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NURS 3524 Study Guide - Midterm Guide: Palliative Care, Cancer Pain, Pain Management

Course Code
NURS 3524
Mavoy Bertram
Study Guide

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Paediatric pain, childhood cancers and end of life/bereavement care
Complex, and subjective
- Emotional
- Behavioural
- Physiological
An unpleasant sensory and emotional experience associated with actual or potential tissue damage,
or described in terms of such damage
Acute : sudden onset
- Less than 3 months
- d/t localized trauma/injury
- no pain once healed
Chronic : slow progression , lasts a long time
- 3+ month
- Persists after healing
Pain assessment tools

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Pain assessment in children
1) Ask the child
- Self reported
Children aged 3 have the ability to self report
The ability to measure, classify and seriate : aged 7
(make sure culturally valid)
Self report pain rating scale
Self-report measures are most often used for children over 4 years of age
- The ability to discriminate degrees of pain in facial expressions appears to be
reasonably established by 3 years of age
Word scale/verbal analog
Ask the child to classify the pain into one of 4 categories:
“a little”
“a lot”
Faces pain scale
Six cartoon faces
Smiling face = “no pain”
Tearful face = “worst pain”
The child chooses a face that describes his or her pain
Numeric pain rating
For 7 years or older
“0 to 10” scale widely used (“no pain to worst pain”)
Self report for procedural, acute and chronic pain
Able to count up to 10, understand classification and seriation
Behaviour measures
Used for preschoolers ¾ years old
Used for infants to preschoolers of age 3/4 years*

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Assessment based on: vocalizations, facial expressions and body movements/positioning
Most reliable for short, sharp procedural pain
Less reliable for recurrent or chronic pain
Less reliable for pain in older children
behaviour pain measure
Behavioral measures of pain are generally used for children from infancy to age 4 year
Behavioral pain measurement tools may be more time consuming than self-reports because they
depend on a trained observer to watch and record children’s behaviors such as vocalization, facial
expression, and body movements that suggest discomfort.
Distress behaviour
vocalization of sounds associated with pain
changes in facial expression
unexpected or unusual body movements
most reliable when one needs
- short
- sharp procedural pain
not reliable when measuring
- recurrent or chronic pain
- assessing pain in older children, where pain scores on behavioral measures do not
always correlate with the children’s own reports
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