Pain Assessment and Management in Children Flashcards

1
Q

imperative understand how show and express pain based on age; diff based on age; to correctly treat pain need understand how showing and expressing it and why not forthcoming with pain

A

Ped nurse:

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2
Q

Newborns do not feel pain.
The intensity of a child’s behavioral reaction indicates the intensity of the child’s pain.
Children are truthful when they are asked if they are experiencing pain.
Children learn to adapt to pain and painful procedures.
Children experience more adverse effects of narcotic analgesics than adults do.
Children are more prone to addiction to narcotic analgesics.

A

False

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3
Q

Exposure to pain at an early age has little to no effect on the child.

A

False
More pain exposed to - long-term sensory issue; SPD long-term

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4
Q

Acute vs. Chronic
Factors influencing pain
Nurses understanding
Infant
Toddler
Preschooler
School Age
Adolescent
*** Unmanaged pain may lead to potential long-term physiologic, psychosocial, and behavioral consequences. - take pain management seriously; assess and re-assess often

A

Pediatric pain

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5
Q

React differently with each
Chronic conditions - DM, cystic fibrosis, cancer, sickle cell, chronic ear infections, migraines

A

Acute vs. Chronic

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6
Q

Age/gender
Cognitive level
Temperament
Previous painful experiences
More trauma in past - worse react
Know what happen
Family Culture

A

Factors influencing pain

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7
Q

Take factors into account

A

Nurses understanding

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8
Q

Clench hands
Flail hands, feet, legs, arms
Grimace
Immobilize them

A

Infant

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9
Q

Cries
BIG: Changes in behavior
Not prolong injuries
Not ability explain pain

A

Toddler

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10
Q

Easier explain
Lot better answering questions - formulate questions and know what looking for; direct parents to ask them to ask questions and how feeling

A

Preschooler

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11
Q

Very good at how pain is, where is, what happened
Might hide injury/completely forthcoming because treatment - past friends or culture

A

School Age

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12
Q

Not want show pain on culture or friends
Good at telling us pain
With-hold that - worried about something and what comes next; being tough

A

Adolescent

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13
Q

Old enough to tell how feeling: 4+ yrs
FACES (Wong-Baker): 3 and older; not use reliably until 4; no hurt or lot hurt; not happy/sad
OUCHER: 3-13 years; pics faces and correlates to number
Numerical rating scale (NRS): 8 and up; scale 1-10
Let child pick whatever comfy with - use same one throughout hospitalization

A

Pain scales - self-reporting

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14
Q

Cannot tell us verbally in pain
Neonatal Infant Pain Scale (NIPS)
NPASS
r-FLACC - 2 months-7yrs; cannot communicate with us
Go based on how reacting; face look, legs, activity, cry, consolable, pts on how acting and add them up; higher number more pain
Assess pain every time

A

Pain scales - behavioral

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15
Q

Which pain scale would the nurse use when assessing a 4-year-old client?
1. CRIES
2. FLACC
3. Numerical
4. FACES

A

Answer: 4

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16
Q

Which is the MOST reliable indicator of a 2.5-year-olds pain?
1. Crying and sobbing
2. Changes in behavior
3. Verbal exclamations of pain
4. Changes in pulse and resp rate

A

Answer: 2

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17
Q

Pharmacologic management
Nurse Management
Consequences of untreated pain in infants
Nonpharmacologic management

A

Pain management

18
Q

Nonopioids
Opioids
Coanalgesic drugs
Choosing the timing of analgesia
Choosing the method of administration
Patient-controlled analgesia
Epidural analgesia
Transmucosal and transdermal analgesia

A

Pharmacologic management

19
Q

Mild-moderate pain: tylenol, ibuprofen; give acetaminophen: at birth: max amt depending on weight - sometimes in cough med - make sure not OD on that
ibuprofen/motrin - 6 months; cannot clear properly
High fever - can alternate meds; due q6hr; alternate q3hr

A

Nonopioids

20
Q

Severe pain: fentanyl, morphine, codeine
Worry about constipation and resp depression
Constipation: hard on toddler esp if recently potty trained if have to go in diaper or adolescent to go in bed pan more likely to hold it

21
Q

Older ones - can do it
Can do parents - maybe - very educated and involved in care

A

Patient-controlled analgesia

22
Q

Monitoring side effects
Evaluation and effectiveness of pain regimen; re-evaluate; cause of pain; making worse; what helping it go away; get parents involved and what works at home and helps child at home

A

Nurse Management

23
Q

Physiologic indicators
Behavioral indicators

A

Consequences of untreated pain in infants

24
Q

Distraction
Relaxation
Guided imagery
Cutaneous stimulation
Containment and swaddling
Nonnutritive sucking
Kangaroo care

A

Nonpharmacologic management

25
Toddler best age; can do little in preschool
Distraction
26
School-age; older kids
Relaxation
27
School-age; older kids
Guided imagery
28
School-age; older kids Helping with deep breathing
Cutaneous stimulation
29
Infants Used being in utero - like borders and boundaries
Containment and swaddling
30
Pacifier with sugar water - relieves more pain than pain med; calms them down and relaxes them
Nonnutritive sucking
31
Skin to skin
Kangaroo care
32
Painful and invasive procedures Postoperative pain Burn pain Recurrent headaches Recurrent abdominal pain Pain associated with sickle cell disease Cancer pain in children Pain and sedation in end-of-life care
Common pain states
33
Procedural sedation and analgesia
Painful and invasive procedures
34
Associated with surgery Combination of medications
Postoperative pain
35
Multiple components Difficult and challenging to control
Burn pain
36
Tension, dental braces, weakness of eye muscles, sinusitis, epilepsy, sleep apnea, injury
Recurrent headaches
37
Common in children
Recurrent abdominal pain
38
ED visits for opioid treatment
Pain associated with sickle cell disease
39
Most prevalent symptom is pain
Cancer pain in children
40
Comfort can be relief with a combination of opioids and adjuvant analgesics
Pain and sedation in end-of-life care