"That hurt's"
What is ?
-whatever the person says it is, existing whenever he says it does
What are ?
-Age, fatigue, genes, neuro function, attention, previous experience, family/social support, spiritual factors, anxiety, coping, culture
This is the most commonly used scale for the assessment of pain. Describe.
What is the numerical rating scale, where 1-3 is mild pain, 4-6 is moderate, and 7-10 is severe. May vary according to hospital policy.
What are ?
- Relaxation
- Distraction
- Music therapy
- Cutaneous stimulation ETC
What are ?
- legal/ethical obligations
- Improves quality of life
- Reduces physical discomfort
- Promotes early mobilization
- Helps return to baseline function
Describe 3 facts about PCA
What are ?
•Allows pts to self-administer opioids to avoid problems with PRN dosing
•Traditionally involves IV or SQ dosing but PO is also available
•Pumps are portable and computerized
•Delivers a small, pre-set dose and allows the patient to push a button for a demand dose at specific, programmed intervals (normally every 8-15 minutes)
•Pt must be able to understand how the pump works and locate the button
•Family members and visitors should be instructed NOT TO PUSH THE BUTTON
•Programming and setting should be done by two nurses for accuracy
•This method allows the patient to feel less anxious about possibly
overdosing
Identify two words that are associated with quality of pain
What are ?
- Burning, shooting, pins and needles, numbness, stabbing,
Guided imagery focuses on images and imagination to create a positive experience
Discuss Visceral pain versus neuropathic pain.
What is ?
- Visceral pain arises from visceral organs, such as those from the gastrointestinal tract. Visceral pain spreads and radiates in several directions and can have a burning quality.
- Neuropathic pain --> results from direct stim of myelin or nervous tissue, feels like burning/tingling, commonly seen in patients with uncontrolled DM, alcoholism, viral infections
What is ?
- Good --> better coping and strategy for next time
- Bad --> worse coping, more fear and anxiety
- None --> may impair ability to cope
This is how we assess the region/location of pain.
What are anatomical landmarks? Where is the pain and does it spread to anywhere else.
What are ?
- decreased HR, BP, & R, heightened awareness, decreased O2 consumption, sense of peace, decreased muscle tension & metabolic rate
What are ?
- Used for mild/moderate pain
- No CNS depression / do not interfere with bowel or bladder
- Risk for GI bleed & renal insufficiency
What are ?
- serves no purpose, not always identifiable cause, longer than 6 months, goal is improve functional status, associated symptoms --> fatigue, insomnia, anorexia, weight loss, apathy, anger, challenges --> financial, relationships, ADLs, labels
How would you treat cancer pain, give example.
What is long acting or controlled release? Transdermal patches last up to 72 hours
This is the most useful assessment characteristic.
What is severity/intensity? how severe is it, does it interfere with your activities of daily living.
Hot and cold therapy relieve pain and promote healing. Identify two ways to avoid injury.
What are ?
- check temp before application & do not apply directly to skin
What are common side effects of opioids?
nausea, vomiting, constipation, memory changes
Some patients may not be able to verbalize pain. Identify 4 behaviors that could indicate pain.
What are ?
-moaning, crying, gasping, grunting, grimace, clenched teeth, lip biting, wrinkled forehead, restlessness, pacing, protective movement, social withdrawal ETC
What is ?
- Anxiety increases perception of pain, and pain can cause feeling of anxiety
Identify pain characteristics to be assessed.
What are ?
-Onset
-Provoking factors
-Quality
-Region (location)
-Severity
-Timing
What are ?
- physical and mental relaxation, pain relief, communicates caring, enhance effectiveness of pain medication