Week 1: Pain Assessment Flashcards
Acute vs. Chronic
Acute pain happens quickly and goes away when there is no cause.
Chronic pain lasts longer than 6 months and can continue when illness or injury has been treated
Importance of Pain?
- a universal symptom experiences by everyone at some point
-is the primary reason for clients access health care in Canada
-can impact client’s function, quality of life, relationship, etc.
-nurses are most often the ones assessing and helping clients manage pain
Physiology of Pain: Nociceptors
-these PNS fibers carry painful stimuli to the CNS
-located in various body tissues
-activated by thermal, mechanical and chemical stimuli
-this is how the pathway starts
Physiology of Pain:
Course of Travel
Impulse PNS -> Spinal cord CNS -> Pain may be blocked/allowed to continue -> Thalamus -> Limbic system (emotions to control pain produced here) -> Cerebral cortex (pain recognized here)
4 Components of Pain (SECS)
Sensory/Physical
-action in pain nerves and effect on physiological status, severity
Emotional/Affective
-how the pain makes us feel, fear, knowledge
Cognitive
-the effect of pain on behavior, coping strategies, (what does it mean?)
Social
-our behavior, (how we react and respond)
Ways to classify pain (DAFF)
Duration
-acute vs chronic
Associated with Cancer
-with cancer and/or with treatment for cancer (this gets its own class)
Frequency
-continuous vs intermittent
Form
-nociceptive vs neuropathic
Types of Pain
Nociceptive
-caused by damage to body tissue
Neuropathic
-a shooting or burning pain (usually chronic)
Visceral
-internal organs in the midline of body
Somatic
-pain in muscles, skin, or bone
Cutaneous
-aching, burning, stinging, tenderness, cramping
Referred
-pain in one part of body caused by pain or injury in another part
Parietal
-caused by irritation of the peritoneal lining that surrounds the abdominal cavity
ACUTE Pain Assessment (Red Flags)
Sudden onset:
-explosive headache
-painful breathing
-chest pain
-abdominal pain
-severe pain unrelieved by appropriate meds
ACUTE Pain Assessment
(what to do)
-focused/emergent history
-involve others, family/witnesses
-observation of the patient and their behaviors
Factors Influencing Pain
-age
-gender
-culture
-spiritual
-family and social impact
-self-perception of pain
-level of anxiety
-coping style
-fatigue
-previous experiences
Role of the Nurse
-nurse is with patient the most and is the best position to observe and notice/monitor changes
-REASSESSMENT of pain ~ follow up is key
-document pain, responses to pain, assessments of pain, outcomes of various treatments, SUBJECTIVE data ~ other clinicians need this data
-make recommendations based on assessments
Effects of poorly managed pain
Results in increased circulating stress hormones which contributes to:
-Reduced cognitive/mental function
-Sleeplessness, anxiety, fear
-Hyperglycemia
-Increased HR, increases cardiac output
-Decreased immune response
-Muscle spasm, immobility
-Decreased urinary output
-Increased suffering for the client and loved ones
Ways to assess pain
-OLDCARTSS
-OPQRSTU
-Numeric pain severity scale
-Pain/distress severity scale
-Visual analogue scale ~ FACES
-FLACC
-Brief pain inventory
-Universal pain assessment tool
