Pain: Fact/Myth
There is a high rate of opioid addiction among older adults.
What is a myth.
Addiction to opioids as a result of pain management is uncommon among most older adults. But a history of addiction may be needed at time of prescribing medications.
What are NSAIDs
Increased risk of falls, poor mobility, poor sleep, impaired immune function are all symptoms of this.
What is unrelieved pain.
True or False
Pain medication can not be administered to a person unless they ask for it.
False
Staff and family should recognize signs/symptoms of pain in individuals and speak on their behalf, always asking the resident first.
Older adults consume one third of the nations prescriptions, therefore they have their pain treated appropriately
What is a myth
Pain is typically underreported and under treated in the elderly.
This is a type of NSAID that can be given IV or IM for pain and is as effective as morphine
What is ketoralac (torodol)
Name 3 signs of pain that might be exhibited by cognitively impaired elders.
Vocal cues such as moaning, saying stop, or cursing
Physical cues such as furrowed brown, grimacing
Movement- shifting, massaging painful body parts, withdrawing
Constipation is a common side effect of this class of medications frequently used to treat pain.
What are opioids.
True or False
Nursing is the only discipline that needs to be educated on pain.
False
All health care workers are part of the team responsible for providing effective pain management.
Exercise will make pain worse
What is myth
Many older adults believe this. Many may need to check with health care providers before engaging in exercise programs but generally exercise has been shown to help with pain if not contraindicated.
This medication binds weakly to opioid receptors and inhibits reuptake of norepinephrine and serotonin
What is tramadol
Shooting, burning, stabbing, tingling, or numbness are words that describe this kind of pain
What is neuropathic pain
This class of drugs is used for pain but the older adult should be monitored for bleeding, nephrotoxicity, and delirium.
What are NSAIDS.
What does OLD CARTS stand for?
Onset
Location
Duration
Characteristics
Aggravating factors
Relieving Factors
Treatments
Severity
What is the WHO step ladder and how is it used?
Provides a systematic approach to treat mild, moderate and severe pain
People with dementia are no longer able to feel pain and/or have pain.
What is myth
Older adults with dementia are able to still have pain sensations.
This medication is used to treat severe pain, but can have serious side effects such as respiratory depression. Typical IV doses are 2 mg, 4 mg, or even 10 mg.
What is morphine
Aching, gnawing, or throbbing are words that describe this kind of pain
What is somatic
When older adults experience opioid related constipation they can institute this, which often includes laxatives/stool softeners, increased fiber, and plenty of fluids.
What is a bowel regimen
Name THREE things to discuss with the older adult and family when starting a pain management treatment plan.
Benefits of effective pain management
Options available
Goals of treatment, including identifying the resident’s goals and an acceptable level of pain
Side effects and their treatment
Cost (financial, emotional and/or physical)
Potential negative effects of pain
Pain symptoms – including nonverbal
What are some non-pharmacological interventions that the departments other than nursing can do?
Involve the resident in activities • Provide 1:1 room visits • Aromatherapy • Touch – massage, lotion • Take on walks • Read or provide other distractions • Support groups
A person who has no functional impairment or appears occupied must not have pain.
What is myth
Patients have a variety of reactions to pain and show pain symptoms in various different ways.
This medication is actually a type of hormone secreted by the thyroid and is useful as an adjuvant in treating musculoskeletal pain
What is calcitonin
This pain assessment tool created by Horgas & Miller (2008) is used to assess pain in the areas of breathing, vocalization, facial expression, body language and consolability.
What is the PAINAD scale.
This OTC medication should be used with caution among older adults with reduced hepatic function.
What is Acetaminophen
List at least three differences between acute and chronic pain.
Acute – Short term, Sudden onset, usually known cause, usually goes away, typically doesn’t cause severe emotional stress
Chronic – Often unknown cau. May cause depression, sadness, anxiety, anger, sense of loss of control. May continue throughout life . Requires comprehensive treatment