PAIN - Chapter 9 Flashcards
Pain – definition
Unpleasant experience that is either emotional or sensory, resulting from actual or possible damage to tissues and is uniquely experienced in described by each person
Describe why pain is the fifth vital sign
+ pain is typically inadequately treated
+ not treating pain has consequences affecting patients in their family
+ pain can alter lives, especially in geriatric patients
Describe pain in children and infants
+ They don’t understand pain
+ have trouble locating it
+ are unable to express it fully
Explain the experience of pain for the elderly
They except pain as part of the aging process, though pain is NOT a normal part of aging!!
+ Impulse transmission may be a little slower but threshold does not change!!
Explain the experience of pain for men and women and how they differ
WOMEN:
+ more comfortable communicating discomfort of pain
+ verbalize emotions relating
to pain
MEN:
+ May have higher threshold intolerance
+ taught to suck it up and not cry
Explain how culture or spiritual beliefs affect pain and how it’s perceived or vocalized
+ The meaning and expression of pain differs between cultures and religion
+ some cultures and religions are much more accepting and expressive of pain than others
+ some cultures and self inflict pain as a side of morning, grief, or right of passage
Mental and psychosocial aspects that affect the expression of pain
+ Attention
+ anxiety
+ fatigue
+ coping style
+ previous experience with pain
+ family and social support port
Describe acute pain
+ Rapid onset
+ short duration
+ well-defined
+ involves tissue damage from trauma or surgery
+ reversible
+ morbidity/mortality if unrelieved
+ vitals increase
Describe chronic pain
+ Appears gradually and persists, may come and go
+ lasts more than three months
+ intermittent or continuous
+ may or may not be well defined
+ not reversible entirely
+ can impact quality of life
+ depression, fatigue, financial burden
+ vitals eventually returned to baseline or new baseline is established
Nociceptive pain – describe
+ Physiologic pain sustained by ongoing activation of sensory system from a noxious stimuli
+ implies existence of damage to somatic or visceral tissues
+ most responsive to non-opioids, opioids and local anesthetics
+ somatic – arises from skin and muscular skeletal structures (surgical, trauma, cancer pain)
+ visceral – arises from organs and linings of body cavity (ulcerative colitis, IBS, Crohns, pancreatitis)
Neuropathic pain – explain
+ Pain caused by injury or dysfunction of nerves from the PNS or CNS resulting in impaired processing sensory output
+ Relief comes from anti-depressants, anticonvulsants, code analgesic agents
+ examples: nerve fibers, spinal cord injury, neuropathy, phantom limb pain, sciatic nerve pain
Pain management for cancer or chronic pain
+ Give meds orally if possible + administer ATC rather than PRN
+ adjust does for maximum benefit with minimum side effects
+ allow patient as much control as possible over regimen
Pharmacologic pain relief – analgesics
+ Non-opioid: aspirin, acetaminophen, NSAIDs
+ opioid: morphine, codeine, fentanyl, oxycodone, meperidine
+ adjuvants: sedatives, and a convulsants, steroids, anti-depressants, anti-anxiety agents, muscle relaxants
+ patient controlled analgesia – PCA
+ Local anesthetics
Nonpharmacologic methods of pain relief
+ Massage
+ imagery and music
+ biofeedback
+ meditation, hypnosis
+ exercise
+ humor
+ therapeutic touch, acupuncture and acupressure
+ relaxation techniques
Explain nursing process and pain management in older adults
+ “Start low and goes slow with drug dosing, especially opioids”
+ Understand that an older adults chronic pain is complicated
+ they are sensitive to medication
+ they are at risk for under treatment of pain
+ their organs don’t process or metabolize / excrete pain meds proficiently
+ they are at risk for toxicity
