Podcast
Questions and Answers
What is a critical caution when using EMLA prior to a procedure?
What is a critical caution when using EMLA prior to a procedure?
- It must be combined with NSAIDs for better effectiveness.
- It should be kept on for a minimum of 12 hours.
- It can be used without any other considerations.
- It needs to be removed as soon as possible after the procedure. (correct)
What is the recommended dose of acetaminophen syrup for children post-immunization?
What is the recommended dose of acetaminophen syrup for children post-immunization?
- 5–10 mg/kg, every 4 hours.
- 10–15 mg/kg, single dose as needed. (correct)
- 20–30 mg/kg, every 6 hours.
- 15–20 mg/kg, single dose.
Why might some institutions refrain from prescribing NSAIDs post-tonsillectomy?
Why might some institutions refrain from prescribing NSAIDs post-tonsillectomy?
- To reduce fever during recovery.
- Because of the risk for bleeding from the tonsil bed. (correct)
- Due to potential risk of sensitization.
- NSAIDs are less effective than opioids for post-operative pain.
What is a common adverse effect experienced by children following routine immunization?
What is a common adverse effect experienced by children following routine immunization?
What form of analgesia has been shown to be effective immediately after tonsillectomy?
What form of analgesia has been shown to be effective immediately after tonsillectomy?
What is a key consideration when assessing acute pain in infants and neonates?
What is a key consideration when assessing acute pain in infants and neonates?
Which medication is contraindicated for children under 16 years of age?
Which medication is contraindicated for children under 16 years of age?
What is considered the first-line choice for mild to moderate pain in infants and children?
What is considered the first-line choice for mild to moderate pain in infants and children?
Why are topical analgesics recommended for infants undergoing painful skin-piercing procedures?
Why are topical analgesics recommended for infants undergoing painful skin-piercing procedures?
What potential side effect can occur from using topical analgesics in infants?
What potential side effect can occur from using topical analgesics in infants?
Why is early examination and pain relief important for patients with acute pain?
Why is early examination and pain relief important for patients with acute pain?
What is one of the reasons for the increased potential for drug-induced toxicity in infants?
What is one of the reasons for the increased potential for drug-induced toxicity in infants?
What is a common characteristic of shock-associated acute pain in patients?
What is a common characteristic of shock-associated acute pain in patients?
What is the primary reason for determining the client's perception of pain?
What is the primary reason for determining the client's perception of pain?
Why is it important to screen pain every time vital signs are evaluated?
Why is it important to screen pain every time vital signs are evaluated?
What vital sign indicates Jack's level of pain, based on his self-report?
What vital sign indicates Jack's level of pain, based on his self-report?
Which statement about the management of acute appendicitis pain is NOT true?
Which statement about the management of acute appendicitis pain is NOT true?
What is the significance of the elevated ST segment on Jack's ECG?
What is the significance of the elevated ST segment on Jack's ECG?
What characterizes the initial pain associated with appendicitis?
What characterizes the initial pain associated with appendicitis?
What initial intervention was prescribed for Mrs D upon her arrival at the emergency department?
What initial intervention was prescribed for Mrs D upon her arrival at the emergency department?
What measures should be taken to relieve pain in a patient before it becomes severe?
What measures should be taken to relieve pain in a patient before it becomes severe?
During which phase should nursing care be performed to optimize the effects of analgesics?
During which phase should nursing care be performed to optimize the effects of analgesics?
What symptom did Jack exhibit that suggested a significant medical concern?
What symptom did Jack exhibit that suggested a significant medical concern?
What does the positive laboratory test for cardiac troponin I indicate for Mrs D?
What does the positive laboratory test for cardiac troponin I indicate for Mrs D?
Why is empathic communication important for nurses caring for patients and their families?
Why is empathic communication important for nurses caring for patients and their families?
What should be done when evaluating the effectiveness of analgesics?
What should be done when evaluating the effectiveness of analgesics?
Which side effects of opioid medication should be monitored closely in children?
Which side effects of opioid medication should be monitored closely in children?
What characteristic of Jack's pain did he describe?
What characteristic of Jack's pain did he describe?
What vital sign was documented as the fifth vital sign in Jack's observation?
What vital sign was documented as the fifth vital sign in Jack's observation?
What role do cognitive behavioral activities play in managing a child's recovery?
What role do cognitive behavioral activities play in managing a child's recovery?
Why should a proactive approach to laxative use be taken in post-operative PCA for children?
Why should a proactive approach to laxative use be taken in post-operative PCA for children?
How did Mrs D's daughter contribute to her care in the emergency department?
How did Mrs D's daughter contribute to her care in the emergency department?
What is a primary cause of acute abdominal pain in adolescents and adults?
What is a primary cause of acute abdominal pain in adolescents and adults?
What is shock primarily associated with?
What is shock primarily associated with?
How does the autonomic sympathetic nervous system relate to the causes of pain during shock?
How does the autonomic sympathetic nervous system relate to the causes of pain during shock?
Which condition is NOT associated with the causes of acute abdominal pain?
Which condition is NOT associated with the causes of acute abdominal pain?
What might cause visceral obstruction leading to acute abdominal pain?
What might cause visceral obstruction leading to acute abdominal pain?
Study Notes
Learning Objectives
- Biopsychosocial pain assessment is crucial for managing acute pain.
- Post-operative tonsillectomy pain is severe; pre-operative education for parents and children is essential.
- Shock-associated acute pain has specific components that need understanding.
- Early evaluation and management of pain in patients is necessary.
Acute Pain in Pediatric Populations
- Special consideration is required for infants and neonates due to underdeveloped body systems.
- Risk of drug-induced toxicity is higher due to decreased hepatic metabolism and renal excretion.
- Aspirin is contraindicated for children under 16 years; overdose of non-opioid medications can lead to liver failure.
- Acetaminophen and NSAIDs are first-line options for mild to moderate pain in infants and children.
Procedural Pain Management in Infants
- Topical analgesics like EMLA cream and 2.5% lidocaine are recommended for frequent skin-piercing procedures in infants, unless allergic to amide anesthetics.
- EMLA cream has a lower melting point, enhancing skin penetration and maintaining safe serum levels.
- Side effects may include blistering, skin blanching, and eruptions.
- Careful monitoring is required for drug interactions and proper timing of application.
Procedural Pain Management in Children
- Routine immunizations may cause fever, irritability, and minor reactions.
- Acetaminophen syrup (10–15 mg/kg) can be used as needed post-immunization to manage symptoms.
Post-Operative Tonsillectomy Pain Management
- High risks of nausea, vomiting, and potentially severe bleeding require careful pain management.
- NSAIDs may not be prescribed by some facilities due to bleeding risks.
- Effective pain relief is critical to prevent sensitization, alleviate distress, and promote recovery.
- Infiltrated tramadol is effective for immediate post-operative pain, with NSAIDs given based on age and weight.
Patient-Controlled Analgesia (PCA) for Children
- All opioids can cause constipation; preventative measures including laxatives are essential.
- Nurses must monitor vital signs, pain management effectiveness, and potential adverse effects.
Acute Abdominal Pain Causes
- Acute abdominal pain in adults and adolescents typically results from tissue damage, organ inflammation, vascular issues, or visceral obstruction.
Acute Pain and Shock
- All acute pain can be linked to shock, a syndrome where cells lack adequate blood supply, depriving them of oxygen.
- Pain is linked to the inflammatory response activated by autonomic nervous system responses.
- Pain perceptions should be gauged through patient communication and should be assessed during vital sign evaluations.
Nursing Practices for Acute Pain and Shock
- Elevated temperature can contribute to stress responses; understanding patient anxiety is essential.
- Clear, empathetic communication with both patients and families is crucial for managing anxiety and confusion.
Acute Appendicitis and Pain Management
- Appendicitis can often lead to misdiagnosis and litigation due to its symptoms.
- Initial pain is vague and poorly localized, with progression leading to sharper, more localized pain.
- Current understanding recognizes that pain management does not delay diagnosis.
Clinical Examples
- Immediate nursing care for suspected acute coronary syndrome focuses on urgent interventions.
- For cases of acute pain, comprehensive monitoring of vital signs including pain levels (5th vital sign) is essential for effective evaluation and response.
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Description
This quiz explores the crucial aspects of acute pain management in pediatric populations, including biopsychosocial assessments and post-operative care for tonsillectomy. It also covers the unique considerations for infants and neonates, such as risks of drug-induced toxicity and appropriate pain relief options. Understanding procedural pain management, including the use of topical analgesics, is also emphasized.
