A nurse is conducting a comprehensive pain assessment for a child who has been complaining of a dull, aching, or throbbing pain that worsens with movement or pressure.
The nurse should consider which of the following as potential sources of the child’s pain? (Select all that apply).

I have a dull, aching pain that worsens with movement.”..

Choice A rationale:

I have a sharp, throbbing pain at the site of my injury.”..

This choice does not align with the reported symptoms of fatigue, decreased appetite, changes in sleep patterns, irritability, and withdrawal from activities.

These symptoms are commonly associated with chronic pain, particularly the dull, aching type.

Choice B rationale:

I feel a burning or shooting pain with numbness and tingling.”..

This choice is more characteristic of neuropathic pain, which may involve burning or shooting sensations and numbness and tingling.

However, the reported symptoms are not typical of neuropathic pain but are more consistent with chronic pain.

Choice C rationale:

My pain is deep and crampy, and I'm feeling nauseous.”..

This description is closer to visceral pain, which can be deep and crampy and may cause nausea.

However, the reported symptoms of fatigue, decreased appetite, changes in sleep patterns, irritability, and withdrawal from activities are not strongly associated with visceral pain.

Choice D rationale:

I have a dull, aching pain that worsens with movement.”..

This is the correct answer.

The reported symptoms of fatigue, decreased appetite, changes in sleep patterns, irritability, and withdrawal from activities are commonly associated with chronic pain, particularly the dull, aching type.

Chronic pain can lead to a decrease in physical and emotional well-being, resulting in these manifestations.

The worsening of pain with movement is also indicative of chronic pain, as it often restricts a person's ability to engage in physical activities.

Choice A rationale:

It's okay to cry.

I know you're in pain.”..

This response is the most appropriate because it acknowledges the child's pain and provides comfort and empathy.

It encourages the child to express their discomfort and emotions, which is essential for effective pain management in pediatric patients.

Validating the child's pain and offering emotional support is a crucial aspect of nursing care.

Choice B rationale:

You're not supposed to be crying.

You're just trying to get attention.”

This response is not appropriate because it dismisses the child's pain and emotions.

It may cause the child to feel guilty or reluctant to express their discomfort.

Effective pain management in pediatric patients involves acknowledging their pain and providing appropriate interventions to address it, rather than attributing their crying to attention-seeking behavior.

Choice C rationale:

"You're not as bad as some of the other kids I've seen with tonsillectomies.”

Comparing the child's pain to that of other children is not a suitable response.

Each child's pain experience is unique, and making comparisons can minimize the child's suffering and discourage them from expressing their pain.

The focus should be on addressing the individual child's pain and providing the necessary care and comfort.

Choice D rationale:

You need to suck it up and stop crying.”..

This response is not appropriate and is insensitive to the child's pain.

It dismisses the child's discomfort and discourages them from expressing their pain.

Effective pain management in pediatric patients involves acknowledging their pain, providing appropriate interventions, and offering emotional support.