When caring for a 1-year-old child with a wound, the nurse observes the child crying and kicking legs. According the FLACC Nonverbal Pain Scale, the nurse should give which score for the child's action represented by his leg movement?
A) 0
B) 1
C) 2
D) 3
C
Feedback:
The nurse should rate the legs in the FLACC score as 2 . A score of 2 is given if the child is kicking or has his legs drawn up. A score of 0 is given if the child is relaxed or in a normal position. A score of 1 is given if the child displays uneasy, restless, or tense movements of the legs. The FLACC scoring system does not have a score of 3 for an individual category.
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