Lecture 2.2 - Pain Management Flashcards
What is pain
Whatever and whenever the person experiencing pain says it is
What are the five dimensions of the pain process?
Sensory, physiological, affective, behavioural, cognitive
What is chronic pain?
Pain that persists 3+ months secondary to a chronic disorder or nerve damage after healing is complete.
What is intractable pain?
A pain state that is severe and has no cure
such as refractory angina
What is neuropathic pain?
Pain that is related to malfunctioning or damaged nervous tissue
What are the two kinds of nociceptive pain?
Nociceptive pain is directly related to tissue damage.
Somatic
–> skin, muscle, bone
Visceral
–> heart, bowel, organs
What is the difference between pain threshold and pain tolerance?
Pain threshold
–> process of recognizing defining, and responding to pain
Pain tolerance
–> Most pain level an individual can tolerate before taking actions
How is neuropathic pain usually described?
Usually described as burning, shooting, stabbing or electrical
Which medication are used to manage neuropathic pain?
Opioids, antiseizure meds, antidepressants
good combo is gabapentin and Celebrex
What does the V in pain assessment stand for?
Values
–> Stressors, spiritual pain
What is the goal of a pain assessment?
To describe the client’s sensory, affective, behavioural, cognitive, and sociocultural pain experience in order to implement pain management techniques or identity the client’s goal for therapy.
What is breakthrough pain?
Transient pain that is moderate or severe that occurs between doses of scheduled doses of analgesia.
Which analgesic is most likely to cause constipation?
Codeine
What is titration?
Use the smallest effective dose to provide effective pain releif.
What medications are used for conscious sedation?
Ketamine and midazolam d/t amnesiac and dissociative properties
What is the purpose of adjuvant analgesia?
Enhance effects of opioids, have analgesia effects of their own, counteracts adverse effects of other analgesics.
adjuvants should aim to cause a 20-60% decrease in opioid use
Why should IM analgesia be avoided?
Painful, damages tissues, slowly absorbed
What is meant by the suffix contin?
Long-acting
How many points on the NRS pain scale should be decreased by effective analgesia?
at least 2 point difference (30% decrease in pain levels)
How to evaluate effectiveness of analgesia?
–> Patient’s goals
–> pain rating (2 points)
–> Patient requests analgesia st onset of pain
–> Patient able to initiate own deep breathing and relaxation breathing in conjunction w analgesia
Reassess effects of pain interventions within ___ mins of administration and document effects.
30
When do we need to intervene for pain?
Pain score higher than 4 or unacceptable to the patient
Patient cannot do ADLs
Patient cannot mobilize/deep breath or cough d/t pain
