Comfort and Pain Management Part 1 Flashcards
What is pain?
an unpleasant sensory and experience associated with actual or potential tissue damage
What is important to remember about the concept of pain?
pain is whatever the person experiencing states it is
- PAIN IS SUBJECTIVE
bradykinin
a powerful vasodilator that increases capillary permeability and constricts smooth muscle
prostaglandins
important hormone like substances that send additional pain stimuli to the CNS
substance P
sensitizes receptors on nerves to feel pain and also increases the rate of firing of nerves
transduction
activation of pain receptors
transmission
conduction along pathways
perception of pain
awareness of the characteristics
ex. oich, knowing that you have pain
modulation
inhibition or modification of pain
pain threshold
minimum intensity of a stimulus that is perceived as painful
adaptation
the body adapts to painful stimuli when introduced slowly
neuromodulators
natural opioid compounds that reduce pain through binding opioid receptors in the CNS
endorphins, dynorphins, enkephalins
pain blocking chemicals that relieve pain
acute pain
- rapid onset
- varies in intensity (mild to severe)
- warns person of damage
- usually due to an injury or surgery
chronic pain
- lasts beyond the normal healing period
- interferes with ADLs
- typically lasts more than 6 months
- periods of remission or exacerbation occur
- pain can be mild or severe
- can cause depression, frustration, anger
location of pain
generalized or localized
cutaneous pain
- superficial
- localized
ex. papercut
somatic pain
- deep pain that is scattered or diffused
- generalized
- ligaments, tendons, nerves
- longer lasting
ex. sprain, arthritis, ligament tears
visceral pain
- originates in a body organ
- generalized
ex. GI infection, labor pain
referred pain
occurs in an area that is distant from original site
nociceptive pain
- most common
- aching pain
- receptors respond to mechanical, thermal, or chemical
- somatic and visceral
neuropathic pain
- nerve pain
- pain that is caused by lesions
- PNS/CNS injuries
- burning, numbness
- typically chronic
ex. PVD from diabetes with peripheral neuropathy
nociplastic pain
- pain that we do not understand, can’t be explained
- no cause
- CNS
ex. fibromyalgia
intractable pain
- pain that is chronic and highly resistant to pain relief
- have to use non pharmacological interventions a lot of the time
phantom pain
- without demonstrated physiologic or pathologic substance
ex. phantom limb pain
psychogenic pain
- physical cause for the pain cannot be identified
ex. pain resulting from a mental event
True or false: it is better to control pain without meds
false
True or false: it is better to deal with pain than side effects of the meds
true, depends on side effect
true or false: I will become addicted to pain meds
false, not always but it can happen depending on the med
true or false: wait until the pain is “bad” before asking for pain meds
false, you want to get ahead of the pain
true or false: it is normal to have severe pain after surgery
false
assessing pain
- pt’s self report in their own words
- report of family member or another person close to pt
- nonverbal behaviors: restlessness, grimacing, crying, clenching fistsm protecting the painful area
- physiologic measures: increased blood pressure and pulse
aggravating factors of pain
- what triggers pain
- what makes pain worse
alleviating factors of pain
what makes pain better
What factors of pain have an effect on activities and lifestyle?
- physical
- social
- mental
- overall quality of life
Behavioral responses to pain
- posture, gross motor
- facial features
- verbal expressions
physiologic responses to pain
- vital signs
- skin color
- perspiration
- pupil size
- nausea
- muscle tension
- anxiety
What is the most common pain scale that is used?
numeric: 0-10
Children in pain
- irritability and restlessness
- crying, screaming, or other verbal expression of pain
- grimacing, grinding of teeth, clenching fists
- touching or grabbing painful body part
- kicking, thrashing, attempting to move away from painful stimulus
Nursing interventions for pain
- establishing trusting nurse-patient relationship
- manipulating factors affecting pain experience
- initiating nonpharmacologic pain relief measures
- managing pharmacologic interactions
- complementary and alternative relief measures
- considering ethical and legal responsibility to relieve pain
- teaching patient about pain
