Pain Flashcards
Most reliable indicator of pain?
Always is the patients-self report
Role of the Nurse
- Ethical responsibility to relieve pain and the suffering it causes
- Provide individualized nursing interventions
- Improve pain management
- Multimodal and inter-professional approaches are necessary
- Informed by evidence
- Nurses most advocate for policies to assure access to all effective modalities
Types of Pain
Acute ( Short, severe )
Chronic ( Persistent, long term )
Nociceptive
Tissue pain
Somatic- C.T
Visceral- Organ
Neuropathic
Nerve malfunctions or is injured
Phantom Pain
Brain sends messages of pain, but it does not exist
Consequences of Untreated Pain
- Prolonged stress response
- Decreased GI motility
- Cardiovascular instability
- Metabolic imbalance
Individual Risk Factors for Pain
- Many OLDER adults have chronic pain
- Physiological changes/ aging affect perception and expression of pain
- Drug interaction: More/ Different medications
Barriers to Pain Management
-Inadequate knowledge of healthcare providers
- Fear of pain meds
- Noncompliance
- Financial barriers
Elements of Pain Assessment
Patients self report of pain!
- Location
- Intensity
- Quality
- Onset
- Alleviating factors
- Effect of pain
- Comfort status
Pain Quality
Stabbing, burning, itchy, cramping, aching, tender, numb, throbbing etc
Behavioral Signs of Pain
- Facial expressions
- Change in activity
- Assessment tools
- Restlessness
- Crying ( In children )
PQRSTU
- Provoking and relieving factors
- Quality of pain
- Region or radiation
- Severity / Intesnity
- Time: Onset, duration, frequency
- Understanding: Effects, meanings, symptoms
How does the nurse assess for breakthrough pain?
Meds, pain level, vitals
How does the nurse conduct a pain reassessment?
Ask them!
What are common challenges with pain assessment?
Subjective, pain tolerance, talking barrier
Pain Across Lifespan: Infants
- Unable to articulate pain
- Display behavioral responses
- Physiologic Responses: Decrease in growth and development, decreased immune, decreased appetite, increased sensitivity ( through past expierneces )
Infants
FLACC Scale
Toddlers
FLACC Scale, faces pain scale
Children
Faces pain scale, numeric pain scale
FLACC Scale
If client is nonverbal, or unable to complete faces pain scale
Elderly:
Older adults that are unable to articulate pain-
- PAINAD: Dementia
- Like FLACC patients ^
Pharm Interventions
Adjuvants, NSAIDS, Tylenol, Weak opioids, strong opioids
Non Pham Interventions
- Massage
- Acupuncture
- Thermal ( Heat and Cold )
WHO Pain Ladder
Pain starting slow, gradually increasing
1. Pain persisting
2. Opioid for mild to moderate pain
3. Freedom from cancer pain ( opioid from severe pain )
Chronic Osteoarthritis Pain
-Diagnosis: X ray, blood tests
-Interventions: Mobility management, pain mangement
-Surgical Interventions: Severe pain, immobility
Surgical Pain ( Acute )
Before Surgery: Assess
- Pain level
- Medications
- Risk factors
- Teach ab post op pain ( what to expect )
After Surgery:
- Reassess pain level
- Prioritize comfort
- Encourage early mobilizations
Post Op Pain
Oral: Pills
Transdermal: Fentanyl patch
Patient Controlled Analgesia: PCA Pump
Nerve Block: For chronic pain
- Must check RR before administering opioids
Wrong Baker Faces
Used for children
Or Numeric
