The nurse is caring for a pediatric client with end-stage leukemia who is on comfort care and is unresponsive. The child's parent asks, "How can you tell if my child is in pain?" Which of these would the nurse describe as signs of discomfort? Select all that apply.

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11ecbb05_cace_2263_b433_f92229fcc998_MD0009_00 The FLACC scale(face, legs, activity, cry, and consolability) can be used to assess pain in the child who is nonverbal. This includes assessment for: Facial grimacing Leg movement, tension, or bending up toward the chest Activity, including squirming, arching, jerking Crying or moaning Difficulty consoling or comforting the child The nurse will provide teaching on signs that should prompt the parent to administer as-needed pain medication to the child. (Option A) A child who is comfortable will usually have a neutral facial expression. A child in pain is likely to exhibit grimacing, frowning, or clenching of the jaw, based on the FLACC face assessment. (Option E) A child who is comfortable will be lying quietly. A child who is squirming and moving is more likely to be in pain, based on the FLACC activity assessment. Educational objective: It is difficult to assess for pain in the nonverbal client, particularly if the person is unresponsive at the end of life. The FLACC scale is an accurate method of assessing pain in the nonverbal child. This tool should be used to teach parents how to promote comfort for their nonverbal child.

The Nurse Is Caring for a Pediatric Client with End-Stage