Acute and Chronic Pain Flashcards
(16 cards)
What is pain?
The 5th vital sign
McCaffrey defined pain as: “Pain is whatever a person says it is, existing whenever the experiencing person says it does”
Must document within 30 mins after med administration
Most common reason to seek medical attention
What are the categories of pain?
Nociceptive (physiologic pain)
Somatic-muscle, skin, and tissue
Visceral-thoracic, pelvic
Neuropathic (pathophysiologic) pain- abnormal processing of pain. Often in spinal cord injuries
Chemical Substances
Prostaglandins-Initiates inflammatory
Endorphins-suppress pain perception=akin to morphine
What factors influence pain response?
Fear has a huge effect on perception of pain
Culture-some large response, some are stoic
Support person during labor can decrease labor time by 6-8 hrs
Some older adults are less vocal than the young about pain
Why is pain important to treat in children?
Decreased growth and development Decreased immune function Lack of appetite Hypertension Increased sensitivity to future pain
Why is pain often misjudged in children and infants?
Change in behavior is one of the biggest indicators of pain
Children remember pain but may not be able to vocalize it correctly
Lack of quality pain assessment
What is a special consideration in regard to pain in adults?
Chronic pain widespread among adults
More prevalent among women than men
Women more likely to develop pain-causing diseases
Lowered pain threshold and tolerance
Men more susceptible to pain from:
Cluster headaches, coronary heart disease, gout, duodenal ulcer, pancreatic disease
What considerations are necessary in regard to pain in the elderly?
Most fear addiction to painkillers
Some may save pills as they can’t afford them all the time
Inadequate knowledge of healthcare providers
What are the different types of pain?
Acute-short term
Chronic-Long term
Mixed-chronic with acute exacerbations
Referred-pain that is felt in an unaffected area
What are effects of pain and acute pain
Sleep deprivation
Acute: Can affect respiratory, cardiovascular, endocrine, immune systems
Stress response increases: metabolic rate, cardiac output, RR, HR, BP, sweating, anxiety, dilated pupils
What are the effects of Chronic Pain?
Could be from fibromyalgia, cancer, etc.
A lot of times antidepressants-Can develop depression
Suppression of the immune system
What are the characteristics of pain?
Intensity=1-10 scale
Onset/Duration
Location
Quality=Dull, Throbbing, cramping, stabbing, continuous, intermittent
Radiation
Aggravating, Alleviating factors-heat/cold, rest, medications
What is the WHO three step approach to pharmacological pain management?
Mild pain step 1
Nonopioid analgesic
Persists, moderate pain step 2
Weak opioid, combination of opioid and nonopioid (with/without coanalgesic)
Persists, severe pain step 3
Strong opioid administered around the clock
Titrated until pain relieved, respiratory effects
How should opioid dosages be calculated?
Safe opioid dose must be individually assessed sometimes size isn’t a good indicator
Tolerance can increase drug dosage
Is addiction from therapeutic use of opioids common?
no it is neglible
What are nonpharmacological interventions that can treat pain?
Cutaneous stimulation, massage Thermal therapies Transcutaneous electrical nerve stimulation Distraction Relaxation techniques Guided imagery Hypnosis Music therapy
What are side effects of opioids?
Respiratory depression Sedation Constipation; Urinary retention Nausea/vomiting Pruritus Sexual dysfunction
