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Pain Assessment & Management
Objectives
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- Pain is an unpleasant sensation that is either acute or chronic, perceived in response to tissue damage.
- Research has revealed that infants and children feel pain, just as adults do, despite past beliefs to the contrary.
- Pain behaviors in children are similar to the behaviors of fearful and anxious children.
- Every infant, child, and adolescent has the right to adequate pain control.
- The goal of pain assessment is to provide accurate information about the location and intensity of the child’s pain and how the child is responding to it.
- Learning how the child expresses pain, both verbally and behaviorally, will help the nurse make a better assessment.
- Children learn how and when to seek help for pain and how to cope with pain by observing other family members.
- Numerous tools have been developed and validated to assess pain in infants and children.
- Pharmacologic interventions for pain control include opioids and nonsteroidal anti-inflammatory drugs (NSAIDs).
- Opioids are equally as effective when given by mouth, intramuscularly, and intravenously when an equianalgesic dose is used.
- Analgesia for continuous or severe pain should be given around the clock to maintain pain control. Patient-controlled analgesia is one method of administering a continuous infusion of an opioid medication and allowing the child to infuse additional small doses for episodic pain.
- Epidural and regional nerve blocks are pain-control methods gaining acceptance because they do not have the side effects associated with systemic medications.
- Nonpharmacologic methods of pain management include parental presence, distraction, cutaneous stimulation, electroanalgesia, imagery, relaxation techniques, hypnosis, and application of heat and cold.
- Parents need education and preparation to provide pain control for children discharged home following surgery and injuries. Children with chronic conditions often need long-term pain management.
- Many diagnostic and therapeutic procedures cause pain and anxiety in children. Provide optimal prophylactic pain management to reduce the anxiety associated with future procedures.
- Conscious sedation is used to reduce the child’s anxiety associated with painful procedures. Analgesia is usually given in association with sedation when the procedure would cause pain or discomfort in an alert child.
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