Unit 8 Peds Pain Flashcards
Why are children less likely to tell the truth about pain?
They feel guilt
What are some general manifestations of pain n children?
Physiological changes: RR, BP, HR, etc
Behavioral changes: facial expressions, body movements, crying, screaming, teeth clenching, saying “ow”, kicking
How would a pre-schooler, school ager, and adolescent respond to pain?
Pre-schooler = thinks pain is punishment/feels guilty
School-ager = responds to pain with muscle rigidity and withdrawing
Adolescent = responds stoically (tough) to pain, might be afraid to show emotions
What is the pain assessment mnemonic QUESTT?
Q = Question the child
U = Use a reliable pain scale
E = Evaluate child’s behavior and physiologic changes to establish a baseline and determine effectiveness of intervention
S = Secure the parent’s envolvement
T = Take the cause of pain into account when intervening
T= Take action
When should the QUESTT assessment be performed?
When taking VS, before and after procedures, after medication administration, etc
Describe what each of the following pain scales are. Neonatal Infant Pain Scale (NIPS). FLACC scale. FACES and OUCHER scale. Visual analog and numeric scale. Adolescent pediatric pain tool scale.
NIPS = Look at facial expression and body movements to determine a score.
FLACC = categories are face, legs, activity, cry, consolability, scored for a point total
FACES and OUCHER = point to face you’re feeling
Visual analog and numeric = 0-10 scale
Adolescent peds pain tool = Draw where pain is, pick descriptions from choices.
What pain scale would be good for an Infant, Toddler, Preschooler, School age, and Adolescent?
Infant = NIPS Toddler = FLACC and FACES Preshooler = FACES School age = FACES and numeric Adolescent = Numeric
What is the overall goal of pain management?
Free of pain as evidenced by appropriate VS and < 3 on numeric scale
Describe Acetaminophen, Ibuprofen, Morphine Sulfate, Codeine, Naloxone in pain mamangement.
Acetaminophen: analgesic, antipyretic.
-Watch for toxicity, liver affected
Ibuprofen: NSAID, for minor to moderate pain even severe pain.
- Anti-inflammatory, must be at least 6 months old.
- Bleeding, ulcer, and kidney issues with long term use
Morphine Sulfate: opioid agonist for severe pain. Gold standard for severe pain.
- Constipation is common issue
- Respiratory depression could be serious issue
Codeine: Opioid analgesic, cough suppressant, addicting.
- Usually combined with acetaminophen
- For moderate pain
Naxolone: Reversal agent for opioids. Have on hand when giving opioid agents.
Demerol: Toxic in kids.
When would the IV route for pain be more appropriate?
During emergencies, N/V, and severe pain.
In what aged patients would a PCA be an option?
11-12 years old usually
What is EMLA?
(Eutectic mixture of local anesthetics)
A pain relief cream used before a cutaneous procedure.
- Apply cream, cover, wait 30 minutes-1hr then carry on.
- Assess pain before and after
What are non-pharmacological pain management techniques for each developmental level?
Infant: swaddle, sucrose pacifier, music therapy, rocking
Toddler: Distraction, holding child, music, toys
Preschooler: Imagine, gentle touch, distraction, comforting, role play
School-age: positioning, splinting, heat and cold applications, breathing techniques
Adolescent: prepare, educate, teach relaxation
What is biofeedback?
Awareness of body functions and learning ways to modify them voluntarily
