Pain and Comfort (Final) Flashcards
Pain
Universal but very individual experience
Under-recognized, misunderstood, and inadequately treated
Pain Defention
-An unpleasant, subjective, sensory, and emotional experience often associated with actual or potentail tissue damage
Nursing and Pain
-Nurses are responsible legally and ethically to assess and manage pain
Nociception
Observable activity in the nervous system in response to an adequate stimulus
4 stages of pain
- Transduction
- Transmission
- Perception
- Modulation
Acute Pain
-Usually a protective mechanism
-Short duration and limited tissue damage
-If not treated can threaten recovery
-May progress to chronic pain
Chronic pain
-Not protective
-Not same symptoms
-More than 3-6 months
-Highly correlated with suicede
Goal of treating chronic pain
Treat to improve functional status
Hard to see physiological symptoms to what kind of pain?
Chronic pain
Nociceptive Pain
-Arises from pain receptors
-Usually responsive to opioids/analgesia
Description of nociceptive pain
Aching, gnawing, pounding
Neuropathic Pain
Injury to nerves or abnormal processes of sensory input
Treat with adjuvant analgesics
Description of Neuropathic Pain
Burning, shooting, electrical, abnormal sensation
Nociceptive Pain types
Somatic: In bones, joints, muscles, skin or connective tissue
Visceral: Internal organs, often associated with referred pain
Cutaneous: In skin or subcutaneous tissue
Idiopathic pain
Form of chronic pain without know cause
Pain that exceeds typical pain levels associated with clients condition
Acute pain often activates with NS
Sympathetic nerovous system
Flight or fight
Tachy-hypertension-anixety-diaphoresis-muscle tension
Behavioral response to pain
Grimacing, moaning, flinching, guarding
Chronic pain response
Physiological not common
Fatigue, depression, decreased level of functioning
Research has shown what about nurses and pain
That nurses subjective opinions about what a patient says about their pain impacts how they decide to treat it
Nursing assumptions limit their ability to offer pain relief
Acknowledging personal prejudices or misconceptions helps address patient problems more professionally
Bottom line
Pain is what the patient says it is and we must assess it and treat it as such
Factors that influence the pain experience
-Age
-Fatigue
-Genes
-Cognitive/Neurologic Function
-Previous pain experinces
-Support systems
-Spirituality
-Anxiety/Fear
Cultural Aspects of Pain
-Cultural Beliefs and vaules affect how individuals cope with pain
-When pain threatens a persons role, they may not acknowledge the pain
-Some cultures find it normal to be very demonstrative about pain
-Make sure that we are assessing pain in a persons native language
Basic Pain Assessment
-Subjective and objective data
-Assess, reassess, then assess again
-Patient is the ONLY authority
-Can assess behavioral responses and physiological indicators
Vertical and Horizontal Pain Scale
Know the pain assessment in the second pain VO’s
PQRSTU
Goals of Pain Management
-Patient and care team decide on an acceptable level of pain
Lots of education go into this
Sometimes 0 is achievable, sometimes it is not. Consider baseline
Pain Treatment Interventions
-Multi dimensional
-Individualized
-Incorporates all aspects of patient concerns
-Use what patient believes in
-Keep open mind and keep trying
Non-Pharmacological Measures
-Relaxation and Guided Imagery
-Distraction
-Music
-Cutaneous Stimulation
If moderate or serve pain then use pain medications first
