Pain Evaluation Tool for use during Newborn Circumcision, Page 4

Hello, I am Debra Neiman, RN BSN.

I have worked in Neonatal Care, at Beauregard Memorial Hospital, DeRidder for over four years. My college experience at Louisiana State University at Alexandria, resulted in a great deal of research papers, which are gathering dust in my office. My curriculum at Northwestern State University also added to this wealth of information.

I hereby begin this series to provide a way to get this information to those in the nursing field and any other person with a passing interest in these subjects.

Feel free to reference or use this information in your practice. However,Please respect my Copyright and do not "BORROW" for your HOMEWORK assignments.

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Pain Evaluation Tool
For Use During
Newborn Circumcision
APPENDIX A

Debra Neiman, RN, BSN, Spring 1995

Prepared as Research Proposal
for Nursing Professional Transition Seminar

Northwestern State University

INDEX:

CHAPTER ONE - INTRODUCTION

CHAPTER TWO - LITERATURE REVIEW

CHAPTER THREE - METHODOLOGY

REFERENCES

APPENDICES:

Postoperative Comfort Scale

BEHAVIOR	0 Poor	1 Mediocre	2 Satisfactory
1. Sleep during preceeding hour - None . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - Short naps between 5 and 10 minutes . . . . . . . . . . . . . . - Longer naps > 10 minutes . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Facial expression of pain - Marked, constant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - Less marked, intermittent . . . . . . . . . . . . . . . . . . . . . . - Calm, relaxed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Quality of cry - Screaming, painful, high-pitched. . . . . . . . . . . . . . . . . . - Modulated (can be distracted by normal sound). . . . . . . - No cry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Spontaneous motor activity - Thrashing around, incessant agitation . . . . . . . . . . . . . . - Moderate agitation . . . . . . . . . . . . . . . . . . . . . . . . . . . - Normal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
5. Spontaneous excitability, responsiveness to ambient stimulation - Tremulous, clonic movements, spont. Moro reflexes . . . - Excessive reactivity . . . . . . . . . . . . . . . . . . . . . . . . . . - Quiet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
6. Flexion of fingers and toes - Very pronounced, marked & constant . . . . . . . . . . . . . - Less marked, intermittent . . . . . . . . . . . . . . . . . . . . . . - Absent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
7. Sucking - Absent or disorganized sucking . . . . . . . . . . . . . . . . . . - Intermittent(3 or 4)& stops with crying . . . . . . . . . . . . . - Strong, rhythmic with pacifying effect . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
8. Global evaluation of tone - Strong hypertonicity . . . . . . . . . . . . . . . . . . . . . . . . . . - Moderate hypertonicity . . . . . . . . . . . . . . . . . . . . . . . . - Normal for age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Consolability - None after two minutes . . . . . . . . . . . . . . . . . . . . . . . - Quiet after one minute of effort . . . . . . . . . . . . . . . . . . - Calm before one minute . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
10. Sociability (eye contact) response to voice, smile, real interest in face - Absent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - Difficult to obtain . . . . . . . . . . . . . . . . . . . . . . . . . . . . - Easy and prolonged . . . . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .
TOTAL SCORE (a total score of 15-20 indicates adequate pain management)	. . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . . . . . . . . . . . . . . . .

Adapted from:
Attia, J., Amiet-Tison, C., Mayer, M., Shnider, S., & Barrier, G. (1987). Measurement of postoperative pain and narcotic administration in infants using a new clinical scoring system. Anesthesiology, 67, A532.