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A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?
- A. Give only an opioid analgesic at this time.
- B. Increase dosage of analgesic until the child is adequately sedated.
- C. Plan a preventive schedule of pain medication around the clock.
- D. Give the child a clock and explain when she or he can have pain medications.
Correct Answer: C
Rationale: For severe postoperative pain, a preventive around the clock (ATC) schedule is necessary to prevent decreased plasma levels of medications. The opioid analgesic will help for the present, but it is not an effective strategy. Increasing the dosage requires an order. The nurse should give the drug on a regular schedule and evaluate the effectiveness. Using a clock is counterproductive because it focuses the childs attention on how long he or she will need to wait for pain relief.
You may also like to solve these questions
What describes nonpharmacologic techniques for pain management?
- A. They may reduce pain perception.
- B. They usually take too long to implement.
- C. They make pharmacologic strategies unnecessary.
- D. They trick children into believing they do not have pain.
Correct Answer: A
Rationale: Nonpharmacologic techniques provide coping strategies that may help reduce pain perception, make the pain more tolerable, decrease anxiety, and enhance the effectiveness of analgesics. The nonpharmacologic strategy should be matched with the childs pain severity and be taught to the child before the onset of the painful experience. Tricking children into believing they do not have pain may mitigate the childs experience with mild pain, but the child will still know the discomfort was present.
The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurses response should be based on which characteristic about preterm infants pain?
- A. They may react to painful stimuli but are unable to remember the pain experience.
- B. They perceive and react to pain in much the same manner as children and adults.
- C. They do not have the cortical and subcortical centers that are needed for pain perception.
- D. They lack neurochemical systems associated with pain transmission and modulation.
Correct Answer: B
Rationale: Numerous research studies have indicated that preterm and newborn infants perceive and react to pain in the same manner as children and adults. Preterm infants can have significant reactions to painful stimuli. Pain can cause oxygen desaturation and global stress response. These physiologic effects must be avoided by use of appropriate analgesia. Painful stimuli cause a global stress response, including cardiorespiratory changes, palmar sweating, increased intracranial pressure, and hormonal and metabolic changes. Adequate analgesia and anesthesia are necessary to decrease the stress response.
The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching?
- A. With minimal sedation, the patients respiratory efforts are affected, and cognitive function is not impaired.
- B. With general anesthesia, the patients airway cannot be maintained, but cardiovascular function is maintained.
- C. During deep sedation, the patient can be easily aroused by loud verbal commands and tactile stimulation.
- D. During moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation.
Correct Answer: D
Rationale: When discussing levels of sedation, the participants should understand that during moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation, cognitive function is impaired, and respiratory function is adequate. In minimal sedation, the patient responds to verbal commands and may have impaired cognitive function; the respiratory and cardiovascular systems are unaffected. In deep sedation, the patient cannot be easily aroused except by painful stimuli; the airway and spontaneous ventilation may be impaired, but cardiovascular function is maintained. With general anesthesia, the patient loses consciousness and cannot be aroused with painful stimuli, the airway cannot be maintained, and ventilation is impaired; cardiovascular function may or may not be impaired.
The nurse is teaching the parents of a child with recurrent headaches methods to modify behavior patterns that increase the risk of headache. Which statement by the parents indicates understanding the teaching?
- A. We will allow the child to miss school if a headache occurs.
- B. We will respond matter-of-factly to requests for special attention.
- C. We will be sure to give much attention to our child when a headache occurs.
- D. We will be sure our child doesnt have to perform at a band concert if a headache occurs.
Correct Answer: B
Rationale: To modify behavior patterns that increase the risk of headache or reinforce headache activity, the nurse instructs the parents to avoid giving excessive attention to their childs headache and to respond matter-of-factly to pain behavior and requests for special attention. Parents learn to assess whether the child is avoiding school or social performance demands because of headache.
What is a significant common side effect that occurs with opioid administration?
- A. Euphoria
- B. Diuresis
- C. Constipation
- D. Allergic reactions
Correct Answer: C
Rationale: Constipation is one of the most common side effects of opioid administration. Preventive strategies should be implemented to minimize this problem. Sedation is a more common result than euphoria. Urinary retention, not diuresis, may occur with opiates. Rarely, some individuals may have pruritus.