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Peds > Pain Assessment > Flashcards

Pain Assessment Flashcards

1
Q

Peds Assessment Triangle: Appearance

A

looking for:
- abnormal tone
- decreased interactiveness
- decreased consolability
- abnormal look/gaze
- abnormal speech and cry

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2
Q

Peds Assessment triangle: Circulation to skin

A
  • pallor/ pale
  • mottling
  • cyanosis
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3
Q

Peds Assessment triangle: Work of breathing

A
  • abnormal sounds
  • abnormal position
  • retractions
  • flaring
  • apnea/ gasping
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4
Q

Pediatric Early Warning Score (PEWS)

A
  • score is based on the most severe finding in each category
  • Categories: behavior, cardiovascular, respiratory
  • HIGH NUMBER = BAD
  • persistent post-op vomiting and every 15 minute nebulizers adds 2 points
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5
Q

The rothman index

A
  • score is based of VS, labs, nursing assessments
  • HIGH SCORE = BETTER
  • tells how likely a kid is going home
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6
Q

Barriers to pain management

A
  • myth: children dont feel pain
  • lack of pain assessment + reassessment
  • “there are no untoward consequences of children’s pain”
  • lack of understanding + knowledge of how to measure and treat
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7
Q

Cultural considerations for pain management

A
  • pain expression depends on racial and ethnic groups
  • Amish: stoic
  • may express to family membranes but not healthcare
  • pain is a sign of weakness
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8
Q

Neonatal pain considerations

A
  • can feel pain at 25 wks
  • frequent procedures can alter the way pain is processed, can create hypersensitivity and lead to chronic pain procedures
  • sometimes too fatigued to show pain behavior
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9
Q

Infant pain response 0-12 months

A
  • memory of pain starts about 6 months
    -chin quivering, facial grimace, poor feeding, reflex withdrawal, cries, disturbed sleep
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10
Q

Toddler 1-3 years old

A
  • doesnt understand, fearful
  • resist w/entire body, move away from pain
  • aggressive behavior, disturbed sleep, cries
  • cannot describe intensity or type
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11
Q

Preschooler pain response 3-6 years old

A
  • relates pain to injury, active physical resistance
  • easily frustrated
  • can identify location and intensity , may deny pain
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12
Q

School age pain response 6-12 years old

A
  • understands pain and disease
  • passive resistance: tries to hold still and be brave
  • can describe intensity, location, psychologic pain
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13
Q

Adolescent pain response 12-18 years old

A
  • sophisticated and complex understanding of pain
  • qualitative and quantitative pain
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14
Q

Consequences of unrelieved pain

A
  1. Resp: shallow breathing, tachycardia
  2. Neuro: not sleeping
  3. Metabolic: increase metabolism, sweating
  4. Immune: decrease immune
  5. Gastro: GI upset, doesnt eat
  6. Pain: increase pain sensitivity + decrease pain threshold
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15
Q

Neonatal Infant Pain scale (NIPS)

A
  • Assess for procedural pain up to 6 weeks old
  • 5 indicators:
    1. facial expression
    2. cry quality
    3. breathing pattern
    4. arm and leg positioning
    5. state of arousal
  • total score 7
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16
Q

N- PASS Pain Scale

A
  • Used for infants and neonates
  • Pain and sedation scoring
  • 5 indicators
    1. crying, irritability
    2. behavior/ state
    3. facial expression
    4. extremities/ tone
    5. vital signs
  • Total score out of 10
17
Q

FLACC Pain Scale ( face, legs, activity, cry, consolability )

A
  • used for ages > 3 months
  • behavioral pain scale - non verbal
  • 5 indicators ( face legs, activities, cry, consolability )
  • observe patient for 2-5 mins
  • total score out of 10
18
Q

Faces and numeric pain scale

A
  • Use faces for children > age 3
  • Numeric for children > age 8
    total score out of 10
19
Q

Acetaminophen

A
  • used for pain and fever
  • 10mg/kg/dose
  • assess liver function
  • antidote: acetylcycteine
  • reassess: PO: 45-60 min
    IV: 10-20 min
20
Q

NSAID: Ibuprofen

A

-used for pain, inflammation, fever
- monitor kidney function ( ibuprofen, advil, motrin )
- ketorolac: risk of bleeeding complications
-** USED OVER 6 MONTHS OLD **

21
Q

OPIODS: morphine, hydromorphone

A
  • adverse effect: resp. depression
  • antidote: Naloxone, narcan
  • ** NO CODEINE UNDE AGE 18 ( metabolizes to morphine and can lead to overdose )
22
Q

EMLA

A
  • used on intact skin, IV starts
  • apply 30-60 min prior to procedure
23
Q

LET

A
  • lidocaine, epinephrine, tetracaine
  • used for laceration repair (open skin )
  • apply 30 min prior to procedure
24
Q

SEDATION: ketamine, propofol, inhaled nitrous oxide, benzodiazepines

A

Nursing: education, medicate as ordered, monitor VS and LOS during procedure

25
Q

non pharmacologic pain management

A
  • distraction, cutaneous stim.- massage, sucrose “sweeties”, swaddling, heat/cold, positioning
26
Q

S/sx of chronic pain

A

BP, HR, RR are not elevated like acute pain

Peds (20 decks)

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