Which assessment indicates to a nurse that a 2-year-old child is in need of pain medication?
a. The child is restless and guarding the painful site.
b. The child's current vital signs are consistent with vital signs over the past 4 hours.
c. The child is quieted when held and cuddled.
d. The child has just returned from the recovery room and is crying.
A
Behaviors such as generalized restlessness, guarding the site, and touching the painful area are signs of pain in the toddler. Current vital signs that are consistent with earlier vital signs do not suggest that the child is feeling pain. Response to comforting behaviors does not suggest the child is feeling pain. Crying in a child who is returning from the recovery room may not be indicative of pain. The child may just be fearful or having anxiety because of the strange surroundings and having just completed surgery.
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