Pain: 3 Flashcards
Low to Moderate pain
Sympathetic (fight or flight)
Increased respirations, heart rate, bp, glucose levels, muscle tension, Dilated pupils, Pallor, Diaphoresis
Low to Moderate pain
Sympathetic (fight or flight)
Increased respirations, heart rate, bp, glucose levels, muscle tension, Dilated pupils, Pallor, Diaphoresis
CONTINUOUS, SEVERE, OR DEEP PAIN
Parasympathetic (rest and digest)
Pallor, Nausea, vomiting, Decreased heart rate and
bp, Rapid/irregular breathing
Acute pain observations
Clenching teeth, Facial grimacing, Holding or guarding
painful areas, Bent posture
Chronic pain affects the following
Activity - eating or sleeping, Thinking, Emotions - more depressed or irritable, Quality of life, Productivity
Physiological factors that influence pain
Age - young kids can’t verbalize pain and older people have other comorbitities so they might not think they can actually feel it.
Fatigue
Genes - how they express their pain
Neurological function - affects patients awareness that they are in pain
Social factors that influence pain
Previous experience - wasn’t treated well the first time so they could anticipate it to be bad and feel worse.
Family and social network - having support from family and others give comfort and decrease stress levels.
Spiritual factors - having positive spiritual coping practices can help patients adjust to pain and give comfort and support.
Psychological factors influencing pain
Focus - more focused on pain = increased pain
Anxiety and fear - more pain = more anxiety
Coping style
Cultural factors influencing pain
Expression of pain - some cultures don’t express pain so they deny being in pain. This doesn’t mean that they are not in pain.
Pain characteristics
Provokes - when did pain start? What relieves or makes it worse?
Quality - used term patient uses to describe it: crushing, throbbing, dull.
Severity/associated symptoms - paint scale to rate severity and other symptoms experienced with pain.
Timing - onset, duration, pattern of pain. When did it start? Constant? Come and go? How long and often?
Understanding - understand effects of pain on patients functioning. How does it affect their everyday life.
Pain scales
Wong baker - age 3 and up, point to the face.
Flacc scale - behavioral pain scaled for kids that are cognitively impaired or can’t speak about their pain. Also, can’t respond verbally or talk.
Number scale
Visual scale
Descriptive scale
Behavioral effects of pain
Saying ouch or that something hurts. Moaning or groaning. Could be withdrawn from seeing others. Cold be making faces. Non-verbal expressions of pain may not match what they are telling you
Cancer and chronic non-cancer pain management
The step ladder. You start at where the patients pain is and work down or up from there.
PCA pump
Patient should be the only person pressing button.
Takes 2 nurses to program it.
Non-pharmacological pain relief
Relaxation and guided imagery - reduces tension and stress. Music, meditation, yoga, create picture in mind.
Distraction and music -takes patient attention away from pain
Cutaneous stimulation - massage, cold, heat therapy. Heat better for tension headaches. Cold better for inflamed joints.
Herbals - make sure patient reports there.
Reducing pain perception and reception - remove stimuli, adjust them, treat symptoms, etc.
