Mod 1 ATI Chapter 9

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Mod 1 ATI Chapter 9
2011-04-08 14:47:57

Pain Management
Show Answers:

  1. How long after given each of the following meds should the child's pain be evaluated?

    • 15 min after IV
    • 30 mins after IM
    • 30 to 60 min after Oral
  2. CRIES Neonatal Postoperative Scale (Pain Assessment Tool)

    32 weeks of gestation to 20 weeks of life
    • Pain rated on a scale of 0 to 10
    • Behavior indicators are:
    • Crying
    • Changes in vital signs
    • Changes in expression
    • Altered sleeping patterns
  3. Faces, Legs, Activity, Cry, and Consolability (FLACC) Postoperative Paint Tool

    2 months to 7 years
    • Behavior indictors:
    • Facial expressions
    • Position of legs
    • Activity
    • Crying
    • Ability to be consoled
  4. Visual Analog Scale (VAS) (Pain Assessment Tool)

    7 years and older ( may be effective with children as young 4.5 years)
    • Pain is rated on a scale of 0 to 10
    • Child points to the number that best describes the pain he is experiencing
  5. Noncommunication Children's Pain Checklist

    3 to 18 years of age (for children with or without congnitive impairment)
    • Pain is rated on a scale of 0 to 18
    • Behavior indicators are:
    • Vocalization
    • Socialization
    • Facial expressions
    • Activity level
    • Movement of extremities
    • Physiologic changes
  6. Give medication routinely versus PRN to manage pain that is expected to last for an extended period of time.
  7. Use caution when administering medications to newborns less than what age because of immature liver function?
    2-3 months
  8. Combine adjuvant medications with other analgesics. What are adjuvant meds?
    steroids, antidepressants, sedatives, antianxiety, muscle relaxants, anticonvulsants
  9. Meds for mild to moderate pain?
    Acetaminophen and NSAIDs
  10. Meds for moderate to severe pain? Give examples.
    Opiods ---- morphine sulphate, oxycondone (Oxycontin), and fentanyl (Duragesic)
  11. What are the benefits of combining a nonopioid and an opioid medication?
    • Treats pain peripherally and centrally
    • Less adverse effects (respiratory depression, constipation, nausea)
  12. How long does it take for oral meds to reach peak analgesic effects?
    1 to 2 hours
  13. What does a eutectic mixture of local anesthetics (EMLA) contain?
    equal quantities of lidocaine and prilocaine to form a cream or a disk.
  14. How long prior to a procedure should the EMLA be applied?
    • 60 min prior to a superficial puncture
    • 2 hours prior to a deep puncture
  15. Remember to place an occlusive dressing over the EMLA cream after application.
  16. What indicates an adequate response to the EMLA?
    reddened or blanch skin
  17. Fentanyl

    • For chidren older than 12 years old
    • Continuous pain control
    • Onset of 12 to 24 hour and a duration of 72 hours
    • Immediate release opioid for breakthrough pain
    • Treat respiratory depression with naxolone (Narcan)