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How long after given each of the following meds should the child's pain be evaluated?
IV
IM
Oral
- 15 min after IV
- 30 mins after IM
- 30 to 60 min after Oral
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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
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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
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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
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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
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Give medication routinely versus PRN to manage pain that is expected to last for an extended period of time.
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Use caution when administering medications to newborns less than what age because of immature liver function?
2-3 months
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Combine adjuvant medications with other analgesics. What are adjuvant meds?
steroids, antidepressants, sedatives, antianxiety, muscle relaxants, anticonvulsants
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Meds for mild to moderate pain?
Acetaminophen and NSAIDs
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Meds for moderate to severe pain? Give examples.
Opiods ---- morphine sulphate, oxycondone (Oxycontin), and fentanyl (Duragesic)
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What are the benefits of combining a nonopioid and an opioid medication?
- Treats pain peripherally and centrally
- Less adverse effects (respiratory depression, constipation, nausea)
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How long does it take for oral meds to reach peak analgesic effects?
1 to 2 hours
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What does a eutectic mixture of local anesthetics (EMLA) contain?
equal quantities of lidocaine and prilocaine to form a cream or a disk.
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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
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Remember to place an occlusive dressing over the EMLA cream after application.
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What indicates an adequate response to the EMLA?
reddened or blanch skin
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Fentanyl
Topical/transdermal
- 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)
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