The nurse is admitting an 8-year-old Vietnamese child who hit a parked car while riding a bike. The child has a fracture of the left radius and femur in addition to a fractured orbit. The child is stoic, and denies pain

Question

The most appropriate initial action by the nurse is to: 1. Use the FLACC scale to determine the child's pain level.
2. Tell the child to ring the call bell if the leg starts hurting.
3. Administer pain medication now and continue on a regular basis.
4. Ask the child's parents to notify the nurse if the child complains of pain.

Answer 1

3
Rationale:
1. The FLACC scale is not the most appropriate tool to use with an 8-year-old.
2. The child's stoic expression is likely to be culturally related, and the child might not admit to hurting.
3. Based on the type of injuries the child has, pain will be present. Analgesics should be given on a scheduled basis so that the pain does not get out of control.
4. Asking the parents to call the nurse is not inappropriate, but it is not the most appropriate initial action.