Question

Which of the following factors should a nurse consider when managing the pain of a terminally ill child? Select all that apply.

A. Pain medications are given on an as-needed schedule, and extra doses for
breakthrough pain are available to maintain comfort.
B. Opioid drugs, such as morphine, are given for severe pain, and the dosage is
increased as necessary to maintain optimum pain relief.
C. Addiction is a factor in managing terminal pain in a child, and the nurse plays an
important role in educating parents that their child may become addicted.
D. Nurses often express concern that administering dosages of opioids that exceed those with which they are familiar will hasten the child's death; in the principle of
double effect.
E. In addition to pain medication, techniques such as music therapy, distraction, and guided imagery should be combined with medications to provide the child and
family strategies to control pain.

Answer 1

A nurse managing a terminally ill child's pain should administer medications regularly with allowances for breakthrough pain, use opioids like morphine and oxycodone as necessary, consider the ethical principle of double effect, and incorporate non-pharmacological interventions to improve comfort.

Step-by-step explanation:

When managing the pain of a terminally ill child, a nurse should consider several key factors:

• Pain medications should be administered on a regular schedule with additional doses for breakthrough pain to ensure ongoing comfort.
• Opioid drugs such as morphine, oxycodone, and codeine may be escalated in dosage to maintain optimum pain relief without undue concern for addiction in a terminal situation.
• The principle of double effect acknowledges that while opioids may hasten death in high doses, the primary intention is pain relief, and this ethical concern must be weighed against the imperative of alleviating suffering.
• Along with prescription medications, non-pharmacological interventions like music therapy and guided imagery can be valuable adjuncts to managing the child's pain and providing comfort both for the child and family.