Module 2-e Flashcards
Pain Experience
defense mechanism, indicates a problem, subjective symptoms. Pain is always subjective.
Sources of Pain- Cutaneous pain
superficial, skin or subcutaneous tissue (top part of the skin- paper cut)
Sources of Pain- Deep Somatic pain
diffuse or scattered, tendons, bones and nerves (sprains)
Sources of Pain- Visceral pain
body organs, poorly localized, referred. (thorax, abdomen, cranium- guarding)
Referred Pain
perceived in area distant to the point of origin (MI pain refers to the jaw, shoulder, and arm)
Duration of pain- Acute
rapid onset, varies in intensity, up to 6 months in duration, protective in nature, disappears when the cause is resolved.
Duration of pain- Chronic
greater then 6 months, limited, persistent, intermittent, poorly localized, periods of remission or exacerbation, intractable. Pain is usually resistent to therapy. (cancer patients)
Common responses to pain- Behavioral
Voluntary- “hot stove” pull away, guarding.
Common responses to pain- Physiological
Involuntary- Sympathetic (fight or flight) /Parasympathetic ( Pulse and resp decrease due to deep, severe pain)
Common responses to pain- Affective
Psychological- past experiences, culture
Gate control therapy
Transmission of painful stimuli. Relationship b/t pain and emotions .Cns processes limited amounts of sensory info. Brain can influence gating mechanism. Pain interpreted individually. (Threshold- 1st inro to pain) Small fibers- transmitted w/ painful stimuli, LG fibers- block painful stimuli (gate closed)
Factors that affect pain- Culture/Ethnicity
Influence response, coping, sterotyping- (crying/not crying)
Factors that affect pain- Family,Gender,age)
Children- pain gets attention
Factors that affect pain- Religion
Pain is purification, or punishment
Factors that affect pain- Enviromentt/ Support people
Support, healthcare compounds pain issues
Factors that affect pain- Anxiety and other stressors
Threat and pain aggrivates
Factors that affect pain- Past pain experience
Influences future pain feelings
Pain Assessment
Verbalization and description, duration, location and quality/intensity. Always assess prior to med administration. Effect on ADL’s. Physiological indicators.
Barriers to Pain Assessment
Misunderstandin pain orders (PRN-ATC), fear of addiction (lack of knowledge/ past Hx of) Complaining is immature, Waiting until the pain is too severe. I don’t want to bother anyone. Havinf pain after surgery is natural.
Barriers to Pain Assessment- Cognitively impaired
unable to report, use intuition, vitals, diaphoresis
Pain Assessment- Children
Wong/Baker Scale (smiley faces) Facial expressions, irritabilty and restlessness, move away from painful stimuli.
Pain Assessment Older adults
Chronic disease, assessment more difficult, expectations of pain, Ominous signs. Comorbidities. Peripheral Neuropathy (diabetics)
Pain Control- Nonpharmacologic (Distraction)
adjunct to med administration (in conjunction with)
Pain Control- Nonpharmacologic (Humor)
w/ tactfulness
Pain Control- Nonpharmacologic (Music)
more so w/ infants
Pain Control- Nonpharmacologic (Imagery)
guided imagery
Pain Control- Nonpharmacologic (Relaxation)
breathing techniques
Pain Control- Nonpharmacologic (Cutaneous stimulation)
gate control method- acupuncture
Pain Control- Nonpharmacologic (Biofeedback)
teaching aparatus
Pain Control- Nonpharmacologic (Hypnosis)
not science based
Drugs for Pain Relief- Analgesics
3 Classes- NSAID’s, Opiods/Narcotics, Adjuvant
NSAID’s
Advil, Motrin (antiinflamatory) knee pain. Reduction of swelling. ASA- headache
Opiods/Narcotics
Morphine, Codeine- resp depression, constipation, and addiction
Adjuvant
Antideppresant, anticonculsant, corticosteroids
General Principles for analgesic administration
Various measures, use before pain increases, past experiences, open minded, persistent, safe, ongoing assessments, timing (PRN, ATC, PCA)
Placebo
Inactive substance (sugar pill/saline flush) in replacement of Narc’s. Deceptive and destroy trust.
