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Terms in this set (63)

Adolescents: be respectful, be honest, stay in character, show an interest, explain the process of the interview and exam, keep questions short and simple, avoid reflection, tackle tougher questions later on, reassure everything is confidential, use positive reinforcement
Older Adults
Use proper surname, i.e. "Mrs. Johnson"
Avoid "elderspeak"
Allow for ample time; older adults may take longer to form answers, and also have much more to tell!
Do not shout: demeaning and actually distorts sound thru hearing aids
Touch can be a great nonverbal skill to use
Different cultures/cultural competence:
Know your own culture first
Consider patient's culture, ethnicity, heritage, immigration status, language barriers, religious status, beliefs as related to health and healing, sexual orientation, gender identity
NEVER ASSUME
Be respectful of cultural views on personal space, eye contact, use proper names and titles
Seek help of professional interpreter
Be sure to address patient, not the interpreter
If a family member must be used as an interpreter, refrain from using medical jargon and note that more personal questions may be harder for them to address
When interpreter is not available: Vocal cues (and silence), action cues (posture, facial expression, gestures),object cues (clothing, jewelry, hairstyle),use of personal and territorial space (belongings),touch (personal space)

Special needs: hearing-imparied, cognitive/developmentally-delayed acutely ill, under influence of street drugs or alcohol (use simple, direct questions), sexually aggressive people (ZERO tolerance), anger (don't personalize this), crying (be supportive), threats of violence (ALWAYS have easy access to the door)
Overall pain assessment tool
Chronic pain conditions or particularly problematic acute pain problems

Initial Pain Assessment
Ask the patient to answer 8 questions regarding location, duration, quality, intensity, and aggravating/relieving factors

Brief Pain Inventory
Ask the patient to rate the pain within the past 24 hours using graduated scales (0-10) → mood, walking ability, sleep

McGill Pain Questionnaire
Rank a list of descriptors in terms of their intensity and to give an overall intensity rating to his or her pain

Wong-Baker Faces
6 drawings of faces that show pain intensity from "no pain" to "very much pain"
Used for children
Avoids smiles or tears so that children will not associate pain with happiness or sadness

Beyer Oucher pain scale
Developed for children to help them communicate how much pain they feel
Uses faces on a scale from 0-100 with 6 photographs of children in pain

FLACC scale (0-2)
0 = normal, 2= pain
Nonverbal assessment for infant and toddlers (under 3)
Assesses: facial expression, leg movement, activity level, cry, and consolability

COMFORT scale (1-5)
Used to assess pain in critically ill pediatric patients
Relies on 6 behavioral and two physiologic factors
Alertness, calmness, respiratory distress, crying, physical movement, muscle tone, facial tension, blood pressure baseline, heart rate baseline



CRIES pain scale (0-2)
0=normal, 2= irregular behavior
Assess postoperative pain in preterm and term neonates by measuring physiologic and behavioral indicators on a 3 point scale
Assess: crying, sleepless, expression, vital signs, requires O2 for sat >95%