Pediatric Lupus - Pain Management

  1. I am in my pediatric rotation in nursing school. This week I had an adolescent pt with lupus and HTN. She was in a lot of pain, which we were unable to control. I gave IV Dilaudid and Phenergan. What better pain meds have you seen being given in these cases? Also, this patient was receiving oral contraceptives. I am curious if this has anything to do with lupus or if it is a choice for true contraception and/or to regulate periods.

    Thanks for any help!
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    About BBQvegan

    Joined: Jan '06; Posts: 184; Likes: 56
    Oncology RN
    Specialty: Medical-Oncology


  3. by   NotReady4PrimeTime
    We had a critically ill lupus patinet in our unit for several months last year. We used Dilaudid for him and when that failed we used methadone. Does your hospital have an acute pain service? We use their services a lot for patients like this. If the pain is chronic, the people from palliative care might have some suggestions.

    The OCs were probably to regulate and minimize her periods. But if she's receiving chemotherapy for her lupus, she would need to be on OCs to ensure there's no risk of pregnancy. Let's be real here... kids are sexually active and things happen.
  4. by   BBQvegan
    No, we don't have an acute pain service. In fact, the hospitalist was communicating with a specialist out of town to plan better pain management. And no, she was not receiving chemo. It may be that she is having a relapse, and a new plan of tx will be needed.

    Thanks again for your help!