A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The child's level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying
and restlessness. What is the most appropriate and restlessness. What is the most appropriate nursing action?
a. Explain that analgesia is contraindicated with a head injury.
b. Have the parents describe the child's previous experiences with pain.
c. Consult with a practitioner about what analgesia can be safely administered.
d. Teach the parents that analgesia is unnecessary when the child is not fully awake and alert.
ANS: C
A key nursing role is to provide sedation and analgesia for the child. Consultation with the appropriate practitioner is necessary to avoid conflict between the necessity to monitor the child's neurologic status and to promote comfort and relieve anxiety. Analgesia can be safely used in individuals who have sustained head injuries. The child's previous experiences with pain should be obtained as part of the assessment, but because of the severity of the injury, analgesia should be provided as soon as possible. Analgesia can decrease anxiety and resultant increased intracranial pressure.
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