Pain Flashcards
nociceptive pain
injury or inflammation
4 processes:
- transduction
- transmission
- perception
- modulation
usually localized, constant, aching or throbbing quality
ex:
- fracture
- burns
- tumors
- obstructions
neuropathic pain
injury or malfunction within the CNS or PNS
associated with:
- disease process sequela (diabetic neuropathy, inflammation around nerves -post-herpes neuralgia – viruses)
- burning, lancinating, or electric shock qualities
Negative Consequences of Pain for Older Adults
– physical
- lowered functional ability
- lowered ADLs
- lowered immune response
- nausea
- insomnia
- anorexia
Negative Consequences of Pain for Older Adults
– psychosocial
- isolation
- relationship stress
- inability to work or do normal activities
- loss of self esteem
- increased care-giver burden
Negative Consequences of Pain for Older Adults
– emotional
- fear
- anxiety
- depression
- hopelessness
- loss of control
- possible risk of suicide
Negative Consequences of Pain for Older Adults
– spiritual
- disconnected
- loss of meaning
- feeling unconnected w/ God, other, the universe…
pain assessment
- 0-10 scale
- verbal descriptor pain scale
comprehensive pain assessment tools: - body mapping of pain
- pain diary
- interview w/ pt & family
other important indicators: - QOL indicators
- ADL and activity level indicators
LOTTAARRPP
- Location
- Onset
- Type
- Timing
- Alleviating factors
- Aggravating factors
- Related symptoms
- Radiating?
- Personal Perception (0-10 scale)
- Precipitating event
assessment for non-verbal or dementia pt.
- basic needs assessment
- ADD protocol
- universal pain assessment
- PAINAD
PAINAD
pain assessment in advanced dementia
- breathing
- negative vocalization
- facial expressions
- body language
- consolability
0 = no pain
1 – 3 = mild
4 – 6 = moderate
7 – 10 = severe
ADD protocol
- rubbing or holding a body part
- grimacing
- restless body movements
- moaning
- tense muscles
- agitation
- combativeness and anger
- crying
- sleeplessness
- decreased appetite
- exiting behavior and withdrawal
- changes in resps
non-opioid analgesics
“painkillers”
OTC
adjuvant analgesics
antidepressants
- SSRIs
Anticonvulsants
- neuropathic pain
- carbamazepine, clonazepam, lyrica
Corticosteroids
- inflammatory pain
Caffeine
- acts as a synergist or booster
opioid analgesics
start LOW and GO SLOW
nursing implications: evaluation
Therapeutic outcomes:
* Decreased complaints of pain
* Decreased severity of pain
* Increased periods of comfort
* Improved activities of daily living, appetite,
and sense of well-being
* Improved ability to relate with family and
friends
* Improved QOL
