Providing Comfort and Managing Pain Flashcards
What are the most essential “ingredients” one must have to care for someone who is experiencing pain or discomfort?
When providing pain management what must we be/do?
-Empathy
-Authentic presence and compassion
-Communication
-Advocacy
Be present, advocate ans communicate
What does it mean to provide comfort? What can it mean?
Providing comfort:
-attending to the individual’s complex physical, emotional, social, and spiritual needs within a context of authentic presence and compassion.
Can mean just sitting quietly and paying attention - a challenging task for many of us who believe our hands must be always busy
definition of pain?
An unpleasant, subjective sensory AND emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
This recognizes the physical and psychological nature of the pain experience
Sustained physiological responses to pain could cause?
Serious harm to an individual such as an altered immune system
What is the most common inital behavoural response to pain?
Anxiety
What are some other non-verbal behavioural responses to pain?
Bracing, splinting or protecting the painful part, rocking, body stiffinging, jaw clenching, grimacing, frowning, crying, moaning, or screaming can indicate pain is present
What kind of affective response can indicate pain?
Social withdrawal, changes in eating or sleep patterns, stoicism, fear, anxiety or feelings of hopelessness
What is Acute pain? If left untreated what can it lead to?
Usually has an identifiable cause that is either somatic, visceral, or nociceptive and is short duration (usually less then 6 months)
Acute pain has a predictable ending and an identifiable cause, and eventually resolves with or without treatment after a damaged area heals
-If left untreated it can lead to the development of chronic pain
What is the nurses primary goals in pain management?
Should be to prevent pain when ever possible and to effectively manage pain so that patients can participate in their own recovery
What is Chronic pain?
Defined as pain that persists the normal time of healing and is distinctly different from acute pain.
Chronic pain can be intermittent (occurs in a pattern) or presistent (lasting more than 12 hours)
-The pain may result from an injured area that healed long ago but continues to be nonresponsive to treatment
What kind of non pharmacological pain management techniques can we use?
The use of evidence-informed adaptive coping strategies such as cognitive-behavoural therapy, relaxation techniques, positive thinking, visual imagery and distraction
Nociceptive Pain?
Normal processing of stimuli that damages normal tissues or has the potential to do so if prolonged, usually responsive to nonopioids, opioids or both
Somatic pain?
Arises from bone, joint, muscle, skin, or connective tissue. It’s usually aching or throbbing in quality and is well localized
Visceral pain?
Arises from visceral organs, such as the GI tract and pancreas.
Can be subdivided into:
1.) Tumor involvement of the organ capsule, which causes aching and fairly well-localized pain
2.) Obstruction of hollow viscus, which causes intermittent cramping and poorly localized pain
How are toddlers and preschoolers able to express pain? How should we prepaire them for pain?
-Toddlers and preschoolers are often unable to recall explanations about pain, or they associate pain with experiences that can occur in various situations
-They may use verbal descriptors that differ from those used by older individuals
*To help prepare the child for a painful procedure ask the parents and child about terms that are most often used by the child to describe the pain experience and pain treatment and then use those terms when communicating about pain with the child
Why may older persons be more sensitive to pain?
As a result of structual, biochemical and functional changes
-Manifestations of different diseases can cause atypical presentations of painful conditions
-Whne older person are confused, they may not be able to recall and explain details of pain experiences
Misconceptions of pain in infants?
-Infants can not feel pain or are less sensitive to pain because of an immature nervous system
-Infants are incapable of expressing pain
-Pain can’t be accurately assessed in infants
-Because infants cannot demonstrate cognitive awareness, they are insensible and lack memory of pain
-Anlagestics and anaesthetics cannot be safely given to infants and neonates because of their immature capacity to metabolize and eliminate drugs, as well as their sensitivity to opioid indices respiratory depression
Misconceptions of pain in older persons?
-Pain is a natural outcome of growing old
-Pain perception or sensitivity decreases with ages
-If the older patient does not report pain, he or she does not have pain
-If an older patient appears to be occupied, asleep, or otherwise distracted from pain, he or she does not have pain
-The potential adverse effects of opioids make them too dangerous to use to relive pain in older persons
-Patients with Alzheimers disease and olter cognitive impairment do not feel pain, and their reports of pain are most likely invalid
What is neuropathic pain?
Result of injury to the nerves or an abnormal processing of stimuli by the peripheral to CNS
Types:
-Peripheral
-Central
-Complex regional pain stndrom (CRPS)
*If you run pain across the arm in an effected area it would feel different then if it went over non-effected skin
What are some misconceptions about pain?
-People who misuse drugs and alcohol overreact to discomfort.
-Patients with minor illnesses have less pain than those with severe physical alterations.
-The amount of tissue damage = pain intensity
Health care providers are the best authorities on the nature of a patient’s pain
-Psychogenic pain is not real.
-Chronic pain is psychological.
-Patients should expect to have pain during a hospital stay.
-Patients who cannot speak do not feel pain.
Infants are incapable of experiencing pain.
-Pain medication tolerance is not real.
What are some misconceptions about pain?
-People who misuse drugs and alcohol overreact to discomfort.
-Patients with minor illnesses have less pain than those with severe physical alterations.
-The amount of tissue damage = pain intensity
Health care providers are the best authorities on the nature of a patient’s pain
-Psychogenic pain is not real.
-Chronic pain is psychological.
-Patients should expect to have pain during a hospital stay.
-Patients who cannot speak do not feel pain.
Infants are incapable of experiencing pain.
-Pain medication tolerance is not real.
What is the purpose of the assesment when doing a pain assesment?
-Determine the patients perspective of pain including history of pain, its meaning and physical, emotional, and social effects
-Measure objectively the characteristics of patients pain
-Review potential factors affecting the patients pain
What should the nurses assesment of noncancer complex pain focus on?
Focus on the relationship between pain, function, quality of life, and treatment side effects because complete pain relief may not be possible
During a pain assesment what must we as nurses consider?
-Possible physical causes
-Behavioural effects
-Nonverbal indicators
-Influences on ADLs
-Cognitive impairment
-Communication barriers
-Alterations in patient perceptions
-Culture
-Spirituality
What does the nurse do for a nursing diagnosis wheh assesing pain?
-The nurse will make a dignosis only after having preformed a complete assesment
-Careful assesment, which should include examiniation of the patients history for recent procedures or preexisting painful conditions, will reveal the presance of or potential pain
*The nursing diagnosis focuses on the nature of the pain so that the nurse can identify the best intervnetions for reliveing pain and minimizing its effect on function
What re the goals for patient education?
Maintaining and promoting health and preventing illness
Restoring health
Optimizing quality of life with impaired functioning
What is the role of a nurse in teaching and learning environments?
In patient education:
-Create an environment to facilitate learning.
-Use a patient-centred approach.
-Assess the learning needs of the patient.
-Use the most appropriate educational strategy.
