Unit 1: Alteration in Comfort: Pain Flashcards
Describe acute, chronic, and neuropathic pain. What is the treatment for each type of pain?
Acute – sudden, if severe can see increased vs, restlessness. Nonopioids, opioids, PT/OT, massage, TENS unit, etc
Chronic- long term, persistent. Body adapts so don’t see vs changes. Need a pain specialist, not Opioids, or adjuvant therapies.
Neuropathic – damage to PNS, CNS. Burning, tingling, shooting pain. Difficult to treat, Gabapentin and pregabalin first choice. Anticonvulsants, antidepressants (TCAs, SNRI).
What is the best assessment for pain?
Self-report- pain scale, then behavioral cues
Who is at the highest risk for undertreated pain?
Elderly, cognitive impairments, those that speak another language, drug abusers.
Describe breakthrough pain meds. When would a patient need it?
NSAIDS or acetaminophen given in between pain med time. Needed for a procedure or dressing change, ambulation etc.
The PCA pump is an excellent way to give patients control of their pain. What will you teach the patient and family about it? What will you monitor?
Patient must be able to understand directions, only the patient can push button, teach side effects of sedation, constipation, urinary retention, nausea, vomiting. Cannot overdose by pressing button due to lock out. Monitor RR related to excessive sedation, constipation, I/Os.
How do you counteract the side effects of pain medicine?
Sit patient up and have them take deep breaths, use IS. Hydration, ambulation, stool softener for constipation.
When would we recommend an NSAID versus ibuprofen versus an opioid?
NSAID – for inflammation, pain and fever- watch stomach for bleeding ulcers or decreased platelets. For mild to moderate pain.
Acetaminophen – pain, fever, watch liver function. Doesn’t affect bleeding time so can take before surgery. For mild to moderate pain.
Opioid – for moderate to severe pain, but watch RR and constipation.
What are the options for pain relief with neuropathic pain?
Anticonvulsants, antidepressants.
Gabapentin and pregabalin first choice
What are nonpharmacological methods for pain relief?
TENS unit – watch intensity.
Massage, music therapy, pet therapy, distraction/diversion, hot/cold therapy, PT/OT.
