Pain Assessment: The 5th Vital Sign- Ch. 10 Flashcards
Pain is subjective..
“It is whatever the person says it is, exciting wherever the person says it does”
Pain assessment requires what?
Attention- respond to pain relief methods, to the side effects of medications, what else can be done if it doesn’t go away?
Alternative/holistic pain relieving methods
Music Decompress pressure/relive pressure- chest tube, catheter, NG Anti-anxiety medications (Xanax) Positioning Heat/cold application Oxygenation
Two types of pain “pathways”
Nocioceptive
Neuropathic
Nocioceptive pain- used to describe how a noxious stimuli are perceived as pain (injury occurs in the fibers)
Where are nocioreceptors located?
How are they stimulated?
Originates from the CNS or PNS
- skin, joints, connective tissue, muscles, thoracic viscera, abdomen
- stimulated by direct mechanical or thermal trauma; chemical mediators are released from the site of tissue damage
Four concepts of nocioceptive pain?
Transduction
Transmission
Perception
Modulation
Transduction
Rx: modify the source of pain
Stimulus takes place in the periphery fibers
-to modify the source of pain: local/topical analgesia, anti inflammatory, aspirin, NSAIDs
Transmission
Rx: block the transmission of pain to the CNS
Pain moves from spinal cord to brain. To modify mover my of pain to CNS: narcotics, opioids, local analgesics, anti inflammatory, aspirin NSAIDs
Perception
Rx: alter the central perception of pain
Awareness of pain sensation, to modify awareness of pain: mediation, music, distraction, hypnosis, acupuncture
Modulation
Rx: modulate the inhibition of pain in the CNS
Inhibition of pain
To inhibit pain: all of the above, analgesics, general anesthetic, morphine, fetynyl
Neuropathic pain- a pain caused by disease or injury that affects the somatosensory nervous System
- abnormal
- doesn’t follow the phases of nocioceptive pain
- most difficult to treat and assess
- pain is felt long after injury heals
- phantom pain, diabetic neuropathy, shingles, chemo, FM, sciatica
Sources of pain
Visceral- large organs
Deep somatic- muscles, joints, tendons, blood vessels
Cutaneous- skin/superficial
Referred pain
Referred pain
Pain that is felt in one area but originates in another location
Two types of pain?
Acute and chronic
Acute pain
Short term Activates ANS- change in vitals Self limiting Ends after injury Protective qualities Malignant
Chronic pain
Long term Malignant Cancer Doesn't stop after healing No protecting quality Level of pain higher Low activity Low appetite Normal vital signs
Pain in the elderly
Not normal aging process
Common ppl > 65 yr
Indicates pathology or injury
Check for objective data whil assessing
