Epidural or Intrathecal Involves catheter placed into epidural, caudal, or intrathecal space for continuous infusion or single or intermittent administration of opioid with or without

Family-Controlled Analgesia One family member (usually a parent) or other caregiver designated as child’s primary pain manager with responsibility for pressing PCA button Guidelines for

Routes and Methods of Analgesic Drug Administration Oral Oral route preferred because of convenience, cost, and relatively steady blood levels Higher dosages of oral form

Pharmacologic management The World Health Organization states that the principles for pharmacologic pain management should include the following: Using a two-step strategy Dosing at regular

Guided imagery Assist the child in an imaginary experience Including as many senses as possible (e.g., “feel the cool breezes,” “see the beautiful colors,” “hear

Appropriate routes Oral Nursing actions Route is preferred due to convenience, cost, and ability to maintain steady blood levels Take 1 to 2 hr to

Non-communicating children’s pain checklist: 3 years and older Behavior are observed for 10 min Six subcategories are each scored on a scale 0 to 3

Pain Assessment Intensity Assessment includes behavioral measures, multidimensional, and self-report. Self-report is used for children 4 years or older. Children under 4 are unable to

Physiologic Data Current health status Health maintenance pattern and last visit Up to date? Safety Activity and exercise Nutrition Sleep Family history Health background Changes

Cranial Nerves I—Olfactory Nerve Olfactory mucosa of nasal cavity (Smell) With eyes closed, have child identify odors, such as coffee, alcohol from a swab, or

Musculoskeletal system Length, position, and size of extremities are symmetric Joints Stable and symmetric with full range of motion and no crepitus or redness Spine

Abdomen Without tenderness, no guarding. Peristaltic waves can be visible in thinner children. Shape: Symmetric and without protrusions are around the umbilicus Infants and toddlers