A 6-year-old child in the pediatric ward has had a minor laceration sutured on the forearm. Vital signs are within normal limits but the child is quiet. withdrawn, and refuses to play. The nurse suspects pain. What action should the nurse take FIRST?

A. The first action when a child shows behavioral signs of pain, such as being quiet, withdrawn, or refusing to play, is to assess pain accurately using a tool suited to the child’s age and developmental level. For a 6-year-old, tools like the Faces Pain Scale–Revised (FPS-R) or Oucher Pain Scale are appropriate. Accurate assessment is essential to guide appropriate pain management interventions and ensure the child’s comfort. B. Vital signs may not always reflect pain, especially in children. Behavioral and psychological cues are often more sensitive indicators of pain than vital signs in pediatric patients. Assuming the child is fine could lead to undertreatment of pain. C. While offering food or drink may provide comfort, it does not address the underlying pain. Without assessment, the nurse cannot determine if the child’s withdrawal is due to pain or another cause. This is not the first or priority action. D. Relying on self-report alone may delay pain recognition and treatment, particularly if the child is quiet, withdrawn, or fearful. Children often do not verbalize pain immediately, so proactive assessment is crucial.