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Module 5 (Pediatrics) > Pain Assessments > Flashcards

Pain Assessments Flashcards

1
Q

Newborns and young infant response to pain

A

crying
brows lowered and drawn together
tightly closed eyes
mouth open
squarish
rigid, thrash, withdrawal reflex
no relationship btw causing pain and response

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2
Q

Older infant response to pain

A

crying
deliberate withdrawal from cause
pain and anger expression
physical struggle, esp. pushing away

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3
Q

Young child response to pain

A

crying and screaming
“Ow, Ouch, It hurts”
thrash around
push when pressure applied
lack of cooperation (possible need for restraint)
begs for end
clings to family, nurse
requests physical comfort
restless and irritable
worries for anticipation of actual procedure

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4
Q

School-age response to pain

A

includes all young children’s responses +
behaviors during the procedure not before
Time wasting “Wait a Minute or I’m not ready”
Muscular rigidity (fist clenching, white knuckles, teeth grit, contracted limbs, stiffness, closed eyes, wrinkled forehead)

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5
Q

Adolescent response to pain

A

less vocal with less restraint
More verbal in the expression “You’re hurting me”
Increased muscle tone and body control

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6
Q

Manifestations of Pain in the Neonate
VS

A

increased heart rate, BP,
rapid, shallow respirations
decreased O2 Sat

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7
Q

Manifestations of Pain in the Neonate
Physical

A

pale or flushed
sweating
increased muscle tone
dilated pupils
low vagal nerve tone
Increased ICP
low pH, high glucose, and corticosteroids

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8
Q

Manifestations of Pain in the Neonate
Behavioral responses

A

crying
whimpering
groaning
grimace, quiver, tightly closed eyes
mouth open and squarish
limb withdrawal
thrash, rigid, flaccid
fist clenching

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9
Q

Manifestations of Pain in the Neonate
Changes in sleep, nutrition, or activity

A

fussiness, irritability
listlessness
inability to sleep at times

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10
Q

Nonpharmacologic Strategies for Pain Mgmt

A

child-life specialist - doll medical play
trusting relationship
express concern regarding their pain and intervention efficiency
active role in seeking effective strategies
preparation for the procedure with atraumatic care
prepare before pain BUT avoid planting the idea of pain - parents to stay if desired
- use non pain descriptors

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11
Q

Instead of saying “This is going to (or may) hurt” what should you say to the child?

A

“Sometimes this feels like pushing, sticking, or pinching, and sometimes it doesn’t bother people. Tell me what it feels like to you.”

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11
Q

Types of Distraction Techniques

A

audio or visual deterrents
deep breaths and blowing
bubbles
Kaleidoscopes
Use humor
with friends

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12
Q

Types of Relaxation Techniques

A

comfort positions
rock wide and rhythmically (NOT bouncing)
repeat comfort phrases “Mommy’s here”
If older = deep breaths, limp like a rag doll, exhale, then yawn, progressive staring with toes, keep eyes open

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13
Q

Types of Guided Imagery Techniques

A

Happy Places
describe details
write down script
encourage to go to a pleasurable place
combine with breathing and relaxation

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14
Q

Types of + self-talk Techniques

A

positive statements

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15
Q

Types of Stop Thoughts Techniques

A

+facts
reassuring
brief statements and memorize them

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16
Q

Types of Behavioral Contracting Techniques
And age

A

4-5 y/o
rewards
limit the time of procedure to the child
reinforce cooperation with a reward if accomplished within a specific time
Contract (formal) - goals and desired behavior, measurable behaviors, written, dated, and signed, rewards and consequences, evaluate, and commitment

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17
Q

Managing Opioid Side Effects
Constipation

A

constipation: stool softeners, increase intake (prune juice, bran cereal, veggies) and exercise

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18
Q

Managing Opioid Side Effects
Sedation

A

Sedation: caffeine
if persists seek alternative

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19
Q

Managing Opioid Side Effects
N/V

A

ondansetron, imagery, deep and slow breathing

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20
Q

Managing Opioid Side Effects
Pruitus

A

Naloxone, oatmeal baths, good hygiene,
exclude other causes of itching
change opioid

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21
Q

Managing Opioid Side Effects
Respiratory depression (mild-moderate-severe)

A

Mild to moderate: arouse gently, O2, encourage deep breaths, hold dose and reduce dose to 25%
Severe: O2, bag and mask when indicated, Naloxone, opioid switch

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22
Q

Managing Opioid Side Effects
Dysphoria, confusion, hallucinations

A

rule out other causes
Haldol or opioid switch

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23
Q

Managing Opioid Side Effects
Urinary retention

A

eliminate antihistamines, antidepressants
Oxybutynin
In/out or indwelling cath

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24
Q

If respirations are depressed (opioid-induced)

A

assess sedation
reduce infusion by 25 % if possible
stimulate pt
admin O2

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25
Q

If pt can’t be aroused / apneic from preparation oioid induced depression, then

A

initiate resuscitation
Naloxone (Narcan) bolus by slow IV push every 2 minutes until effect
close monitor pt (duration is shorter than opioid requiring repeated doses)

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26
Q

For children < 40 kg (88lbs) dilute 0.1 mg naloxone in

A

10 mL sterile saline to make 10 mcg/mL solution and give 0.5 mcg/kg

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27
Q

For children > 40 kg (88lbs) dilute 0.4 mg naloxone in

A

10 mL sterile saline and give 0.5mL

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28
Q

Signs of opioid tolerance

A

decreased pain relief and duration of relief

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29
Q

Initial Signs of Withdrawal Syndrome in Patients with Physical Dependence

A

Lacrimation
Rhinorrhea
yawning and sweating

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30
Q

Later Signs of Withdrawal Syndrome in Patients with Physical Dependence

A

restlessness
irritable
tremors
anorexia
dilated pupils
goosebumps
N/V

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31
Q

Physical dependence

A

abrupt cessation of the opioid, or administration of an opioid antagonist, results in a withdrawal syndrome.
does not imply addiction

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32
Q

Tolerance

A

neuroadaptation to the effects of chronically administered opioids after 10-21 days of morphine
need for increasing or more frequent doses of the medication to achieve the initial effects of the drug.
does not imply addiction

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33
Q

Addiction

A

persistent pattern of dysfunctional opioid use:
adverse consequences, loss of control, preop with obtaining opioids

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34
Q

Consequences of Untreated Pain in Infants

A

pain triggers constant stress responses
- hemorrhage, high morbidity, hypersensitive, unknown origins of pain, poor motor functions, neuro and cognitive behaviors, inabile to cope, impulsivity, learning deficits,
emotional temperament in childhood

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35
Q

Define Pain for a pt

A

whatever the experiencing person says it is, existing whenever he says it does
BELIEVE THE PT

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36
Q

True meaning of pain in medical terms

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.

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37
Q

T/F: Neonates and Infants Do Not Feel Pain With The Same Intensity As Adults Because A Child’s Nervous System Is Immature.

A

False, pain is felt regardless of age
Actually feel more pain due to immature nervous system and lack of gate

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38
Q

The youngest premature infant has the anatomic and physiologic components to perceive ___________ and demonstrates what?

A

nociception

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39
Q

The complete myelination of nerve pathways is not required for

A

pain transmission

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40
Q

Nociception

A

Process by which pain becomes conscious

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41
Q

Transduction

A

process of noxious stimuli converted to electrical signals (impulses) in sensory nerve endings

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42
Q

Transduction occurs at the site of

A

tissue damage

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43
Q

What is the process of pain perception

A

Transduction
Transmission
Perception
Modulation

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44
Q

Transmission of pain

A

spreading the sensation along the nerves to the CNS (ending in the brain stem)

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45
Q

Perception of pain occurs

A

transmission reaches the brain and is perceived as a conscious, emotional and physical experience

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46
Q

Modulation involves

A

changing or inhibiting the transmission of the initial impulse
- occurs after the perception of pain reaches the brain

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47
Q

Premature infants may have a

A

greater sensitivity

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48
Q

Why do infants have a greater sensitivity to pain?

A

can not control the gate of the Nervous system as well so they feel more pain

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49
Q

Unrelieved pain in infants can permanently change their nervous system and may

A

prime them for having chronic pain

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50
Q

T/F: Repeated Experience With Pain Teaches The Child To Be More Tolerant Of Pain And Cope With It Better.

A

False, children do not tolerate pain better than adults.

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51
Q

Children’s tolerance to pain actually __________ with age.

A

increases
- some they have more pain

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52
Q

Children do not become accustomed to pain/painful procedures; they actually demonstrate an

A

increased behavioral signs of discomfort with repeated painful procedures

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53
Q

Children have increased behavioral signs of discomfort because

A

they know what it feels like

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54
Q

T/F: Children usually don’t tell you if they are in pain.

A

True, some children won’t tell you if they are in pain to be brave or have cultural tendencies.

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55
Q

T/F: Children do not need medication unless they appear to be in pain.

A

False, children can tell you where they hurt and accurately point to the area or draw beyond infancy

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56
Q

If a child is nonverbal, how will they express their pain?

A

pointing or drawing a picture of the painful sites
show on the pain scale at 3+

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57
Q

Children do/do not always admit to having pain.

A

do not

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58
Q

Why would a child not admit to having pain?

A

avoid injections
constant/chronic pain (normal is a 2-3 to others)
believe others know how they are feeling (egocentricity)
culture seen as a weakness, stoic or expressive when expressing emotions)
gender (suck it up and be a man)

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59
Q

Behavioral manifestations of pain may not reflect pain

A

intensity

Predominantly crying and difficult mood

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60
Q

Pain s/s may be affected by

A

developmental level
coping abilities
temperament (activity level, intensity of reaction, influence pain behavior)

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61
Q

If the child has a decreased activity level and a decreased intensity of reaction, it may make it more

A

difficult to realize they are in pain

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62
Q

A child with an increased intensity of reaction and negative mood may look like

A

they are in a lot of pain

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63
Q

What are some behavioral traits that would make it more difficult to see if they are hurting?

A

decreased activity level
increased adaptability
decreased intensity of the reaction
positive or neutral mood

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64
Q

T/F: Infants And Children Have No Memory Of Pain.

A

False, infants cry in anticipation of immunizations
- associate alcohol smell with heel sticks and will pull their feet away to avoid the pain

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65
Q

T/F: Parents Exaggerate Or Aggravate Their Child’s Pain

A

False, parents know their children better than anyone else and able to identify when the child is in pain

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66
Q

T/F: Parents want to be involved in their child’s pain control.

A

TRUE, parents need info about assessing pain and using interventions to relieve pain

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67
Q

Parental presence during painful procedures is

A

desirable for the child and parent

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68
Q

What can a nurse teach the parents regarding pain interventions?

A

nonpharmacologic measures lessen the child’s pain
parental presence during procedures (Atraumatic care)

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69
Q

T/F: Children Often Become Addicted To Pain Medication.

A

FALSE, physical dependence if on 7 + days and need to wean off or develop tolerance

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70
Q

One reason for the prevalent fear of addiction from opioids used to relieve pain is a misunderstanding of

A

differences between drug tolerance, addiction, and physical dependence

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71
Q

Physical dependence

A

withdrawal symptoms when chronic use of an opioid is D/C, or an opioid antagonist (Naloxone or Narcan) is given

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72
Q

Physical dependence may require reducing the dose of opioids

A

gradually (weaning off over several days without symptoms)

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73
Q

Opioid antagonist

A

Narcan or naloxone

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74
Q

Physical dependence develops when the pt is on opioids for how long

A

typically 7+ days

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75
Q

Withdrawal

A

collections of symptoms (behaviors and physiologic) occur when opioids or sedatives have been administered for 7 days +
and abruptly decreased or D/C

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76
Q

Withdrawal s/s

A

anxiety, agitation, insomnia, and tremors
irritable
N/V/D or feeding intolerance
HIGH HR, RR, BP, and fever
sweating

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77
Q

Involuntary physiologic responses relates to what drug effect

A

Drug tolerance

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78
Q

Drug tolerance

A

need a larger dose to maintain original effect (or more frequent)

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79
Q

Drug tolerance could occur when children have been taking opioids or sedatives for

A

several days (5-7)

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80
Q

Tolerance side effects

A

respiratory depression
sedation
nausea
Stop after initial doses

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81
Q

When do the side effects of opioids usually occur?

A

initial dose and improves after 2 days

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82
Q

Narcotic Addiction is what type of pattern

A

behavioral and voluntary

83
Q

Narcotic Addiction is characterized by

A

compulsive drug-seeking behavior

84
Q

Narcotic Addiction leads to

A

overwhelming involvement with acquiring the drug

85
Q

Narcotic Addiction is the use of opioid

A

NOT for medical reasons (pain relief)

86
Q

Addiction r/t pain tx with opioids characterized by

A

a persistent pattern of dysfunctional opioid use
- impaired over drug use
- compulsive drug use
- continued use of drugs despite harm

87
Q

Addiction r/t pain tx with opioids involves

A

adverse consequences
loss of control
preoccupation with obtaining opioids despite adequate analgesia

88
Q

What factors characterize the complex condition of addiction with opioids

A

genetic, psychosocial, and environmental

89
Q

The continued use of the drug causes changes in the _______ ________ leading to

A

brain wiring
leads to powerful cravings and difficulty stopping the drug

90
Q

Infants, young children, and comatose or terminally ill children _________ become addicted because they are incapable of a consistent pattern of drug-seeking behavior

A

can not

91
Q

T/F: Children Are Not In Pain If They Can Be Distracted Or They Are Sleeping.

A

False, distraction to cope

92
Q

Children use what to cope with pain

A

distraction

93
Q

Children use distractions to cope with pain, but soon they become

A

exhausted when coping with pain from energy spent up and fall asleep

94
Q

An infant may be experiencing pain even when

A

lying quiet with eyes closed

95
Q

Is this infant experiencing pain?
If they are postoperative, they may wake and complain of pain and then fall back to sleep because of the anesthesia.

A

Yes

96
Q

QUEEST is what type of assessment

A

Multidimensional Model of Pain Assessment mnemonic

97
Q

QUEEST

A

QU = vocal
E = behavioral
E = Physiologic
ST = contextual

98
Q

What is the gold standard for pain assessment?

A

patient self-report (vocal)

99
Q

Vocal assessment of pain includes what in multidimensional

A

Specific = self-report
Nonspecific = cry, scream, groan

100
Q

Nonspecific vocal assessment

A

cry
scream
groan

101
Q

Behavioral assessment in multidimensional

A

Facial expressions
rigid posture
less activity
sleep more
response to interventions

102
Q

Contextual assessment in multidimensional

A

pain stimulus/ hx
temperament
age, sex
culture
significant other input

103
Q

Physiologic assessment in multidimensional

A

VS
O2 change
hormonal changes
sweating
palmar sweat

104
Q

QUESTT assessment

A

Question the pt and parents
Use pain rating scale
Evaluate behavior and physiologic signs
Secure family’s involvement
Take cause of pain into account
Take action and assess the effectiveness

105
Q

Verbal Indications of Pain

A

less common than adults
not understand the pain term
speak globally “I don’t feel good.”
Deny pain for fear of injection
Cries, screams, groans, moans

106
Q

Synonyms for pain in children

A

hurt
owwie
ow ow
booboo
ouch
don’t feel good
What do you call pain at home?

107
Q

Synonyms for pain in other languages

A

ay ay
duele
lele
dolor

108
Q

When questioning the parents about pain what should be said?

A

previous experiences with pain

109
Q

Initial Pain Assessment

A

Location (point/drawing)
Quality
Intensity
Onset, duration, variation, and patterns
Alleviating and aggravating factors
maybe not all from pt but some helps

110
Q

How can a child show the nurse the location of the pain?

A

marking body parts on a human figure drawing
point to an area on self, doll, or stuffed animal
Transition objects

111
Q

When selecting a scale that is appropriate for a child what should the nurse take into account?

A

age
developmental level and abilities

112
Q

When should you teach a child to use the pain scale?

A

before pain is expected (preoperative)
however not always the case

113
Q

Use the _______ scale with a child each time pain is assessed

A

same

114
Q

What should you tell/present to a physician regarding a pt’s pain to lead to a favorable change in analgesic orders?

A

objective documentation
rather than opinions

115
Q

If a physician only ordered acetaminophen with hydrocodone po for a postoperative patient and you administer it for a pain level of 8, and after 30-60 minutes, they are still hurting at a 6. What would you tell the physician?

A

pain scale would be beneficial in getting additional opioid orders to better alleviate the child’s pain

116
Q

When should you reassess pain?

A

30-60 minutes after giving medication

117
Q

What are the 3 pain intensity scales?

A

Subjective
Behavioral
Multidimensional

118
Q

Subjective pain scales

A

scores and 1-10s
Wong-Baker FACES Pain Scale
Oucher Scale - vertical with races of pain
Word-Graphic Scale - only words an line
Numeric Rating Scale = 1-10

119
Q

Behavioral pain scale

A

assessing behaviors identified as indicators of pain
- FLACC
- Revised FLACC
- Modified FLACC

120
Q

Multidimensional pain scale

A

NICU - undergone reliability and validity testing
-N-PASS
-NIPS
-PIPP
-CRIES

121
Q

Wong-Baker FACES Pain Rating Scale

A
  • subjective
  • 6 drawn faces from smiling to tears
122
Q

Wong-Baker FACES Pain Rating Scale
is used on what age of children?

A

3+ years old

123
Q

T/F: You can not compare the child’s face with those on the FACES Wong-Baker scale.

A

True, the faces could be subjective to the person based on the culture
- You don’t have to cry to have the worse pain/hurt.

124
Q

The Oucher pain rating scale uses

A

6 photographs of a child’s face from “no hurt” to “biggest hurt you could ever have”

125
Q

Oucher pain rating scale includes

A

vertical sale of Caucasian, AA and Hispanic children

126
Q

The Oucher pain scale is for children

A

3-13 years old

127
Q

Word-Graphic Rating Scale uses

A

descriptive words with vary intensities of pain

128
Q

With the word-graphic rating scale, the nurse needs to explain

A

each of the words to the child
from “no pain”
to “worst possible pain”

129
Q

The Word-graphic rating scale is used in children’s ages

A

4-17 years old

130
Q

In order to utilize the numeric pain scale, what age do they need to be and they must be able to

A

5+ (school age more like 6-8)
count and have a number concept and understand concepts
- More or less
- Higher or lower
- Number order

131
Q

According to The Children’s Hospital Association, the numeric rating scales is appropriate for a child who is at least

A

developmentally 7-8-year-olds

132
Q

FLACC stands for

A

Face
Legs
Activity
Cry
Consolablilty

133
Q

FLACC is used on children’s ages

A

2 months to 7 years

134
Q

FLACC behavior needs to be observed for how long

A

1-5 minutes during routine care

135
Q

The FLACC total score is calculated by

A

adding up all 5 categories

136
Q

Pre-verbal is for

A

infants to 3+

137
Q

A high FLACC score is

A

high pain

138
Q

A low FLACC score means

A

little to no visible pain

139
Q

The revised FLACC scale is used for all children with

A

cognitive impairment

140
Q

The revised FLACC score shows the

A

behaviors commonly associated with pain in cognitively impaired children
- caregiver to identify pain behaviors specific to child assessed

141
Q

The modified FLACC Scale is used in children with

A

mechanically ventilated pts

142
Q

The modified FLACC scale includes

A

additional parameters for cry category assessment

143
Q

Which is the most appropriate pain scale for procedural pain in the intubated child?

A

Modified FLACC Scale

144
Q

N-PASS stands for

A

Neonatal Pain, Agitation, and Sedation Scale

145
Q

NPASS is used in what specific department

A

NICU

146
Q

N-PASS is used in what “age” of children

A

23-40 weeks gestation

147
Q

N-PASS combines

A

assessment of pain
agitation
sedation

148
Q

N-PASS is used in

A

preemies with procedural and prolonged pain

149
Q

The N-PASS looks like what in adults

A

MEWS score but for neonates with assessment criteria reared towards premature pain

150
Q

What are the assessment criteria for the N-PASS?

A

crying, irritability
behavior state
facial expression
extremities tone
VS (HR, RR, BP, and O2)

151
Q

What are the best (no pain) to worst (worst pain or sedation) scores on the NPASS?

A

Sedation -25 = -10
Normal = 0 (best)
Pain/Agitation = 25= 10

152
Q

Assessment Sedation criteria for -2 on NPASS

A

no cry with painful stimuli
no arousal to any stimuli
no spontaneous mvmt
mouth is lax
no expression
no grasp reflex
flaccid tone
no VS variable with stimuli
Hypoventilation or apnea

153
Q

Assessment Pain/Agitation criteria for -2 on NPASS

A

high pitched or silent-continuous cry
Inconsolable
arching, kicking, constantly awake
arouses minimally/no mvmt (not sedation)
any pain expression continual
continual clenched toes, fists, and finger splay
tense
> 20% from baseline
< 75% with stimulation (slow increase)
out of sync with vent

154
Q

Assessment Normal criteria for 0 on NPASS

A

appropriate crying
not irritable
appropriate behavior for gestational age
relaxed appropriate
relaxed hands and feet
normal tone
within baseline or normal for them

155
Q

NIPS stands for

A

Neonatal Infant Pain Scale

156
Q

NIPS is recommended for children

A

less than 1 year old (26-40 weeks)

157
Q

NIPS is composed of how many indicators

A

6

158
Q

In the NIPS scale, each behavioral indicator is scored from

A

0 or 1 with 0,1,2 for crying

159
Q

NIPS scale is observing the neonate for

A

1 minute

160
Q

The NIPS scale best with no pain score is

A

0 (calm, sleep, absent)

161
Q

The NIPS scale with worse pain score is

A

7 (contracted, vigorous/mumbling crying, different breathing, flexed, uncomfort)

162
Q

NIPS score is based on

A

facial expression
cry
breathing
arms
legs
alertness

163
Q

PIPP scores
minimal or no pain

A

0-6

164
Q

PIPP scores
slight to moderate pain

A

7-12

165
Q

PIPP scores
severe pain

A

12+

166
Q

The max severe score for PIPP is

A

21

167
Q

PIPP is used for

A

procedural and post-op pain

168
Q

PIPP is used for what age of children?

A

25-40 weeks (HESI 28-40)

169
Q

CRIES is what type of scale

A

10 points

170
Q

CRIES is used for

A

neonates 32-40 weeks gestation
- 32-60 weeks for HESI

171
Q

CRIES is used for

A

postop pain

172
Q

CRIES consists of

A

5 physiologic and behavioral indicators rated from 0-2

173
Q

On the CRIES scale, if the score is 3+, what does the nurse do?

A

some intervention should be initiated

174
Q

On the CRIES scale, if the score is 4+, what does the nurse do?

A

indicates the infant should be medicated

175
Q

The CRIES scale cannot be utilized on infants who are

A

intubated
paralyzed
bc they can not grimace or cry

176
Q

In the CRIES scale the higher the score the

A

higher intervention needed

177
Q

Behavioral variables as possible s/s of pain
Vocalization

A

crying with apneic spells
whimpering
groaning
moaning

178
Q

Behavioral variables as possible s/s of pain
State changes

A

sleep/wake cycle
activity level
agitation or listlessness

179
Q

Behavioral variables as possible s/s of pain
Bodily Mvmts

A

limb withdrawal
swiping
thrashing
rigidity
flaccidity
clenching fists
- also in adolescents

180
Q

Behavioral variables as possible s/s of pain
Facial expression

A

Eyes tightly closed or opened
Mouth opened, squarish
Furrowing or bulging of brow (together)
Quivering of chin and tongue
nose bulging
Deepened nasolabial fold

181
Q

Of the behavioral variables which one is the most reliable?

A

facial expression

182
Q

Infants behavioral variables in pain

A

loud inconsolable crying
facial expression (furrowed eyebrows, eyes closed, mouth open)
decreased appetite

183
Q

Young children’s behavioral variables in pain

A

Loud crying or screaming
Using words such as “ouch” or “it hurts”
Thrashing of extremities
Clinging to parent
Restless and irritable
Lack of cooperation

184
Q

School-age child behavioral variables in pain

A

stalling
muscular rigidity
restless
sleep disturbances

185
Q

Adolescents behavioral variables in pain

A

Withdrawn
Decreased activity
Increased muscle tension (rigidity)

186
Q

Observe for specific behaviors that indicate the location of pain

A

Pulling ears - infection
Rolling head from side to side - ear infection
Lying on the side with legs flexed on the abdomen - abd pain
Limping - extremity pain
Refusing to move a body part - extremity pain

187
Q

Physiologic Signs of pain in the neonate

A

increase HR, RR, B/P
shallow respirations
decrease vagal nerve tone (shrill cry) decrease pallor or flushing
diaphoresis, palmar sweating
low O2 saturation
Increased muscle tone
EEG changes

188
Q

Physiological indicators of acute pain

A

Dilated pupils
Increased perspiration
Increased rate/ force of heart rate
Increased rate/depth of respirations
Increased blood pressure
Decreased urine output
Decreased peristalsis of GI tract
Increased basal metabolic rate
fight or flight

189
Q

Physiologic measures should only be used as adjuncts to

A

self report of pain and behavioral observation

190
Q

Physiologic indicators do not differentiate from pain response and other forms of

A

stress

191
Q

Acute Pain activates

A

body’s fight or flight stress response

192
Q

When pain persists, body begins to

A

adapt and there is a decrease in the sympathetic responses

193
Q

In chronic pain, stress response is

A

absent or diminished

194
Q

How do you secure the family’s involvement?

A

parents need info about assessing pain and using interventions to relieve pain
parents’ presence during painful procedures is desirable for relationship
- talk and hold

195
Q

By taking the cause of pain into account the nurse is

A

anticipating pain when you know the illness or injury is painful

196
Q

What is the golden rule of pain in children

A

What is painful to an adult is painful to an infant and child unless proven otherwise

197
Q

The only reason to assess pain is to

A

take action to relieve the pain

198
Q

After the intervention of pain,

A

assess child’s response to pain relief measures

199
Q

When do you assess IV analgesics

A

after 5 minutes and 15 minutes

200
Q

When do you assess PO analgesics

A

30-60 MINUTES

201
Q

Do you tell the parents about the reassessment of pain after receiving the analgesics?

A

yes, reassure the parents the duration of the pain interventions

202
Q

When Can a child use a pain scale?

A

At 3

203
Q

What temperament makes it more difficult to see pain level?

A

Easy and slow to grow

204
Q

What temperament makes it harder to figure out where on the pain level they are due continuous painful expressions?

A

Difficult

Module 5 (Pediatrics) (27 decks)

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