A 5-year-old child presents to the emergency department with a right arm fracture.
The child is crying and restless.
The nurse uses the Numeric Rating Scale (NRS) to assess the child's pain.
The child rates their pain as an 8/10.
Which of the following statements by the nurse is appropriate?

Choice A rationale:

I will observe your facial expression.”..

This statement is not appropriate for assessing pain in a non-verbal child using the FLACC Scale because it does not address the five behavioral indicators the scale measures.

The FLACC Scale assesses facial expression, leg movement, activity level, cry, and consolability.

Choice B rationale:

I will watch how you move your legs.”..

This statement is also not appropriate for using the FLACC Scale as it only focuses on one of the five behavioral indicators.

While leg movement is assessed, it's crucial to evaluate all indicators for a comprehensive pain assessment.

Choice C rationale:

I will note your activity level.”..

This statement is partially correct, as the FLACC Scale does assess activity level.

However, it does not cover all the indicators, and it's essential to mention the other components for a complete assessment.

Choice D rationale:

I will listen to your cry and observe your consolability.”..

This statement is the most appropriate choice.

The FLACC Scale rates five behavioral indicators, and this statement acknowledges two of them: cry and consolability.

A comprehensive assessment should include all five indicators for an accurate pain evaluation in non-verbal children.

Choice A rationale:

The FLACC Scale (Face, Legs, Activity, Cry, Consolability) is a pain assessment tool specifically designed for children who cannot effectively communicate their pain verbally.

It assesses various aspects, including facial expression, leg movement, activity, cry, and consolability.

It is particularly suitable for infants and young children who may not be able to describe their pain in words.

Choice B rationale:

The Wong-Baker FACES Pain Rating Scale is designed for children aged 3 years and older and is based on facial expressions to assess pain intensity.

While it is suitable for this age group, it may not be the most appropriate choice for a 4-year-old child who has just undergone surgery, as it may not accurately capture the child's pain experience.

Choice C rationale:

The Numeric Rating Scale (NRS) requires the child to assign a numerical value to their pain, typically on a scale from 0 to 10.

This may not be the most appropriate tool for a 4-year-old child, as they may have difficulty using numbers to describe their pain, especially immediately after surgery.

Choice D rationale:

The Visual Analog Scale (VAS) requires the child to mark their pain level on a line, which may also be challenging for a 4-year-old child.

This tool is typically used for older children and adults who can better understand and use a visual representation of pain.