Week 4 - Pain

Question 1

Pain

Answer 1

An unpleasant sensory & emotional experience associated with actual or potential tissue damage

Question 2

Acute Pain

Answer 2

Sudden, short duration, associated with a single event or exacerbation, has a predictable cause & identifiable end

Question 3

Chronic Pain

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Answer 3

Persistent, lasting longer than 3 months, & often associated with a prolonged disease process

Question 4

Nociceptive Pain

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Answer 4

Pain from a normal process pain stimuli caused by tissue injury or damage

Question 5

Neuropathic Pain

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Answer 5

Arises from stimuli abnormally processed by the nervous system

• EX:damage to a nerve, infiltration, compression, infection

Question 6

Infant Pain

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Answer 6

Grimacing, poor feeding, crying, irritability, restlessness

Question 7

Toddler Pain

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Answer 7

Aggressive behavior or physical resistance

Question 8

School-Age Pain

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Answer 8

rigid, still, emotional withdrawl, may project bravery, may regress

Question 9

Adolescent Pain

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Answer 9

controlled behavioral response, verbal expressions, distracts or denys pain

Question 10

Physiological Pain Response

Answer 10

• tachycardia
• ↑ cortisol
• ↓ electrolytes
• ↓ gastric motility
• tachypnea = respiratory alkalosis

Question 11

NIPS (Neonatal Infant Pain Scale)

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Answer 11

• Pain assessment for infants
• > 3 or higher = pain

Categories: Facial expression, crying, breathing, arms, legs, alertness

Question 12

FLACC

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Answer 12

• Pain scale for children up to 4 years old
• 3 or above = intervention required

Categories: face, legs, activity, cry, consolability

Question 13

FACES

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Answer 13

• Pain scale for ages 4-5 years or higher
• Child points to faces based on how bad their pain is

Question 14

Numeric Scale

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Answer 14

• Pain scale from 1 - 10
• Most ages; 4-5 years + OR if they can distinguish between a larger number & a smaller number

Question 15

Body Pain Scale

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Answer 15

Have the child color in the areas where it hurts

Question 16

Motrin

Answer 16

• NSAID
• NOT given under 6 months of age
• Safe Dose: 10 mg/kg q6

Question 17

Age requirement for motrin

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Answer 17

NOT under 6 months

Question 18

Safe Dose for Motrin

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Answer 18

10 mg/kg q6h

Question 19

Tylenol

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Answer 19

• Analgesic
• Given PO / PR / IV

Safe Dose: 15 mg/kg q4-6 hours

Question 20

Tylenol Safe Dose

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Answer 20

15 mg/kg q4-6 hours

Question 21

EMLA

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Answer 21

Lidocaine & prilocaine
* Used for numbing IV start sites
* Watch for necrosis on fingers, toes, nose, genitals
* Apply 60 minutes before procedure

Question 22

Nonpharmacological Pain Management

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Answer 22

• distraction
• guided imagery
• breathing techniques
• cutaneous stimulation
• sucrose
• heat or cold

Question 23

Principles of Pain Assessment in Children: QUESTT

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Answer 23

• Question the child
• Use a pain rating scale
• Evaluate behavioral & physiologic changes
• Secure parent’s involvement
• Take the cause of pain into account
• Take action & evaluate results

Question 24

Acute Pain Management

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Answer 24

• Gate Control Theory: inhibitory neuron stimulation reduces pain sensation

Drug Administration
* mg/kg
* drug of choice for level & quality of pain
* appropriateness of interval, route

• Patient-controlled Analgesia (PCA pump)
• Regional Pain Management
• Children may develop physical dependence & tolerence after prolonged use of opioids for a serious injury, but addiction is uncommon