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29 Cards in this Set
- Front
- Back
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What is pain? |
An unpleasant sensory & emotional experience that is associated with actual or potential tissue damage |
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What are the percentages of childhood pain at the IWK? |
80% of kids have had at least 1 painful procedure in 24 hours 70% had no pain management documents It is undertreated |
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What is the "spillover effect"? |
Parent behaviour & anxiety levels are strongly correlated with how a child responds |
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What are some benefits of a positive environment and experience for children? |
decrease trauma and negative associations less fear & anxiety = better long term adjustments entering into a procedure less anxious = faster healing & decreased hospital stay |
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What are some factors that influence pain in children? |
Age, gender, cognitive level (chronological vs. developmental age), temperament, previous experiences, family & culture, and situational factors |
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What are the 3 types of pain assessment tools, and who is each type directed to? |
Behavioural (infants - age 4 years) Physiologic (neonates) Self-report (children over 4 who can talk) |
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What does the behavioural pain assessment include? |
Assessment of vocalization, facial expressions, and body movements with specific tool |
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When should the behavioural pain assessment tool be used? |
Most reliable for short, sharp pain Most reliable for pain in infants *If done on older children, it may not correlate with child's self-report about pain |
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What is the FLACC scale? |
Face, Legs, Activity, Cry, Consolability Assesses pain in children from 2 months - 7 years who cannot communicate their pain 0 indicates no pain |
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What is the COMFORT scale? |
The ONLY tool recommended for use with unconscious and ventilated infants, children, and adolescents. |
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What are the eight indicators of the COMFORT scale? |
1. Alertness 2. Calmness/agitation 3. Respiratory response 4. Physical movement 5. Blood pressure 6. Heart rate 7. Muscle tone 8. Facial tension |
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How do you use the COMFORT scale? |
Observe for 2 minutes and add the scores of each indicator Total scores range from 8-40 A score of 17-26 = adequate sedation & pain control |
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If you are paralyzed and/or sedated, can you still feel pain? |
Yes! |
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What is the Wong-Baker FACES pain scale? |
Has six cartoon faces smiling face = no pain tearful face = worst pain |
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What is the Bieri Faces Pain Scale? |
Six faces that = 0 to 5 no smiling face at the no pain end no tears face at the most pain end *equivalent to a 0 to 10 metric system (0, 2, 4, 6, 8, 10) |
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What is the numeric pain rating, and who is it for? |
For 8 years and older 0 - 10 Easy to use |
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How is pain shown differently in neonates? |
Response may behaviourally "blunted" or absent Sleep states in preterm infants Paralytic agents (it'll look like they fell asleep) |
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What is the physiologic pain assessment tool used for neonates? |
CRIES |
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What is CRIES? |
Crying Requiring Increased Oxygen Increased vitals Expression Sleeplessness *common with NAS |
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What is NAS? |
Neonatal Abstinence Syndrome Infants with withdrawal symptoms as soon as umbilical cord is cut |
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What factors can affect coping? |
Age (chronological vs. developmental) Temperament Family involvement Support Current medical stae Previous medical experiences |
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What 3 things nurses should consider about children's coping strategies? |
Perceptions Previous experiences Developmental understanding That every child does their best |
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What external factors can decrease coping? |
Reassurance Criticism and threats |
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When coping during a procedure, what is the child's role and what can the nurse do to help? |
Make them a participant rather than recipient Give them a sense of control & independence *remind child about their role during a procedure *give ongoing praise for desired behaviour |
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When coping during a procedure, what is the parent's role and what can the nurse do to help? |
Encourage parental participation (if they are comfortable doing so) They can give information abut the child *ask for suggestions *specify a role for them and where to be *comfort positioning |
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What are some nonpharmacological coping strategies? |
Breathing Relaxation Distraction |
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What should to preparation for procedures include? |
Psychologic prep (age-specific and based on developmental characteristic) Establish trust & provide support Parental presence and support Explanation to the child |
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Why do we use procedural distraction? |
decreases anxiety in child and parent teaches child how to cope facilitates FCC directs focus away from procedure a better experience for all |
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yea |
cool |
