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Peds > pain assessment and management (1) > Flashcards

pain assessment and management (1) Flashcards

1
Q

what is abnormal processing of pain by the peripheral or central nervous system

A

neuropathic pain

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2
Q

what kind of stuff treats neuropathic pain?

A

Acupuncture, massage, medication

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3
Q

what is normal pain called

A

Noicioceptive pain

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4
Q

at what age gestation can children feel pain?

A

25 weeks, the full third trimester

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5
Q

can neonates an infants feel pain?

A

Yes

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6
Q

Do children feel pain with the same intensity as adults?

A

Yes

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7
Q

Are infants incapable of expressing pain?

A

No

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8
Q

Can infants and children remember pain?

A

Yes

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9
Q

Are children still in pain if they are distracted or sleeping?

A

They can be

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10
Q

Do repeated experiences with pain teach children to be more tolerant of it and cope better?

A

No

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11
Q

Do children recover more quickly from adults from painful experiences such as surgery?

A

No

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12
Q

are children at risk for addiction?

A

No

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13
Q

Does culture affect pain response in children?

A

Yes

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14
Q

What are respiratory consequences of unrelieved pain in children?

A
  • Shallow breathing
  • Inadequate lung expansion
  • poor cough
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15
Q

what are neurologic consequences of unrelieved pain?

A
  • Increased SNS activity and release of catecholamines
  • Tachycardia, hypertension, change in sleep
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16
Q

Metabolic consequences of unrelieved pain?

A
  • Increased metabolic rate, sweating
  • increased cortisol and blood glucose
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17
Q

what are immune consequences of unrelief pain?

A
  • Depression of immune and anti-inflammatory response
  • causes increased risk of injection or delayed wound healing
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18
Q

GI consequences of unrelieved pain?

A
  • Delayed return of GI function
  • Anorexia, poor nutritional intake
  • ileus, bowel obstruction
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19
Q

which indicators are measured by pain assessment tools?
1. Tachycardia
2. Tachypnea
3. behavior measures
4. self reporting of pain
5. hypertension
6. Flushing and pallor
7. Perspiration
8. decreased oxygen saturation

A

Only 3 and 4

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20
Q

What pain skills used for infants, young children, and those with developmental delays

A

FLACC

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21
Q

What does FLACC stand for

A

faces, legs, activity, cry, consolability

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22
Q

describe the faces scale

A
  • 0-5 scale
  • point to face that corresponds to #
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23
Q

what ages is the faces scale used for?

A

as young as 3

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24
Q

describe the oucher scale

A
  • series of 6 photos of faces
  • 0-10 scale
25
Q

what ages is the oucher scale used for?

A

3-12

26
Q

describe visual analog or numerical scale

A
  • 0= no pain, 10= worst pain
27
Q

what ages are the visual analog or numerical scale used for?

A

9 years to adult

28
Q

what behaviors indicate pain?

A
  • crying
  • restlessness or agitation
  • hyperalertness or vigilance
  • sleep disturbances
  • irritability
29
Q

what 3 kinds of drugs are ued for pediatric pain management?

A
  • opioids
  • NSAIDS
  • nonnarcotic analgesics
30
Q

examples of opioids used for pain in kids

A

morphine, dilaudid

31
Q

what kind of opioids can’t be used in kids

A

demerol (meperidine) or codeine

32
Q

which NSAIDs are used for peds pain?

A

toradol, ibuprofen

33
Q

which nonnarcotic analgesic is used for pain?

A

tylenol

34
Q

max dose of opioids for newborns?

A

0.1 mg/kg/dose

35
Q

max dose of opioids for 3 month old?

A

2 mg/dose

36
Q

max dose of opioids for 6 year old?

A

4 mg/dose

37
Q

max dose of opioids for 12 year old?

A

8 mg/dose

38
Q

max dose of opioids for adolescents?

A

10 mg/dose

39
Q

side effects of opioids?

A
  • resp depression
  • sedation
  • constipation
  • pruritis
  • nausea
  • vomiting
  • urinary retention
40
Q

what orders would combat the side effects of opioids?

A
  • antiemetics
  • use low doses of opioids and non-opioids together
  • stool soft/laxatives
  • antihistamine (itching)
  • catheter
41
Q

what drug reverses opioid effects?

A

naloxone

42
Q

what are signs of respiratory depression?

A
  • sleepiness
  • small pupils
  • shallow breathing
43
Q

what is the cycle of consequences of long-term (1-2 weeks) opioid use in peds

A

physical dependence -> tolerance -> withdrawal -> (repeat)

44
Q

what is the weight based dosing of acetaminophen

A

10-15 mg/kg/dose

45
Q

what is the max dosing of acetaminophen q4-6h, q6-8h, and daily

A
  • q4-6h= 325-650 mg
  • q6-8h= 1000 mg
  • daily= 4g
46
Q

weight based dosing for ibuprofen

A

5-10 mg/kg/dose

47
Q

q4-6h dose for ibuprofen?

A

200-400 mg

48
Q

weight based dosing of ketorolac (and max)

A

0.5 mg/kg (up to 15 mg)

49
Q

q6h dosing of ketorolac

A

15-30 mg q6h

50
Q

what organ is damaged in acetaminophen overdose, and what is the antidote?

A

liver, acetylcysteine

51
Q

what are side effects of ibuprofen and ketorolac?

A

increased risk for GI irritation, ulceration, and bleeding

52
Q

which med administration method is most commonly avoided in peds?

A

IM (pain/stress)

53
Q

what are the 2 kinds of PCA pump med administration?

A

Basal (constant level)
Demand (smaller dose on demand)

54
Q

what is emla cream made of?

A

mixture of lidocaine 2.5%, and prilocaine 2.5%

55
Q

what consitions cause chronic pain in children?

A
  • juvenile idiopathic arthritis
  • cancer
  • headaches
  • recurrent abdominal pain
  • sickle cell disease
  • HIV
56
Q

when is procedural sedation used?

A

for painful diagnostic and therapeutic procedures

57
Q

what kind of procedures require procedural sedation?

A

chest tube insertion, arterial puncture, burn debridement, laceration repair, bone marrow aspiration, fracture reduction

58
Q

moderate vs. deep sedation?

A

moderate= maintain refelxes / respond
deep= can’t maintain airway or refelxes

59
Q

what are the goals of procedural sedation?

A
  • prevent or releive pain & anxiety
  • ease of doing procedure
  • prevent complications

Peds (30 decks)

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