Pain Management Flashcards
What is pain?
Unpleasant sensory, emotional experience with actual or potential tissue damage
What is acute pain?
Typically, rapid onset and intensity ranges from mild to severe
It disappears after the underlying cause is resolved
Result of tissue damage or organic disease
What are examples of acute pain?
Surgery, sore throat, pricked finger
What is chronic pain?
Last beyond “normal” healing period
Can be time limited, or last a lifetime
Varies: severe, consistent, or have periods of remission and exacerbation
(Break through pain)
Can lead to depression, frustration, and anger
What are examples of chronic pain?
Cancer: peripheral neuropathy
Back pain
Osteoarthritis
What is nociceptive pain?
Physiologic
-tissue damage
What is neuropathic pain?
Pathophysiologic
-damage to the peripheral or central nervous system
Examples of neuropathic pain
Phantom limb syndrome
Diabetic neuropathy
Complex regional pain syndrome
What are behavioral responses (voluntary movements) to pain?
Moving away
Clenching
Guarding painful area or limb
Bent posture
Grimace
Crying
Moaning
Restlessness
What are psychological responses to pain?
Fear
Exaggerated weeping and restlessness
Powerlessness
Withdrawal
Anorexia
Depression
Anger
Hopelessness
What are physiological responses to pain? (involuntary responses)
Sympathetic responses
- Tachycardia, hypertension
-Pupil dilation
-Pallor
-Tachypnea
Parasympathetic responses
-Tachypnea (irregular)
-N/V
-Syncope, hypotension, bradycardia
What are we going to assess for regarding pain?
Physiological
Emotional factors
Sociocultural
Physiological factors
What are the assessment tools for pain?
Numeric ratings scale
Verbal descriptive pain scale
Wong - Baker FACES pain rating scale
Pain assessment in advanced dementia scale
What is special population when assessing pain?
Children
Patience with dementia
Critically ill
Developmentally delayed
Cognitive impairment
Language barriers
What are some basic comfort measures?
Tighten and smooth wrinkled bed linens
Position tubing on which client is lying
Loosen constricting bandages
Change wet dressings and linens
Lift client up in bed
Position correctly on bed pan
Prevent urinary retention
Prevent constipation with fluids, diet and exercise
Clear clutter away from patients
What are some nonpharmacological ways to ease pain?
Ice
Heat
Elevation
Compression
Physical therapy/exercise
Cutaneous (TENS) stimulation
What are pharmacological ways to ease pain
Analgesics
-opioids
-non-opioid like acetaminophen and NSAIDs
-anti-depressants, anti-convulsants like gabapentin
What are some pharmacological interventions?
Know previous response to analgesics
Select proper medication when more than one is ordered
-use pain scale for assessment
Assess the right time, route, and interval for administration
No accurate dosage
What scale do you use after you give a narcotic?
The Pasero opioid induced sedation scale
How do you use the pasero opioid sedation scale
S- sleep, easy to arouse
1- awake and alert
2- occasionally drowsy, but easy to arouse
3- frequently drowsy and drift off to sleep during conversation
4- somnolent with minimal or no response to stimuli
What are the levels of consciousness?
Normal
Confusion/delirium
Lethargy
Obtundation
Stupor
Coma
How can distraction help with pain?
It is believed that conscious attention may be necessary to experience pain
Most effective for mild pain at the beginning of pain symptoms
What are some distraction techniques?
Counting
Listening to music
Playing with a toy
Rubbing a pet
Drawing
Watching TV
How can humor ease pain?
It can be used in combination with analgesics, but should never replace pharmacological intervention
May have a positive effect on the immune system
