Neonatal Pain Assessment &Management

8/4/2019 Neonatal Pain Assessment &Management

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Common Approaches to a CommonProblemThe inability to communicate in no way negates the

possibility that an individual is experiencing pain and isin need of appropriate pain relieving treatment (IASP,

2001,p2)


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Neonatal Pain Assessment

&Management

Presented By

Khaula F. Reid R.NStudent

George Brown College

Toronto, Ontario, Canada

In Partial Fulfillment of CourseRequirements

Perinatal Intensive Care Nursing

S404

Common Approaches to a

Common Problem


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Objectives:

Define nociception, perception, pain Describe common myths about

neonatal pain

Case Study Baby A

Common Nursing Diagnoses Outline methods for assessing

neonatal pain in the NICU

Outline methods for relievingneonatal pain including Fentanyl

Nurses as advocates for neonates:Recent Findings

Conclusion: Moving Forward

Bibliography: Giving Account


&Management


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&Management

Neonatal Pain:

Common Myths

The neural and endocrine systems ofthe newborn infant are not

developed to the stage that allowsfor transmission of painful stimuli

Newborn term and preterm infantscannot remember pain and

therefore, there can be no sequelaeof pain.

Pain cannot be adequately assessedin the newborn infant

No self report of pain hence no painintensity rating.

Common methods for relieving painare not baby friendly.


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&Management

Nociception

,

Perception, Pain


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&Management

Neonatal Pain:

Case Study: Baby A

Name: Baby A, Twin Female

Age: 4 days as of April 7

th

, 2009BW: 930gms

Delivery Hx: C-section, decreasingfetal heart rate, decreased tone,

respiratory distress. Apgar 71, 85,Maternal Hx: 34 yr old G2 P0+

1 BloodGroup A-, GBS+, UTI for 2 wks,prior to delivery. Placental growth

discordance.Social Hx: Mom, dad, grand mom

support


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Parent/infant/child attachment,altered, risk forParenting, alteredParenting, altered, risk for

Role performance, alteredSocial interaction, impairedSocial isolation

Neonatal Pain Assessment&Management

Neonatal Pain:

Nursing Diagnosis

NANDA Nursing Diagnosis

PainAcute

Chronic


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Neonatal Pain:

Sources Birth Events

Major Surgery and Invasive

Procedures Diagnostic Examinations

Neonatal Conditions


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Neonatal Pain:

Assessment Methods

Commonly

Used Pain Rating Scales

Premature Infant Pain Profile Crying, oxygen requirement,

increased vital signs,expression, sleeplessness

Face, Legs, Activity, Cry,Consolibility

Neonatal Infant Pain Scale Neonatal Facial Coding System Others: Modified post-operative

comfort score, PokelasBehavioral pain score, ModifiedBehavioral Pain Scale and InfantBody Coding System

Sedation Scores


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Neonatal Pain:

Assessment Criterion

Points to Consider

Newborns, even the most immature feel

painNewborns in the NICU are subjected tomultiple painful procedures thatmay result in an altered painresponse later in infancy

If a procedure is painful in adults itshould be considered painful in thenewborn.

Adequate treatment of pain may beassociated with decreased clinicalcomplications and decreasedmortality.

Consider a combination of therapies torelieve pain.


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Types of Pain Management

Therapies

Prevention

Non-Pharmacological Pharmacological


Neonatal Pain:

Management Strategies


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Neonatal Pain:

Nursing Advocates

References:

A discussion of Neonatal Pain Among Health

Professionals:

Procedural pain in newborns at risk forneurologic impairment

Bonnie Stevens, R.N. PhD et al

Healthcare professionals perceptions of pain in

infants at risk for neurologic impairment.Lynn M Breau et al

Consistent Management of Repeated ProceduralPain with Sucrose in Preterm Neonates: Is iteffective and safe for repeated use over time.

Bonnie Stevens, R.N. PhD et al

Evaluation and development of potentiallybetter practices to improve painmanagement of neonates.

Paul J. Sharek et al


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Neonatal Pain:

Conclusion

References: contd:

1. Human Neonates and PainJ. Boumeester, M. van Dijk & D. Tibboel, Sophia

Childrens Hospital and Erasmus UniversityRotterdam, The Netherlands.

2. Assessment And Management Of Acute Pain In

The Newborndeveloped for AWHONN by Robin Koeppel, MS, RNC,

CPNP.3. Pain Management and Sedation in the NICUN. Abalavanan MD, Assistant Professor, Division of

Neonatology, University of Alabama at

Birmingham. Feb 2003.


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A society will be judged on the basis of how it treats itsweakest members and among the most vulnerable are surely theunborn and the dying,"

~Pope John Paul II (and the newborn)

Thank You

Neonatal Pain Assessment &Management

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