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Peds Exam 1 > Pain Management > Flashcards

Pain Management Flashcards

1
Q

Do infants and children feel pain?

Is it different from adults?

A

Yes!!!!

Children may have a higher pain tolerance but they still feel it. So we still need to take it seriously.

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2
Q

How has history treated pain in infants and children?

A

Pain goes under-treated. Especially in infants.

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3
Q

Tanking Definition

A

Put into world pool to help debree

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4
Q

T/F
Nervous System of the neonate is too immature to feel pain

Is myelination needed?

A

False.
Their pain receptors are developed.

Myelination is not necessary for pain perception.

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5
Q

How do we give child dosages of medicine?

A

We do it based off weight and size

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6
Q

T/F

Nonprofessional organizational associated nurses score higher on pain management evaluation

A

False!

The professional nurses associated with an organization scored better.

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7
Q

Wongs Golden Rule

A

Whatever is painful in an adult is painful for a child until proven otherwise.

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8
Q

How do infants, young children, and older children communicate that they feel pain?

A

Clinical signs for infants
Picture pain tools for young children
Older children can communicate it

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9
Q

Will a child report pain or request pain meds?

Why?

A

No. We have to pick up on assessment to figure it out.

To them, adults should just know they’re in pain. Very egocentric.

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10
Q

Do children cry during procedures just because they’re restrained?

A

They don’t like to be restrained but they also can tell when something is going to hurt - and so they’re scared.

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11
Q

T/F
Narcotics will cause respiratory depression in kids.

What do we need to do to avoid resp depression in general?

A

True
BUT
this would happen to anyone so its not a good reason to not give them the medication.

We assess and evaluate! It’s no different.

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12
Q

Will a child remember pain later on in life?

A

Yes. If you didn’t give an infant pain meds for an intervention they often grew up to not be able to handle pain very well.

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13
Q

Is there any proof that narcotic addiction is higher in adolescent?

What about dependence?

A

Nope, none.

Dependence happens to anyone. It’s just what happens when the body relies on a medication for a long time.

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14
Q

Are addiction and dependence the same thing?

A

No.
Dependence is when your body relies on it for pain control & without it your body has a physical dependance.

Addiction is when you are physically and PSYCHOLOGICALLY in need of the drug.

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15
Q

What is a good way to know how a drug works?

A

The receptor site. It helps reminds us what the potential side effects are.

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16
Q

Which receptor is more likely to cause respiratory depression?

A

Mu agonist
Opioids really.
morphine, codeine, fentanyl , etc

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17
Q

What is antidote for mu agonist?

How fast will we give it?

A

Narcan

We will do it slowly bc we don’t need to reverse the whole thing. If we knock off the whole mu then the patient will just be in so much pain

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18
Q

Why use Kappa and Sigma meds?

A

These receptors don’t have respiratory depression. They’re jus sedation.

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19
Q

What is the Wong Baker’s scale?

What if you just ask a child about their pain?

A

Scale that helps children express how their pain feels by the picture but must be 3+
“Which face shows how your pain feels”

Sometimes if you ask the kid, they’ll say no.

20
Q

What is the Beyer Oucher’s scale?

How old does a child have to be?

A

Uses actual photos for pain scale but it is not as readily available.

For children 3+

21
Q

Do children understand horizontal or vertical order better?

Do they understand numbers?

A

vertical

numbers are harder for them to understand.

22
Q

What can older kids use to communicate pain?

A

They can go ahead and use numerical scales. Just make sure they know the understanding of numbers.

23
Q

Are there tools for non-verbal patient children to communicate pain?

A

Yes. It’s more of a focus of what we see going on.

Also they can draw.

24
Q

Nips tool

What does it require?

A

Measures pain by an infants behavior and cues.
Add up all the points & if it is higher, it means they’re in pain.

Requires the infant to be able to move limbs

25
Q

Face, legs, activity, cry, consolability tool

A

Also measures pain by behavior and physical cues.

26
Q

Is parent input important for pain management?

A

Yes, parents know their child best.

27
Q

What do we look at when no other tool works for pain assessment?

A

We have to look at..

vitals
grimacing
moaning/crying
muscle tension
parental input
28
Q

What does sucrose do?

How do we administer sucrose?

A

Triggers endogenous pain control centers in infants.

We administer 2-5 prior to procedure, some in between, and it works.

Dip in pacifier (best)
Syringe

29
Q

Does a sedation medication provide pain management?

A

No, sedation is not pain management.

30
Q

Does route change drug dosage?

A

Yes.
PO is slower and more needed.
IV is fast and less needed.

31
Q

How often should you administer pain meds for first 24 hrs of initial surgery/exposure to pain?

A

Round the clock

32
Q

What can you do if the dose of narcotics wasn’t quite enough for the patient to be comfortable?

A

Give them NSAID - if their health allows it.

Liver issues
Renal
Risk of bleeding

33
Q

Toradol is what class/type of med?

route?

Black box warning?

how many days can you use it?

A

NSAID
Mostly given IV

GI bleeding & ulceration especially with peds.
- pay attention to renal function, hydration, and dosage

Don’t give for more than 5 days in a row

34
Q

How is it that Tricyclic antidepressants are used for pain?

Watch for?

A

They’re for off label use for neuropathic pain

Watch for OD

35
Q

What is PCA analgesia?

A

Patient can push button to give them their pain meds. It helps give patient control.

36
Q

First phase for PCA pumps

A

Start pump bolus to get blood level of medication up enough to work and be therapeutic.

37
Q

Second phase for PCA pumps

A

Basal dose or low level dose which is set - to keep them right on that therapeutic level. Meds infuses on continuous basis.

38
Q

Third or extra phase for PCA

A

Breakthrough dose of a set amount, available at set times for when pain is getting to be too much.

39
Q

What should you monitor for when using a PCA pump?

What tool helps you monitor for this?

A

Respiratory depression. Especially for children bc they are smaller & have immature systems making the onset be more rapid if it were to happen. YOU are responsible.

End tidal CO2 monitor. It indicates you early on about gas exchange and end product of co2 being released

40
Q

What is EMLA LMX4?

A

A topical analgesic that numbs the area.

Can also come in a spray.

Can do this before an IV.

41
Q

Can you put topical anesthetics anywhere?

A

No, don’t put on arterioles bc it can cause lack of perfusion.

42
Q

What is a J tip?

A

Injects medication with pressure

No needle.

43
Q

Tissue adhesives are used for?

A

For minor laceration repair. Like glue.

It is quicker, less painful. Good for children.

44
Q

A baby has had a fracture repair with pins on the femur area. They’re given morphine already but they cry every once in a while. Why?

A

Muscle spasms.

Give muscle relaxers.

45
Q

How can you cause less distress for a child about to go under anesthesia for a sterile procedure?

Bubbles?

A

Allow the parents to be there for when they go under. Just want the child to be comfortable.

Bubbles are also a good way to help with distraction.

Peds Exam 1 (6 decks)

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