Pain menagement/Hospitalized Child

Question 1

Brain neuromatrix

Answer 1

series of connected neural cells with pathways that combine in a feedback loop

Question 2

Acute pain

Answer 2

pain felt for a short period of time, can be due to illness or injury

Question 3

Chronic pain

Answer 3

persistent pain lasting longer than 3 months

Question 4

chronic primary pain

Answer 4

pain in one or more anatomic regions that last longer than 3 months and is associated with emotional distress

Question 5

What are the most common neurologic issue peds and what is the percentage?

Answer 5

Headaches; 88%

Question 6

you must have at least one of these characteristics to be diagnosed with migraines

Answer 6

aggravated by physical activity
associated with nausea or vomiting
photophobia
phonophobia
behavioral interference
lack of identified cause of headache

Question 7

Functional dyspepsia and IBS are diagnosed if symptoms occur a minimum of […..]

Answer 7

4x in a month for 2 months

Question 8

neuropathic pain

Answer 8

results from injury or dysfunction of the somatosensory system

Question 9

Wind up phenomenon

Answer 9

decreases pain threshold and chronic pain

Question 10

Percentage of children worldwide that experience abdominal pain

Answer 10

25%

Question 11

Burn pain is the [….] most common nonfatal cause of injury

Answer 11

5th

Question 12

Vasooclusive crisis (VOC)

Answer 12

in sickle cell anemia; visible swelling of finger hands and toes

Question 13

Besides facial expression what other cues do you assess that indicate pain?

Answer 13

sleep, emotional function, physical functioning

Question 14

What is FLACC and what is it used for?

Answer 14

pain observation tool; facial expression, leg movement, activity, cry and consolability

Question 15

What are special populations to be aware of when it comes to pain assessment?

Answer 15

preterm infants, cognitively impaired, children post anesthesia and PICU, culture, and spectrum disorder

Question 16

What are some pain behaviors of cognitive impaired children?

Answer 16

crying, less active, moaning, not cooperating, irritability etc

Question 17

What is the most used pain scale tool for ventilated critically ill children?

Answer 17

COMFORT-B scale

Question 18

Pain diaries purpose

Answer 18

to assess pain symptoms and response to treatment in children with recurrent or chronic pain

Question 19

biobehavioral interventions

Answer 19

distraction, relaxation, guided imagery, hypnosis, cognitive-behavioral therapy, massage, TENS

Question 20

Two-step approach for pain

Answer 20

administer nonopioid first before an actual opioid

Question 21

What is the most common opioid of choice?

Answer 21

Morphine

Question 22

Nonopioids include

Answer 22

NSAIDS, acetaminophen

Question 23

What are adjuvants?

Answer 23

can be used alone or with nonopioids or opioids to control pain and to enhance analgesics

Question 24

what is the main difference between opioids and nonopioids?

Answer 24

nonopioids have a ceiling effect, doses higher than recommended will not produce greater pain relief

Question 25

Why do oral dosages have to be higher than parenteral?

Answer 25

first pass effect, oral dosages is absorbed in GI and liver before reaching the blood

Question 26

What are some side effects of opioids?

Answer 26

resp depression, constipation, miosis, pruritus, N&V, sedation, physical dependence

Question 27

What is CRIES?

Answer 27

neonatal pain scale crying requiring increased oxygen increased vital signs expression sleeplessness

Question 28

What is the typical amount of morphine for PCA usage?

Answer 28

1 mg/mL

Question 29

Children who weigh greater than [...] should be prescribed [...]

Answer 29

50 kg; average adult dose

Question 30

What do you use to treat opioid toxicity?

Answer 30

Naloxone (Narcan)

Question 31

What are the three modes of drug infusion for a PCA?

Answer 31

patient administered bolus preset dose nurse administered continuous

Question 32

What is the most consistent and commonly used indicator of pain in infants?

Answer 32

Facial expression of discomfort

Question 33

The nurse is educating a new nurse on identification of pain in children. What does the nurse teach about physiologic measurements in children’s pain assessment?

Answer 33

Not as useful as the only indicator for pain

Question 34

What self-report pain rating scales can be used in children as young as 3 years of age?

Answer 34

FACES pain rating scale

Question 35

What information does the nurse include when teaching parents about nonpharmacologic strategies for pain management in children?

Answer 35

May reduce pain perception

Question 36

A 5-year-old has patient-controlled analgesia (PCA) for pain management after abdominal surgery. What information does the nurse include in teaching the parents about the PCA?

Answer 36

The pump allows for a continuous basal rate and delivers a constant amount of medication to control pain.

Question 37

Stages of separation anxiety

Answer 37

Protest despair detachment

Question 38

What are some fears of a child experiencing hospitalization?

Answer 38

loss of control, bodily injury, and pain

Question 39

What are some manifestations of separation anxiety in young children?

Answer 39

crying, screaming, searching for parent with eyes, physically attacks stranger, clinging to parent

Question 40

The age of child who may react to the dependency of hospitalization with rejection, uncooperativeness, or withdrawal is

Answer 40

Adolescent

Question 41

Factors affecting the parents’ reactions to their child’s illness include:

Answer 41

-Seriousness of the threat to the child -Previous experience with illness or hospitalization -Available support systems -Previous coping abilities -Communication patterns among family members