Pain Flashcards
Pain; definition
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
Different definitions of pain
-Whatever and wherever the person experiencing pain says it is.
-Unpleasant sensory and emotional experience associated with actual or potential tissue damage.
-Multidimensional and entirely subjective.
-Pain can be experienced in the absence of identifiable tissue damage.
-Pain is not synonymous with suffering.
-Pain is subjective - it is entirely the clients experience and self report is essential.
Pain
-A major problem that causes suffering and reduces quality of life.
-One major reason why people seek health care.
-Nurses have a central role in assessment and management of pain.
-Effective pain relief is a basic human right.
Pain Management; an individuals rights
-Their pain to be acknowledged and expected.
-The best possible personalized evidence-based pain assessment and management including relevant bio-psychosocial components.
-Ongoing information and education about the assessment and management of pain.
-Involvement as an active participant in their own care in collaboration with the inter professional team.
-Communication and documentation among interprofessional team members involved in their care to monitor and manage their pain.
Nursing intervention; pain
-Assess pain, document it, and communicate with other health care providers.
-Ensure delivery of adequate pain relief measures.
-Evaluate effectiveness of interventions.
-Monitor ongoing effectiveness of pain management strategies.
-Provide education to clients and their families.
Consequences of untreated pain…
-Unnecessary suffering.
-Physical and psychosocial dysfunction.
-Impaired recovery from acute illness and surgery.
-Immuno-Suppression
-Sleep disturbances
Dimensions of pain
-Physiological
-Sensory-Discriminative
-Motivational-affective
-Cognitive-evaluative
-Sociocultural
Causes and types of pain; by underlying pathology
Nociceptive
-Somatic
-Visceral
Neuropathic
Causes and types of pain; by duration
-Acute
-Persistent
Acute pain
-Sudden onset
-Usually within the normal time for healing
-Mild to severe
-In general, a precipitating illness or event can be identified
-Lowers over time and goes away as recovery occurs
-Manifestations reflect sympathetic nervous system activation:
•Increased HR
•Increased RR
•Increased BP
•Diaphoresis, Pallor
•Anxiety, agitation, confusion
NOTE: responses normalize quickly owing to adaptation
-Goal is pain control with eventual elimination.
Persistent Pain
-Gradual or sudden
-May start as acute injury but continues past the normal time for healing to occur
-Mild to severe
-cause may not be known; original cause of pain may differ from mechanisms that maintain the pain
-Typically, pain persists and may be ongoing, episodic, or both -predominantly behavioural manifestations:
•Changes in affect
•Decrease in physical movement and activity
•Fatigue
•Withdraw from other people and social interaction
-Goal is minimizing pain to the extent possible; focusing on enhancing function and quality of life
Nursing assessment of pain
Assess for the presence or risk of pain
•on initial assessment and all subsequent assessments
• Each time vital signs are completed
•Prior to, during and after a procedure
•Prior to and following using pharmacological and non-pharmacological treatment for pain
Assessment: the patients pain goal or expectations of comfort and pain relief
Characteristics: intensity, timing, location, quality
Aggravating or reliving factors
Behaviours associated with the pain
Assesment
-PQRST
-Wong-baker FACES pain rating scale
Pain assessment; components
-Effects of pain on clients sleep and daily activities, relationships, physical activity, and emotional well-being should be assessed.
-Past pain experiences, meaning of pain for the client, ways client expresses the pain, and clients pain-Control strategies should all be included.
Pain Treatment: basic principles
-Routine assessment is essential for effective management
-Unrelieved acute pain complicates recovery
-Clients self-report of pain should be used whenever possible
-Health providers have a responsibility to assess pain routinely, to accept clients pain reports, to document them, and to intervene in order to manage pain.
-The best approach to pain management involves clients, families, and health providers.