module 3: pain management Flashcards
nursing assessment of pain?
- pain is whatever the patient says it is
- important to be alert to patients who deny pain when pain would be expected
- includes determining level of pain relief the acutely ill patient believes is needed to recover quickly or improves function
pain behaviours?
-nonverbal and behaviour expressions of pain are not consistent or reliable indicators of the quality or intensity of pain and they should not be used t determine the presence of or severity of a pain
in unconscious patients pain?
should be assumed to be present and treated
is it wise to make judgements and formulate treatment plans based on behaviours that may or may not mean pain?
no!
physiologic responses to pain include?
- tachycardia
- hypertension
- tachypnea
- pallor
- diaphoresis
- mydrasis
- hypervigilance
- increased muscle tone
instruments for assessing perception of pain?
- only patient can accurately describe or assess his or her pain
- visual analogue scales and other intensity scaes
- faces pain scale
instruments for assessing pain in patients with disabilities
- blind you can use braille
- deaf you can use interpreters
identifying goals for pain management?
- shared and validated with patient
- consider: severity of pain, anticipated harmful effects of pain, anticipated duration of pain
- most successful: pharmacological and nonpharmacological means
barriers to pain management?
- lack of education
- addiction fears
- confusion
- 6 breaths per minute is adequate
goal of pain management?
relieving pain
pharmacologic interventions of pain? (premed assessment)
close collaboration with HC providers
- allergies
- med history
- ethic
massages for pain?
-gate control of pain proposes that stimulation of fibers that transmit nonpainful sensation can block or decrease transmission of pain impulse
thermal therapies?
cold ice to injury immediately (only 15-20 mins at a time, avoid if bad circulation)
heat to increase blood flow- speed healing
transcutaneous electrical nerve stimulation?
battery operated unit applied to skin: tingling, buzzing sensation acute and chronic pain
distraction?
doesnt work for all pt, especially not severe
relaxation techniques?
almost all pains benefit, abdominal breathing
music therapy?
causes patients to have less pain and need less meds even after it stops
what are neurologic and neurosurgical approaches to pain management?
- when usual methods are ineffective, these may be considered
- stimulation procedures and interruption of pain pathways
what are stimulation procedures
intermittent electrical stimulation of a tract or center to inhibit pain impulse
- blocks painful stimuli
- TENS and dorsal spinal cord stimulation are most common
interruption of pain pathways?
destructive procedures only used after other methods have failed
- can be interrupted at any point from origin to cerebral cortex
- some part of NS is purposely destroyed, usually near end of life
cordotomy?
-division of certain tracts of spinal cord
rhizotomy?
- sensory roots are destroyed where they enter the spinal cord
- mild sensory deficits and mild weakness
what does a successful pain control plan include?
- establishing pain diagnosis
- treating cause of pain when possible
- optimizing analgesic use
- if needed, considering non-pharmacological interventions
60-90% of patients with advanced cancer experience moderate to severe pain and..
over 40% receive inadequate treatment, leading to suffering
each persons suffering is a?
unique experience
