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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers
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5 - Pain in Children: Significance, Assessment, and Management Strategies

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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Registered Nurse (RN) School Study Aid

5 - Pain in Children: Significance, Assessment, and Management Strategies
38 Picmonics to Learn | 1 hr 5 mins
Pain Assessment
Types of Pain
Acute Pain
Chronic Pain
OPQRST Mnemonic
Onset
Provoking or Palliative
Quality
Radiation
Severity
Timing
Nursing Considerations
Subjective Findings
Objective Findings
Reassessment of Pain
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2 mins
Anxiety Assessment
Mild
Increased Alertness
Heightened Perception
Moderate
Perception Narrowed
Short Attention Span
Shaking
Severe
Ineffective Problem Solving
Automatic Behavior
Hyperventilation
Panic
Hallucinations
Inability to Function or Communicate
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2 mins
Depression Assessment
Physical Changes
Anergia
Self Neglect
Decreased Libido
Vegetative Signs
Mood
Sad Affect
Worthlessness
Guilt
Anger and Irritability
Cognitive
Ineffective Problem Solving
Slowed Thinking
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1 min
Native American Culture
No Direct Eye Contact
No Organ Donation
No Blood Donation
Strong Handshakes Offensive
Tribal Shaman
Navajo Mother Massage Newborn
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2 mins
Asian American Culture
Avoids Direct Eye Contact
Conflict Avoidance
Soft Voice Tone
Males Make Most Decisions
Feet Considered Dirty
Hot-Cold Theory of Illness
Soups and Rice After Birth
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2 mins
Arab American Culture
Touch Only When Same Gender
May Request Same Gender Healthcare Provider
Females Avoid Eye Contact with Males
Males Often Make Decisions
Muslims
Infertility Grounds for Divorce
No Organ Donation
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2 mins
Mexican American Culture
May Avoid Eye Contact with Authoritative Figures
Family Involved in Decisions
Emotional Bereavement
No Organ Donation
Curandero (Curandera)
Hot-Cold Theory of Illness
Abdominal Binder after Pregnancy
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2 mins
Pediatric Vaccinations - Age 2 Months
2 B DR HIP
Hepatitis B
DTaP - Diphtheria Tetanus acellular Pertussis
RV - Rotavirus
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
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1 min
Pediatric Vaccinations - Age 4 Months
4 DR HIP
DTaP - Diphtheria Tetanus acellular pertussis
RV - Rotavirus
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
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1 min
Pediatric Vaccinations - Age 6 Months
B DR HIP In 6 Months
Hepatitis B
DTaP - Diphtheria Tetanus acellular pertussis
RV - Rotavirus
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
Influenza
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2 mins
Pediatric Vaccinations - Age 12 to 15 Months
1 Very MAD HIP-ster
Varicella Zoster
MMR
Hepatitis A
DTaP - Diphtheria Tetanus acellular pertussis
HiB - Haemophilus Influenzae Type B
IPV - Inactivated Polio Vaccine
PCV - Pneumococcal
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2 mins
Pediatric Vaccinations Age 4-6 Years
Very DIM between 4-6pm
Varicella Zoster
DTaP - Diphtheria Tetanus acellular pertussis
IPV - Inactivated Polio Vaccine
MMR
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1 min
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
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1 min
Breastfeeding
Benefits
Complete Nutrition
Antibody Protection
Bonding
Convenient
SIDS Risk Reduced
Possible Enhanced Cognitive Development
Long-Term Health Benefits
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2 mins
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
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2 mins
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
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2 mins
Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
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2 mins
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
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2 mins
Tricyclic Antidepressants (TCAs)
Mechanism of Action
Inhibits Reuptake of Norepinephrine and Serotonin
Indications
Depression
Bipolar Disorder
Fibromyalgia
Side Effects
Sedation
Orthostatic Hypotension
Anticholinergic Effects
Cardiac Toxicity
Considerations
Delayed Effect
Do Not Stop Abruptly
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5 mins
Gabapentin
Primary Indication
Seizure Treatment
Secondary Indications
Peripheral Neuropathy
Postherpetic Neuralgia
Bipolar Disorder
Migraine Prophylaxis
Characteristics
Inhibits Voltage-Gated Ca2+ channels
Designed as a GABA Analog
Side Effects
Ataxia
Sedation
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2 mins
Carbamazepine (Tegretol)
Mechanism
Inactivates Na+ Channels
Indications
Seizures
Bipolar Disorder
Trigeminal Neuralgia
Side Effects
Nystagmus
Ataxia
Hepatotoxicity
Blood Dyscrasias
Water Retention
Stevens-Johnson Syndrome
Considerations
Avoid Grapefruit Juice
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2 mins
Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
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2 mins
IV Anesthetics
Barbiturates
Benzodiazepines
Respiratory Depression
Hypotension
Ketamine
NMDA Receptor Antagonist
Hallucinations
Opioids
Propofol
Potentiates GABA-A
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2 mins
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
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2 mins
Opioid Use Disorder and Withdrawal Assessment (Formerly Opioid Abuse and Withdrawal Assessment)
Abuse Assessment
Euphoria
Miosis
CNS Depression
Abuse Withdrawal
Yawning
Gooseflesh
Sweating
Rhinorrhea
Kicking Movements
Consideration
Naloxone
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1 min
Opioid Antidote
Antidote
Naloxone
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29 secs
Burns Considerations
Maintain Body Temperature
Increased Risk of Infection
Venous Thromboembolism (VTE) Prophylaxis
Curling's Ulcer
Excision and Grafting
Adequate Nutrition
Contractures
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2 mins
Stages of Burn Care
Phase / Stage 1
Resuscitative/Emergent Phase
Injury to Return of Capillary Permeability
48-72 hours
IV Fluid Replacement
Phase / Stage 2
Acute Phase
Diuresis to Near Wound Closure
Phase / Stage 3
Wound Closure to Return of Optimal Level
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2 mins
Burns Interventions
Ensure Airway Patency
O2
IV Fluid Replacement
Dry Sterile Dressing
Debridement
Elevate Burned Limbs
Analgesics
Silver Sulfadiazine
Escharotomy
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2 mins
Sickle Cell Anemia Assessment
Cause/Mechanism
Hemoglobin S (Genetic Defect)
Sickle Shaped RBCs
Assessment
Jaundice
Vaso Occlusive Crisis
Fever
Priapism
Severe Pain
Considerations
Prominent in African Americans
May be Asymptomatic
Increased Risk of Infection
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2 mins
Sickle Cell Anemia Interventions
Interventions
Increase Hydration
Analgesics
Oxygen
Warm Compress
Bone Marrow Transplant
Hydroxyurea
Considerations
Avoid High Altitudes
Prophylactic Antibiotics
Avoid Strenuous Exercise
Vaccines
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3 mins
Amphotericin B
Indications
Systemic Mycosis
Fungal Meningitis
Last Resort for Protozoan infections
Mechanism
Polyene
Binds Ergosterol
Forms Membrane Pores
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1 min
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
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1 min
Lumbar Puncture
Indications
CSF Sample
CSF Pressure
Considerations
Empty Bladder
Side-lying Position
Between 3rd and 4th Lumbar Vertebrae
Number Tubes
Supine Position After Procedure
Contraindications
Increased ICP (Intracranial Pressure)
Infection at Puncture Site
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2 mins
Tricyclic Antidepressants (TCAs) Indications
Indications
Major Depression
Bedwetting
Fibromyalgia
OCD
Drugs
-Iptyline or -Ipramine Suffix
Amitriptyline
Desipramine
Clomipramine
Imipramine
Nortriptyline
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2 mins

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