Pain exam 1

Question 1

Infant understanding of pain, behavioral response, and verbal description

Answer 1

under 6 mo:
No apparent understanding to parental anxiety
Generalized body movements, chin quivering, facial grimacing, and poor feeding
Cries

6-12 mo:
Has a memory of pain; responsive tp parental anxiety
Relax withdrawal to stimuli, facial grimacing, and disturbed sleep, irritability, and restlessness
Cries

Question 2

Toddler understanding of pain, behavioral response, and verbal description

Answer 2

1-3 yrs:
Lacks of understanding of what causes pain and why he or she might be experiencing it

Demonstrate fear of painful situations, may resist with entire body or have localized withdrawal, aggressive behavior, and disturbed sleep

Cries and wails, cannot describe intensity or type of pain, may use common words for pain such as owie and boo-boo after age 2 yrs

Question 3

Preschooler understanding of pain, behavioral response, and verbal description

Answer 3

3-6 yrs: (pre-operational)
Pain is a hurt and does not relate pain to illness but may relate pain to an injury, often believes pain is punishment or someone else is responsible for his or her pain, unable to understand why a painful procedure will help them feel better.

Active physical resistance, directed aggressive behavior, strikes out physically and verbally when hurt, and easily frustrated.

Has the language skills to express pain on a sensory level, can identify location and intensity of pain, may deny pain, may believe their pain is obvious to others

Question 4

School age kid understanding of pain, behavioral response, and verbal description

Answer 4

7-9 yrs (concrete opperations):
Understands simple relations between pain/disease, understands the need for painful procedures to monitor or treat disease, may associate pain with feeling bad or angry, may recognize psychologic pain related to grief and hurt feelings

Passive resistance, clenches fists, holds body rigidly still, suffers emotional withdrawal, and engages in plea bargaining

Can specify location and intensity of pain, can describe pain’s physical characteristics in relation to body parts

10-12 years (transitional):
Has a better understanding of the relation between an event and pain, has a more complex awareness of physical and psychologic pain, such as moral dilemmas and mental pain

may pretend comfort to project bravery, may regress with stress and anxiety

able to describe intensity and location with more characteristics, able to describe psychologic pain

Question 5

Adolescent

Answer 5

13-18 yrs (formal operations):
Has a capacity for sophisticated and complex understanding of the causes of physical and mental pain, recognizes that pain has both qualitative and quantitative characteristics, can relate to the pain experienced by others

Wants to behave in a socially acceptable manner (adults), shows a controlled behavioral response, may immerse self in an activity as a pain distraction, may not complain about pain if given cues from nurses and other healthcare providers who believe it should be tolerated

More sophisticated descriptions as experience the gained, used common meanings of words to describe pain (pain, hurt, ache) similar to adults, and may think nurse are attuned to their thoughts, so it is unnecessary to tell the nurse about the pain

Question 6

Neonatal pain scale

Answer 6

Behaviors are scored 0 (none) to 7 (worst)
Behavior each ranked 0-2 then added
Cry, Facial expression, Arm, Legs, Breathing pattern, and State of arousal

Question 7

FLACC pain scale

Answer 7

FLACC (used for children 2 months – 7 years)

Behaviors are scored 0 to 2 for each of five behaviors for a total of 0 (no pain) to 10 (worst)
Facial expressions
Position of Legs
Activity
Crying
Ability to be Console

Question 8

Non-pharm pain treatment

Answer 8

Parental involvement
Play
Distraction
Relaxation/guided imagery
Heat/cold
Positioning
Favorite toy, pillow, TV show