
moderate to severe?
opioids- this is based on the disease and the child.
For severe pain- it would be IV pain meds
what is a med that is used for conscious sedation, especially when a pt needs stitches?
Midazolam
Acute, continuous pain is best managed with a _____ dose scheduling and around the clock medications- teach parents and patients to give medication at a lower pain level.
fixed
PRN orders are typically used for what types of pain?
breakthrough pain or activity pain
Dressing changes should be done during a drugs ____ time.
peak
What are the peak times for nonopioids, PO opioids, and IV opioids?
Nonopioid: 2 hours
PO opioid: 45-60 minutes
IV opioid: 15-30 minutes
Children older than ___ months metabolize more rapidly and may require higher doses of meds.
6
NO _____ for children ever because it will convert to morphine in the ____ and puts the child at risk for toxic levels of morphine.
- codeine
- liver
When a child is given hydrocodone with acetaminophen, we need to be very aware of the amount of _________ the child is getting because this is a huge risk for accidental ________.
- acetaminophen
- poisoning
-Physical Dependence-
Tolerance?
dose needs to be increased to achieve desired effect–Two options: increase dose or decrease the amount of time between doses
-Physical Dependence-
Addiction?
characteristics pattern of some type of opioid use, may have a loss of control over use, preoccupation with obtaining the drug
-Physical Dependence-
Ceiling effect?
the dose goes beyond with no relief- need to increase the dose to help the pain which increases the adverse effects and increases the risk for addiction
Common side effects of NSAIDs?
N/V, dyspepsia, epigastric pain, diarrhea, constipation, gastric ulcers and bleeding
True or False: NSAIDs can be taken on an empty stomach.
false-need to take with food r/t GI bleeds
What are some common side effects of opioids?
constipation, sedation, N/V, pruritus, respiratory depression, dysphoria, confusion, hallucinations, urinary retention
