Pain in Infants & Children

Question 1

Under recognized and under treated pain may lead to

Answer 1

• Physiologic instability in infants
• Anxiety, withdrawal, and depression in children
• Increased stress inc caregivers

Question 2

Define pain

Answer 2

• A disturbed sensation that causes suffering or distress

Question 3

Define pain expression

Answer 3

• A form of communication
• Functions to solicit comfort from caregiver or warn that action is harmful

Question 4

Pain expression is influenced by

Answer 4

• Social context: culture, modeling
• Psychological/Cognitive: personality, perception of threat
• Biological: genetics, age, severity of pain, location of pain

Question 5

When selecting a pediatric pain assessment tool you should consider

Answer 5

• Age
• Developmental level
• Sensory function
• Type of pain (acute, chronic, procedural)

Question 6

Self report measures for pediatric pain

Answer 6

• Intensity
• Sensory (location, quality)
• Temporal (duration/frequency)
• Functional (interference)
• Emotional (affect)
• Cognitive (attributions)

Question 7

Physiological responses to pain

Answer 7

• Heart rate/rhythm variability
• Color changes (mottled, flush skin)
• Respiratory rate
• O2 Saturation
• Cyanotic
• Seizures
• Tremors, Startling, Twitching
• Peripheral (reflex responses)
• Autonomic NS: (sweating, gagging, spitting up, hiccups, yawning, coughing, sighing, sneezing)

Question 8

Observational behavioral assessment for pain

Answer 8

• Facial expression most common component in scales
• Multi-item scales (Require observer training)
• Vocalization (cry, moan, whimper)
• Movement (rub, arch, flex legs, flinch, wring hands, pull
  away, squirm)
• Tonal changes (increase or decrease)
• Changes in affect, sleeping habits, eating habits

Question 9

Guidelines for interpreting physiological measures of pain

Answer 9

• Obtain baseline measures in stress-free condition
• Correlate with environmental circumstances
• Consider meds, age, cardio-resp. status, chronicity of pain, previous pain experiences

Question 10

What are some common atypical pain behaviors in children with neurological impairments

Answer 10

• Laughing
• Drooling
• Self-abusive behaviors (biting, head banging)

Question 11

Exposure to painful medical procedures leads to

Answer 11

• Lower sense of control over health
• Heightened medical fears
• Withdrawal
• Avoidance of health care as adult

Question 12

What are the 5 S’s of pain management for infants

Answer 12

• Sucrose/sucking
• Stomach positioning
• Swaddling (containment)
• Swinging (movement while held)
• Shushing (similar to sounds in the womb)