Module 1: Pain Flashcards
definition of pain
- unpleasant sensory and emotional experience associated with actual or potential tissue damage
- whatever the person says it is (subjective)
- not synonymous with suffering
consequences of pain
- unnecessary suffering
- physical and psychosocial dysfunction
- impaired recovery from acute illness and surgery
- immunosuppression
- sleep disturbances
definition of suffering
a state of distress associated with events that threaten the intactness of a person
why is pain undertreated
- inadequate skills to assess and treat pain
- misconceptions about pain
- inaccurate information about addiction and other side effects of opioids
- fear of hastening death
- patients underreporting pain
why is pain underreported
- fear of addiction, tolerance, side effects
- belief that pain is inevitable
- expectation that drugs will not relieve pain
- desire to be a “good” patient and not complain
dimensions of pain
- physiological
- sensory → discriminative
- motivational → affective
- cognitive → evaluative
perception of pain
occurs when pain is recognized, defined, and responded to
modulation of pain
activation of descending pathways that exert inhibitory or facilitatory effects on the transmission of pain
dimensions of pain: sensory - discriminative
- the recognition of the sensation as painful
- sensory-pain elements include pattern, area, intensity, and nature
dimensions of pain: motivational - affective
- emotional response to pain experience:
- anger
- fear
- depression
- anxiety
dimensions of pain: behavioural
- observable actions used to express or control the pain
- facial expressions
- posturing
- adjusting social and physical activities
dimensions of pain: cognitive - evaluative
beliefs, attitudes, memories, and meaning attributed to pain
dimensions of pain: sociocultural
demographics, support systems, social roles, past pain experiences, and culture
nociceptive pain
damage to the somatic or visceral tissue
somatic tissue pain
- aching or throbbing
- localized
- arises from bone, joint, muscle, skin, or connective tissue
visceral tissue
- tumor involvement or obstruction
- arises from internal organs
neuropathic pain
- damage to the peripheral nerve or central nervous system
- burning, shooting, stabbing, or electrical in nature
- sudden, intense, short-lived, or lingering
neuropathic pain: peripherally generated
- painful peripheral neuropathies
- felt along many nerves
- painful peripheral monopathies
- one nerve
acute pain
temporarily related to injury, resolves after appropriate healing time
persistent (chronic) pain
outlasts “usual” healing process
incidental pain definition
pain that is caused by a healthcare worker in the clinical setting
incidental pain examples
- transfers, ambulation
- bathing
- changing clothes
- dressing changes
goals for pain assessment
to describe the patient’s sensory, affective, behavioural, cognitive, and sociocultural pain experience (in that order
OPQRSTUV
- onset
- provoking
- quality
- region/radiation
- severity
- timing/treatment
- understanding/impact on you
- values
PAIN acronym
- pattern: onset, duration, breakthrough pain
- area: locations assists in identifying the cause and treatment
- intensity: reliably measure to determine treatment
- nature: quality or characteristics of the pain
breakthrough pain
a sudden severe pain that erupts while a patient is medicated, usually happens quickly
neuropathic qualities of pain
- burning, cold, shooting, stabbing, or itcy
nociceptive pain qualities
sharp, aching, throbbing, and cramping
scheduling analgesics
used for patients with chronic pain that require constant pain meds rather than PRNs
considerations for putting patients on opioids
do not give to patients that are experiencing nausea/vomiting, sedation, and constipation
tolerance
when the pts body gets used to the medications being administered, and overtime different opioids or higher dosages are required for the drugs to take effecg
psychological dependence
the idea from a patient that they are required to take medications in order to function properly
physical dependence
when the patient experiences unpleasant physical symptoms of withdrawal when taken off the medication
opioid filtration
essential that doses be titrated up to effect and down as cause of pain diminishes
opioids rotation
opioids switched if adverse reactions or not effective
opioid toxicity
- caused by the neuro-excitatory activity of opioids or their metabolites
- symptoms include:
- confusion
- myoclonus (a quick and involuntary muscle jerk)
- paradoxical pain (abnormal pain)
- hyperalgesia (extreme sensitivity to pain)
- allodynia (extreme sensitivity to tough)
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