General Pain
This is the nurses' definition of pain.
What is ?
-whatever the person says it is, existing whenever he says it does
Identify two factors that influence pain, and explain how.
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.
Identify 3 non-pharmacological interventions for pain relief.
What are ?
- Relaxation
- Distraction
- Music therapy
- Cutaneous stimulation ETC
Identify 3 types of analgesics.
What are non-opiods, opioids, and adjuvants?
Identify 2 benefits to adequate pain management.
What are ?
- legal/ethical obligations
- Improves quality of life
- Reduces physical discomfort
- Promotes early mobilization
- Helps return to baseline function
Discuss two contributing factors specific to the pain experience in the older adult.
What are ?
- Ability to interpret can be difficult d/t multiple diseases with vague symptoms and/or cognitive impairment
- Changes in muscle mass, body fat, % of body water --> concentration/distribution of meds
- Decreased albumin --> affects protein bound meds --> increased risk of side effects
- Decreased liver/kidney function --> affect metabolism/excretion
- topical analgesic absorption d/t thinning/elasticity
In terms of the quality, identify two words that are often associated with neuropathic pain.
What are ?
- Burning, shooting, pins and needles, numbness
Distraction is best for which type of pain?
What is short, intense pain?
What medications are classified as non-opioids?
What are acetaminophen and NSAIDS?
Discuss nociceptive pain versus neuropathic pain.
What is ?
- Nociceptive pain --> most common, caused by damage to somatic or visceral tissue, occurs abruptly after injury, persists until healing occurs
- 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
Discuss how previous experience can impact the pain experience.
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 location of pain.
What are anatomical landmarks and description language?
Identify 3 benefits to relaxation.
What are ?
- decreased HR, BP, & R, heightened awareness, decreased O2 consumption, sense of peace, decreased muscle tension & metabolic rate
Discuss 3 important facts about NSAIDS.
What are ?
- Used for mild/moderate pain
- No CNS depression / do not interfere with bowel or bladder
- Risk for GI bleed & renal insufficiency
Identify 3 characteristics of chronic pain.
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
Which factor helps to explain the benefits of distraction, music therapy etc?
What is attention?
This is the most useful assessment characteristic.
What is severity/intensity?
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
Identify the two benefits of adjuvants.
What are ?
- enhance other analgesics
- have analgesic properties of their own
Some patients may not be able to verbalize pain. Identify 6 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
Discuss anxiety as a factor influencing pain.
What is ?
- Anxiety increases perception of pain, and pain can cause feeling of anxiety
Identify seven pain characteristics to be assessed.
What are ?
-Onset
-Provoking factors
-Quality
-Radiating (location)
-Severity
-Timing
-You (relief)
Identify 3 benefits to providing massage to your patient.
What are ?
- physical and mental relaxation, pain relief, communicates caring, enhance effectiveness of pain medication
Identify a severe risk for the patient taking an opioid and the antidote.
What is respiratory depression and Narcan 0.4mg IVP?