Pediatric Pain Management Learning Objectives

Both behavioral and physiological consequences of untreated pain

2 prevalent myths about the effects of pain medications on infants and child say that they put the children at risk of respiratory depression and physical addiction of pain medicationsOther myths include: infants cannot feel pain, children have no memory of pain, children are not in pain if they can sleep, parents exaggerate their child's pain, repeated painful experiences teach the child how to be more tolerant, children recover more quickly than adults, children tell you if they are in pain, and that children have a high risk of addiction

Ass the pain by evaluating behavior and physiologic signs, using a developmentally appropriate pain assessment tool. Nurses should not rely on personal, subjective appraisals of behavioral and psychological indicators.

Managing pain in children requires a calm environment, as well as non-pharmacologic and pharmacologic interventions

Whatever the person experiencing the pain says it us, existing whenever the person says it doesAn unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

A gate mechanism in the spinal cord facilitates or inhibits the transmission of pain signal. Stimulation of the larger afferent nerves, which carry benign sensations, can blunt the transmission of pain signals

Mild-moderate pain commonly receive acetaminophen. Moderate to severe acute and chronic pain commonly receive opioids

Distractions, Breathing techniques, guided imagery, biofeedback, progressive muscle relaxation, hypnosis, acupuncture, topical heating and cooling, massage, and transcutaneous electrical nerve simulation

Standards for the assessment and management of painPatients are educated about pain and managing painPatients have the right to an appropriate pain assessment and management The patient is monitored before and after a painful procedure

Infant - TrustToddler - Autonomy Preschooler - InitiativeGrade Schooler - IndustryAdolescent - Identity

Infant: CRIESYoung Children: FLACC, VAS, FACESSchool Aged/ Adolescent: Oucher, Adolescent Pediatric Pain Tool (pg.

975-977)

Q - Question the childU - Use a pain rating scaleE - Evaluate behavior and physiologic changesS - Secure parental involvementT - Take cause of pain into accountT - Take action and evaluate resultsD - Document

Family Centered Care, encourage parental participation, and comfort items from home

1) Relieve pain2) Maximize function 3) Minimize side effects of medications

Should supplement and not replace for pharmacologic interventions, enhance the effects of the analgesic, gives child a sense of control over pain

WHO recommendations (pg. 970), Oral route preferred, use ATC, use topical anesthetic creams for procedures, IV provides steady blood level, morphine is gold standard for severe pain, avoid IM, no placebos lol

Developmental and cognitive level, past experience, culture

philosophy of care and an organized program for delivering care to children with life limiting conditions; focuses on enhancing quality of life for the child and family, minimizing suffering, and providing opportunities for growth and development

philosophy of care that combines palliative and hospice care principles, hospice care is a philosophy that regards dying as a natural process and care of dying patients as including management of the physical, psychosocial, and the spiritual needs of the patient and familyCaring, not curing