Question

The Neonatal Infant Pain Scale (NIPS) is a tool used to assess newborn pain. List 6 assessment indicators that reflect pain response.

1. __________________________________
2. __________________________________
3. __________________________________
4. __________________________________
5. __________________________________
6. ­­­­­­­­­­­­­­­­­­­­­­­­­­­­__________________________________

Define when an APGAR score is completed: ___________________________

Answer 1

SOLUTION

• The Neonatal Infant Pain Scale (NIPS), is a tool which is used to measure pain in neonates and infants.This tool uses mainly uses behavioural responses of babies to assess the pain level and thus helps to take suitable medical and nursing interventions.
• It includes 6 assessment indicators, they are FACIAL EXPRESSION CRY BREATHING PATTERNS ARMS LEGS STATE OF AROUSAL

EXPLANATION:

• HOW TO SCORE THE INDICATORS?
• FACIAL EXPRESSION:
• Relaxed facial muscles-0 (The baby shows restful face with neutral and normal facial expressions)
• Tightened facial muscles-1( The baby shows grimace facial expression)
• CRY
• Not crying--0 (The baby is quiet and do not cry)
• Mild cry-1 (The baby neither cries a lot nor cries a little but cries mildly like moaning)
• Severe cry-2(The baby expresses continuous loud scream)
• BREATHING PATTERNS
• Normal pattern-0( The baby breathes normally without any ease)
• Change in breathing pattern -1(Irregular breathing which may be faster than usual breathing pattern ,also associated with chest indrawing)
• ARMS
• Relaxed arms-0(The baby does normal movements of arms)
• Tensed arms-1(The baby may rapidly extend or flex the arms)
• LEGS
• Relaxed legs-0(The baby does normal movements of legs)
• Tensed legs-1 The baby may suddenly flex or extend the legs
• STATE OF AROUSAL
• Sleeping/Awake-0(The baby may be sleeping peacefully or alert doing some normal limb movements)
• Fussy-1 (The baby may be alert but look restless)
• FINAL SCORING
• TOTAL SCORE IS 7
• If the score is 0-2=it s considered as no pain or mild pain and probably the baby needs no nursing or medical interventions for pain
• If the score is 3-4= it is considered as mild to moderate pain and the baby may need some nursing interventions like feeding,changing the diaper and changing the position to more comfortable.
• If the score is more than 4=it is considered as severe pain and the baby compulsurily needs interventions like kangaroo mother care,feeding, and possibly pharmacological measures .The baby must be reassed for every 30 minutes until reduction in pain is noted.
• APGAR SCORING
• This is the initial assessment of the neonate done at first and fifth minute of birth.
• This is mainly used to assess the respiratory,circulatory and neurological status of the neonate.
• Usually the neonates have lower score at first minute than the score at fifth minute due to the presence of depression immediately after birth normally.    A-APPEARANCE
• Blue,pale-0
• Body pink.limbs blue-1
• Completely pink-2
• P-PULSE RATE
• Absent-0
• Below 100 beats per minute-1
• Above 100beats per minute-2
• G-GRIMACE/REFLEX
• No response-0
• Grimace present-1
• Cry present-2
• A-ACTIVITY
• Flaccid muscle tone-0
• Some flexion of extremities-1
• Active body movements-2
• R-RESPIRATION
• Absent-0
• Irregular and slow-1
• Regular and normal-2
• FINAL SCORING:
• TOATAL SCORE IS 10
• The score of 7-10 indicates good condition of the baby.
• The score of 4-6 indicates mild depression of the baby
• The score of 0-3 indicates severe depression of the baby.
• (If you have any doubts and clarifications,please do comment,Thank you)