The nurse is completing a pain assessment on a 4-year-old child. ...

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The nurse is completing a pain assessment on a 4-year-old child. Which of the depicted pain scale tools should the nurse use with a child this age?
 
  a.
  b.
  c.
  d.

Question 2

A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply _____ before the procedure.
 
  a. TAC (tetracaine-adrenaline-cocaine) 15 minutes
  b. transdermal fentanyl (Duragesic) patch immediately
  c. EMLA (eutectic mixture of local anesthetics) 1 hour
  d. EMLA (eutectic mixture of local anesthetics) 30 minutes

[blakcmamba]

Answer to Question 1

ANS: A
The pain scale appropriate for a 4-year-old child is the FACES pain scale. Numeric pain scales can be used on children as young as age 5 as long as they can count and have some concept of numbers and their values in relation to other numbers. Word graphic scales and visual analogue scales are used preferably for school-age children.

Answer to Question 2

ANS: C
EMLA is an effective analgesic agent when applied to the skin 60 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. TAC provides skin anesthesia about 15 minutes after application to nonintact skin. The gel can be placed on the wound for suturing. Transdermal fentanyl patches are useful for continuous pain control, not rapid pain control. For maximal effectiveness, EMLA must be applied approximately 60 minutes in advance.