Pain Assessment and Management Notes Flashcards
What is nociceptive pain?
The nervous system is functioning properly (somatic {skin/ muscles} or visceral {organs})
What is neuropathic pain?
Damaged or malfunctioning nerves (burning, shocking, tingling, dull, achy)
What factors affect pain experience?
- Ethnic and cultural values
- Developmental stage
- Environment and support
- Previous pain experiences
- Meaning of pain
- Emotional responses to pain
What are the types of pain stimuli?
Mechanical
Thermal
Chemical
List examples of mechanical pain stimulus
Trauma to body parts
Tumor
Muscle spasm
Blockage of body duct
Alterations in body tissues (pressure on pain recpetors)
List examples of thermal pain stimuli
Extreme hold or cold like burns or frost bite
List examples of chemical pain stimui
Tissue ischemia due to accumulated lactic acid or other chemicals in tissues
With ethnic and cultural values, you must be able to recognize___________ differences
transcultural
In the developmental stage of factors affecting pain experience, pain is more prevalent in which type of population?
The older population due to acute and chronic conditions
How often should the nurse assess pain?
Depends on the situation and from the pt and by the nurse
What s/e is aspirin associated with?
GI bleeding and Reyes syndrome
What is the main difference between acetaminophen, NSAIDs, and and aspirin?
Inflammatory response
What is unique about Celecoxib (Celebrex)?
Common NSAID
COX-2 Selective - needs a prescription
What is a PCA?
PT Controlled Analgesia
What does a PCA do?
PTs relieve their pain by self administering doses of analgesic via the IV.
What are major problems using a PCA?
Programming issues
Requires 2 nurses to check
BIG concern is PCA by proxy (someone in the rooms pushes med for pt)
When making the decision to prevent pain using PRN pain meds, how are they administered?
Around the clock or prior to potentially painful procedures
What is the nature of pain?
- Location (locate the pain source, radiate or referred)
- Duration: Acute or chronic (3 months or more)
- Intensity: mild / moderate/ severe
- Etiology: nociceptive or neuropathic
What is the difference between chronic and acute pain ?
Acute pain: increased pulse, BP, RR, dilated pupils. PT could be anxious. Less than 3 months.
Chronic: PT depressed, withdrawn, behavior absent, 3 months or more.
What is the difference between pain threshold and pain tolerance?
Threshold - least amount of stimuli that is needed for someone to label a sensation of pain
Pain tolerants (tolerance) - max amount of painful stimuli that an individual is willing to withstand without seeking avoidance of the pain relief
Describe the physiology of pain
Transmission - periphery to spinal cord to brain, then perceived
Perception - person becomes conscious of pain
Modulation - release of substance to help reduce painful impulses (which are endogenous opioids produced by body to help regulate and reduce pain)
How do we respond to pain? especially unrelieved pain?
Interferes with sleep
Impairs Immune response
Slows healing process
Increases susceptibility to infection
List the factors that affect pain experience?
Ethnic and cultural values (transcultural differences)
Developmental stage (pain is more prevalent in older population)
Environment and support people (hospital is unfamiliar and support groups are distracting to pain)
Previous pain experiences (personal or exposure to others)
Meaning of pain (acceptance of pain = +outcome // negative outlook = view pain as an inconvenience)
Emotional response to pain (anxiety // however anxiety decreases when pts believe they have control over pain)
Using the pain hx assessment, the location is described as:
Pointing to the site and using land marks
Using the pain hx assessment, the pain intensity and rating scales is described as
Numeric (0 -10)
FLACC (2 months - adolescence)
*Self report must be used to determine intensity
*record as reported
Using the pain hx assessment, the pain quality is described as
The description the pt gives you
“Tell me what your discomfort feels like” Pt: tv static down my whole leg
Using the pain hx assessment, the pattern is described as
Time of onset (when did the pain start)
Duration (how long have you had it)
Constancy (Do you have pain free periods)
Using the pain hx assessment, the precipitating factors are described as
What causes the pain to happen? A storm (storms include precipitation; precipitation can cause pain)
Using the pain hx assessment, the alleviating factors are described as
Hot
Cold
Immobility
Using the pain hx assessment, the associated sx are described as
n/v/d
dizziness
SOB
Using the pain hx assessment, the effect on ADL is described as
Sleep
Appetite
Working
(Can be used in nursing dx [problem] r/t ________)
Using the pain hx assessment, the psychosocial is described as
Marital status
Social support
Home and work environment
Social status
Mood
Coping ability
Nonpharmacologic methods to relieve pain
Massage
Acupressure
Immobilizing/ bracing
Distraction
Relaxion
Imagery
Biofeedback
Does distraction (nonpharm cognitive behavioral intervention) work if pt is in pain?
No
Opioid A/E include?
Bradypnea
Nausea
Orthostatic HTN
Urinary incontinence
Morphine antagonist is
Nalaxone
If pt has severe abdominal pain your number one priority is to _____________ first
Assess
Opioids are given to pts with which types of pain?
Moderate (4-6)
Severe (7-10)
Nonopioids, like NSAIDs are given to pts with which type of pain?
Mild (1-3)
