A nurse is preparing to administer immunizations to a 3-month-old infant.
Which of the following is an appropriate action for the nurse to take to deliver atraumatic care?
A.
Provide a pacifier coated with an oral sucrose solution prior to the injections.
B.
Use a 20-gauge needle for the injections.
C.
Apply eutectic mixture of local anesthetics (EMLA) cream immediately before the injections.
D.
Inject the immunizations into the deltoid muscle.
The correct answer and Explanation is :
The correct answer is A. Provide a pacifier coated with an oral sucrose solution prior to the injections.
Explanation:
Administering immunizations to infants can cause pain and distress, so the concept of atraumatic care is used to minimize discomfort and emotional distress. Atraumatic care involves strategies that reduce pain, anxiety, and the physical and emotional trauma associated with medical procedures.
Option A: Using a pacifier with oral sucrose solution is a well-researched method to reduce pain in infants during procedures like immunizations. Sucrose activates endogenous opioid pathways in the infant’s brain, providing pain relief. Offering a pacifier, which also engages the natural soothing reflex of sucking, further calms the infant. This combination has been shown to be effective in reducing pain perception in infants.
Option B: A 20-gauge needle is too large for an infant’s immunization. For intramuscular injections in infants, smaller needles, like a 25-gauge needle, are typically recommended. A larger needle would not only cause more discomfort but might also increase the risk of tissue damage, which is not consistent with atraumatic care.
Option C: Eutectic mixture of local anesthetics (EMLA) cream requires about 1 hour for full effect. Applying it immediately before the injection would not provide adequate time for numbing to occur, so it would not contribute to atraumatic care in this scenario. EMLA can be useful if applied well in advance of a procedure.
Option D: The deltoid muscle is not appropriate for injections in a 3-month-old infant because it is not yet fully developed. The preferred site for intramuscular injections in infants is the vastus lateralis muscle (located in the thigh), which is larger and more developed in infants, reducing the risk of complications and making the injection less painful.
Therefore, providing a pacifier with sucrose is the best atraumatic care intervention in this scenario, as it effectively minimizes pain during the immunization process.