Lesson 2.2 - Pain Assessment Flashcards
Empathy
-put yourself in the patients shoes
-you can’t feel their pain directly but that doesn’t mean it isn’t there
Communication
-communicate with your patients
-builds trust
-ie. I will be back in .5 hour to give your meds (and actually do it!)
Advocacy
-if the patient says they are in pain, they actually are in pain
Presence + Compassion
-show understanding and be authentic
-don’t mock the patient
Providing Comfort
-attend to physical, emotional, social, spiritual needs with compassion and authenticity
-can be just sitting quietly with patient
Pain Interventions
-various
-medication
-comfortable position
-hot/cold compress
-movement
Nausea and Vomiting Interventions
-medications
-hydration
-cool cloth
Itching Interventions
-medications
-heat/cold
-lotions
Constipation Interventions
-nutrition
-hydration
-ambulation
-medications
Pain is Subjective
-it is whatever the person says it is
-it occurs when the person says it does
Physiology of Pain
-brain perceives pain consciously
-everyone perceives pain differently due to natural opiate release
-sensory impulse leads to the release of an action potential (electrical message) and then neurotransmitter release (chemical message) in the synapse
Sympathetic Nervous System
-fight & flight
-increased respirations, HR, BP, blood glucose
-diaphoresis
-muscle tension
-dilated pupils
-nausea
-vomiting
Parasympathetic Nervous System
-rest & digest
-pallor
-muscle tension
-decreased HR, BP
-rapid, irregular breathing
-weakness
-exhaustion
Common Behavioural Responses to Pain
-non-verbals (groaning, guarding, crying)
-physical and emotional exhaustion
-anxiety, fear
-depression, hopelessness
-irritability, anger
-fatigue, trouble sleeping
Why is relieving pain important?
-allows them to focus on things that will help (ie. mobility, eating) them heal instead of the pain they feel
Older Adult (Under-reporting pain)
-may think pain is a normal part of aging
Stoic Individual (Under-reporting pain)
-society respects those who suffer in silence
Uninformed Person (Under-reporting pain)
-may not know to ask for pain meds
Marginalized Individual (Under-reporting pain)
-don’t want to be stigmatized
Misconceptions (Under-reporting pain)
-some think pain medications will lead to addictions
Acute Pain
-identifiable cause
-predictable ending
-short duration
-pain stops with healing
-quick onset
-usually measurable/describable
-usually responds to analgesics
-dissipates once healing occurs
Chronic Pain
-persistent or intermittent
-may not have identifiable cause
-long term
-can result from acute pain
-vague symptoms
-may be difficult to manage
Breakthrough Pain
-pain breaks through medication that is controlling the pain
-need to advocate for dosage adjustment
Cancer Pain
-acute or chronic
-due to disease or treatment
Children & Pain
-difficulty expressing pain
-ask parents about words child usually uses to describe pain
-infants and young toddlers show behavioural responses to pain
Older Adults & Pain
-interpreting pain can be complicated by presence of multiple diseases
-confusion may complicate ability to recall details of pain
-ADLs, mobility, social activities may be reduced from pain
Pain Assessment (Subjective)
PQRSTU
Provokes
-what makes the pain worse or better?
Quality
-what does the pain feel like?
Radiates
-does the pain radiate?
-which region does it radiate to?
Severity
-on a scale of 1-10 how would you rate the pain?
Timing
-when did the pain start and how long does it last?
Understanding
-what do they think is causing the pain?
Values
-what do you want to get your pain level to so you can…?
Other Assessment Considerations
-physical causes
-behavioural effects
-nonverbals
-ADLs
-communication barriers
-alterations in perception
-culture
-spirituality
Non-pharmacological Interventions
-bed linens
-temperature
-patient positioning
-changing wet clothes and dressings
-preventing urinary retention and constipation
-distraction
-music
-acupuncture
-massage
-TENS
NSAIDS
non-steroidal anti-inflammatory drugs
