Chapter 14 Peds

Which dietary recommendations should a nurse make to an adolescent patient to manage constipation related to opioid analgesic administration? (Select all that apply.)

- Bran cereal - prune juice - Vegetables

A nurse recognizes which physiologic responses as a manifestation of pain in a neonate? (Select all that apply.)

- Diaphoresis - Decreased SaO2 - Increased heart rate

Surgery has informed a nurse that the patient returning to the floor after spinal surgery has an opioid epidural catheter for pain management. The nurse should prepare to monitor the patient for which side effects of an opioid epidural catheter? (Select all that apply.)

- Nausea - itching - Respiratory depression

A nurse is monitoring a patient for side effects associated with opioid analgesics. Which side effects should the nurse expect to monitor for? (Select all that apply.)

- Respiratory depression - Pruritus - Sweating

A nurse is using the FLACC scale to evaluate pain in a preverbal child. The nurse makes the following assessment: Face: occasional grimace; Leg: relaxed; Activity: squirming, tense; Cry: no cry; Consolability: content, relaxed. The nurse records the FLACC assessment as which number? (Record your answer as a whole number.)

2 The FLACC scale is recorded per the following table: Because the child has a grimace and is squirming and tense, 2 total points are given. Relaxed legs, no cry, and content and relaxed consolability get 0 points.

A dose of oxycodone (OxyContin) 2 mg/kg has been ordered for a child weighing 33 lb. How many milligrams of OxyContin should the nurse administer? (Record your answer as a whole number.)

30 The childs weight is divided by 2.2 to get the weight in kilograms. Kilograms in weight are then multiplied by the prescribed 2 mg. 33 lb/2.2 = 15 kg. 15 kg 2 mg = 30 mg.

The nurse is caring for a 6-year-old girl who had surgery 12 hours ago. The child tells the nurse that she does not have pain, but a few minutes later she tells her parents that she does. Which should the nurse consider when interpreting this?

Children may be experiencing pain even though they deny it to the nurse.

A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply before the procedure.

EMLA (eutectic mixture of local anesthetics) 1 hour

A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain?

FLACC tool - The FLACC (face, legs, activity, cry, consolability) tool should be used with a 2-year-old child.

Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?

Morphine

A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, I have been getting a migraine every 2 or 3 months for the last year. The nurse documents this as which type of pain?

Recurrent

The nurse is completing a pain assessment on a 4-year-old child. Which of the depicted pain scale tools should the nurse use with a child this age?

The pain scale appropriate for a 4-year-old child is the FACES pain scale.

The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to:

administer naloxone (Narcan).

A patient on an intravenous opioid analgesic has become apneic. The nurse should implement which interventions? Place the interventions in order from the highest priority (first intervention) to the lowest priority (last intervention).

b. Administer the prescribed naloxone (Narcan) dose by slow IV push a. Place the patient on continuous pulse oximetry to assess SaO2. c. Ensure oxygen is available. d. Prepare to calm the child as analgesia is reversed.

Nonpharmacologic strategies for pain management:

may reduce pain perception.

Physiologic measurements in childrens pain assessment are:

of limited value as sole indicator of pain.