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Pediatric Pain and Visual Auditory Hematologic Systems
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Pediatric Pain and Visual Auditory Hematologic Systems
test 4
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1
Question
What defines chronic pain and what are examples mentioned?
Answer
Chronic pain lasts longer than 3 months, is recurring and unpredictable in time, with examples including cancer and sickle cell disease.
2
Question
How can age affect a person's experience and reporting of pain?
Answer
Age affects ability to inform about pain, may alter pain threshold (higher or lower), and is influenced by previous pain experiences.
3
Question
In what ways does gender influence perception and expression of pain?
Answer
Gender affects pain through different perceptions of how one should feel or express pain, with men often feeling pride which may influence their reporting of pain.
4
Question
How do different age groups indicate or cope with pain when they cannot fully communicate? Provide examples.
Answer
Neonates show pain via facial expressions and high-pitched cries; toddlers may cry longer, show guarding of painful areas but may not want it touched; preschoolers are egocentric, may not understand pain's warning role, possibly showing anger or sleep disturbances; school-age children fear injury and remember painful experiences, showing guarding or clinching fists.
5
Question
What is the QUESTT method for pediatric pain assessment and what are its key steps?
Answer
QUESTT stands for Question the child about pain, Use reliable/valid pain scales, Evaluate behavior and physiological changes, Secure parents' involvement, Take the cause of pain into account and Take action to treat it.
6
Question
What physiological and behavioral signs indicate pain in neonates and infants?
Answer
Indicators include facial expressions, high-pitched irregular crying, changes in heart rate, respiratory rate, blood pressure and oxygen saturation, and facial grimacing.
7
Question
Describe the considerations and approach when assessing pain in young children who may deny or underreport pain, such as adolescents or school-age children.
Answer
Children may deny pain due to fear of shots, losing sports eligibility, or misunderstanding drug use. It's important to educate about differences between prescription pain meds and harmful drugs and to use observations and reliable pain scales rather than relying solely on self-report.
8
Question
What are some common pain rating scales used for children and their age applicability?
Answer
FACES scale (ages 3+), Oucher pain rating with photos (ages 3+), Poker chip tool (ages 3+), Visual Analog/Numeric scales (ages 3+), and Adolescent Pediatric Pain Tool (ages 8-15).
9
Question
How does the FLACC scale assess pain and for which patients is it appropriate?
Answer
The FLACC scale rates Face, Legs, Activity, Cry, and Consolability from 0-10, used especially for unconscious or cognitively impaired children who cannot self-report pain.
10
Question
What nursing approaches help build trust and obtain accurate pain assessment from toddlers?
Answer
Avoid prompting or leading answers, maintain eye level during interaction, and ensure the child feels safe to express pain honestly.
11
Question
What are key nonpharmacological pain relief methods for children?
Answer
Relaxation techniques, massage, imagery, and distraction are important nonpharmacological interventions.
12
Question
Why might healthcare providers hesitate to provide adequate analgesia for children, and why is this a barrier?
Answer
Fears include risk of addiction, respiratory depression, feeling the child doesn’t need medication, or that analgesics are inappropriate. These beliefs can lead to undertreatment of pain, but providers do not decide if a child needs analgesics—pain must be treated effectively.
13
Question
What are important safety considerations when using a patient-controlled analgesia (PCA) device for children?
Answer
The family must not push the PCA button for the child; two nurses check dosage; effectiveness must be continuously reassessed; and monitors for respiratory and cardiovascular status must be used continuously, with emergency medications ready.
14
Question
What are common side effects of narcotic analgesics in pediatric patients?
Answer
Side effects include respiratory rate drop, constipation due to slowed GI motility, sedation, nausea/vomiting, and pruritus (itching).
15
Question
What steps are recommended to manage procedural pain in children?
Answer
Prepare child and family beforehand, use topical anesthetics at puncture sites, choose the smallest gauge needle, use venous sticks for blood draws when possible, provide skin-to-skin contact after procedures, and use nonnutritive sucking like pacifiers for infants during procedures.
16
Question
What are key elements to assess when examining a child's eyes?
Answer
Assess pupil reaction (PERRLA), symmetry and positioning of eyes, sclera color for signs like jaundice or pink eye, eye muscle function via penlight movements (up/down, side to side, making an X), presence of nystagmus, squinting, ptosis, strabismus, slant in eyes, and tearing issues.
17
Question
Why is binocularity important and how is it assessed?
Answer
Binocularity means both eyes focus on the same object at the same time, allowing the brain to interpret images accurately. Assessment includes observing eye alignment and focus coordination.
18
Question
How is visual acuity tested in young children and what are normal developmental expectations?
Answer
Visual acuity testing uses eye charts (Snellen or picture charts) at 20 feet. Testing starts around age 3-4, with normal vision improving from 20/400 at birth to near normal by age 7. Failure to meet milestones requires referral.
19
Question
What advice and precautions should be given to parents of visually impaired children?
Answer
Parents should announce when they enter a room, tell the child before touching and where, describe the environment, use the clock method for food placement, avoid rearranging furniture, add bumpers on sharp corners, and warn about dangers of environmental changes.
20
Question
Describe common pediatric eye conditions: Amblyopia, Strabismus, and Conjunctivitis.
Answer
Amblyopia is lazy eye where the affected eye wanders; treated by patching the good eye. Strabismus is crossed eyes, normal in newborns but concerning if persistent; esotropia is inward turning, exotropia outward. Conjunctivitis (pink eye) involves redness, tearing, and drainage; bacterial form has matted eyes and purulent discharge, viral is watery with no need for antibiotics.
21
Question
What are common eye injuries in children, particularly boys aged 11 to 15?
Answer
Common eye injuries include corneal abrasion, hemorrhage, and hyphema (blood in the interior chamber of the eye), which is an emergency.
22
Question
Which eye injuries require referral to an eye doctor after trauma?
Answer
Blowout fracture, ruptured globe, thermal injury/corneal flash burn, extensive animal bite, lid laceration with underlying structural involvement, corneal abrasion with corneal penetration, and foreign body embedded in the eye.
23
Question
What are the risk factors for Retinopathy of Prematurity (ROP)?
Answer
Low birthweight, early gestational age, sepsis, high light intensity, hypothermia, hypoxia, and the duration and concentration of supplemental oxygen.
24
Question
What are signs and symptoms of visual impairment in children?
Answer
A dull, vacant stare; inability to "fix and follow" an object; unaffected by bright lights; doesn't imitate facial expressions; sits close to the TV; bumps into things; rubs or covers eyes; frequently squints and blinks.
25
Question
Why is early hearing impairment identification important in newborns?
Answer
Early identification is key because hearing impairment can delay language development and affect behavior; all newborns must have a hearing test before leaving the hospital and follow-up if they fail.
26
Question
What does conductive hearing loss indicate and is it reversible?
Answer
Conductive hearing loss is usually temporary and reversible; it can be caused by conditions like otitis media (middle ear infection).
27
Question
What distinguishes sensorineural hearing loss?
Answer
Sensorineural hearing loss is permanent and irreversible, caused by factors like meningitis, rubella, head trauma, measles, viral illnesses, or mumps.
28
Question
What is central hearing loss?
Answer
Central hearing loss means a person can hear sounds but cannot differentiate between them properly.
29
Question
What are important injury prevention tips for ears?
Answer
Be aware of objects that can get stuck in the ears, keep sharp objects away, never use Q-tips, and use ear protection when exposed to loud noises.
30
Question
What are the roles of red blood cells, white blood cells, and platelets in the hematologic system?
Answer
Red blood cells carry oxygen; white blood cells fight infection; platelets help with clotting and hemostasis.