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Pediatrics Ch21
Drug
| Question | Answer |
|---|---|
| What is the accepted definition of pain | Whatever the experiencing person says it is, existing when the experiencing person says it does |
| What is the fifth vital sign | Pain |
| What hormone is secreted when children are in pain | Cortisol |
| What are the effects of pain | Higher cortisol levels, compromised immune systems, more infections, delayed wound healing |
| What are reasons children’s pain is often untreated | Infants can’t say where it hurts, Reports of pain not given credibility, Children may not realize they are supposed to report or may not report pain fearing an injection |
| What is looked for to assess infant pain | Tightly closed eyes, clenched fists, furrowed brows |
| Other than pain, why might cause a toddler to cry | Anxiety and fear |
| What reaction might chronically ill children have to pain | Withdrawing from surroundings |
| What nonpharmacological techniques can be used to enhance analgesia and provide relief from pain in children | Distraction, Drawing, Imagery, Relaxation, and Cognitive strategies |
| How might drawing be used to help a child in pain | They can draw how the pain feels and where it is located |
| What distraction techniques can be used to help a child in pain | Storytelling, quiet conversation, puppet play |
| What imagery techniques can be used to help a child in pain | Imagining a safe place |
| What techniques can be used to help an adolescent in pain | Slowing respirations and listening to relaxation tapes, cognitive thought stopping |
| What is cognitive thought stopping | Repeating the word stop in response to negative thoughts and worries |
| What may be used for infants and newborns undergoing brief, painful procedures | Oral sucrose |
| How do infants and children respond to drugs differently than adults | Prolonged elimination from an immature liver, Greater renal clearance, Decreased protein binding capacity in small newborns allows a greater portion of free unbound drug in the body |
| What influences the dosages of drugs for children | Weight, Differences in expected absorption, Metabolism, Clearance |
| Which medications must be calculated by the nurse before administering | All |
| What is commonly used for relief of mild to moderate pain in infants and children | Acetaminophen (Tylenol) |
| What is the maximum dosage of acetaminophen for infants and children | 15mg/kg/dose, maximum of 5 doses/24 hours |
| What does acetaminophen toxicity involve | Liver failure |
| What is the maximum dose for anti-inflammatory drugs | 8 – 10 mg/kg q6h |
| What is a parenterally administered NSAID and for how long can it be given | Ketorolac – maximum 5 days |
| What medications are used for children and infants with moderate to severe pain | Opioids |
| What should be given to infants and children taking opioids | Stool softeners |
| What can occur if opioids are used to relieve pain for long periods of time | Tolerance and respiratory depression |
| What is the correct dose of an opioid drug | The amount that relieves pain with a margin of safety for the child |
| When should a dose of medication for pain be repeated | Before the pain recurs |
| What is the maximum dose for morphine | 4 mg |
| What do patients with unrelieved pain focus on | The pain and when the next dose of medication will be given to stop it |
| What do patients with adequate pain relief focus on | Their surroundings and other activities |
| What does lortab elixir contain that causes nurses to be especially careful with other medications that are prescribed | Acetaminophen/Tylenol |
| What is fentanyl | A potent narcotic analgesic with a rapid onset and short duration of action given for short surgical procedures |
| What should be available for use in case of an opioid overdose | Naloxone/Narcan |
| What should be available almost immediately after the use of naloxone | A dose of pain medication |
| What should be available for use in case of a midazalam/versed or diazepam/valium overdose | Flumazeril/Romazicon |
| What is used for IV placement and lumbar punctures | Topical anesthetics |
| What is EMLA cream | Lidocaine and prilocaine that is applied topically to intact skin and can be used in neonates |
| What is Numby Stuff | Topical anesthesia that uses a mild electrical current to push a preparation of lidocaine and epinephrine into the skin providing local anesthesia within 10 minutes of patch application |
| What is LMX4 | Nonprescription topical anesthetic similar to EMLA |
| What does a vapocoolant spray provide | Superficial skin anesthesia for short periods of time |
| Who can use a PCA pump | Children over 7 |
| What may allow lower doses of pain medication to be effective and what is this called | Around the clock administration on a regular schedule – Preventative pain control |
| What is conscious sedation | Administration of IV drugs to a patient to impair consciousness but retain protective reflexes, the ability to maintain a patent airway, and to respond to physical and verbal stimuli |
| What is conscious sedation used for | Performing therapeutic of diagnostic procedures outside the traditional operating room setting |
| Who must monitor the patient receiving conscious sedation | RN |
| What nurse patient ratio is used during conscious sedation | 1:1 until there are stable vital signs, Age appropriate motor and verbal abilities, Adequate hydration, and a Presedation level of responsiveness and orientation |
| When should EMLA cream be applied | 1 hour before routine procedures and 2 hours before painful procedures |
| How long after patch removal of EMLA cream with the anesthetic effects last | 1 hour |
| What are positive symbols in gypsy culture | The color red and number 3 |
| What does a smile indicate to Russian culture | Happiness |
| What does touching the head mean to the Vietnamese | They are robbed of their soul |
Created by:
futurenurse
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