Chapter 10: nursing care of patient in pain Flashcards
pain
“an unpleasant sensory and emotional experience associated w/ actual or potential tissue damage or described in terms of such damage”
types of pain
acute vs chronic
acute pain
- lasts < 3 months
- prompts an inflammatory response
- signs and symptoms are short term, objective, physical. ex: increased heart rate
chronic pain
- lasts more than 3 months
- signs and symptoms persistent
risks of uncontrolled pain
- body produces a stress response that causes harmful substances to be released from injured tissues
reactions to uncontrolled pain
- breakdown of tissue
- increased metabolic rate
- impaired immune function
- negative emotions
*** prevents patient from participating in self-care activities
cultural considerations of pain
- language
- family engagement
- spirituality
- treatment preferences
- assess each patient’s pain experience
- remember ethical principles
who is responsible for pain management?
- pt is center of health care team
- entire health care team is responsible for pain management
- regulatory bodies review pain management practices
- the joint commission
- centers for medicare and medicaid services
- agency for healthcare research and quality
opioid addiction
- tolerance
- physical dependence
- addiction/psychological dependence
- pseudoaddiction
pain transmission
- transduction
- transmission
- perception
- modulation
neurotransmitters
- prostaglandins
- bradykin
- serotonin
- substance P
- endorphins —> enkephalins
mechanisms of pain transmission
nociceptive pain
neuropathic pain
nociceptive pain
tissue damage
neuropathic pain
nerve damage
pain treatment
- opioid
- nonopioid
- adjuvant
- opioid antagonists
- other treatments
placebos
- administered inactive substitutes for analgesics
- not justified in the treatment of pain
analgesic routes
- oral
- rectal
- inhalation
- transdermal
- intramuscular
- IV —> pt controlled analgesia (PCA)
- intraspinal
cognitive behavioral nonpharmacological therapies
- education
- relaxation
- imagery
- distraction
- biofeedback
physical agents for nonpharmacological therapies
- heat
- cold
- massage/vibrations
exercise - immobilization
- transcutaneous electrical nerve stimulation (TENS)
pain assessment: WHAT’S UP?
W - where is the pain?
H - how does the pain feel?
A - aggravating and alleviating factors?
T - timing
S - severity ( on 0-10 scale)
U - useful other data
P - patient’s perception
patient education
- drug effects
- adverse effects
- dose frequency and duration
- interactions
- safety
- special considerations
