Chapter 43-Pain Management Part I Ouch! That hurts! I’m hurting! OMG! It’s killing me. I can’t live any longer! Can’t you do anything?
The Concept for this unit is com·fort (k m f rt) tr.v. com·fort·ed, com·fort·ing, com·forts 1. To soothe in time of affliction or distress.2. To ease physically; relieve.n. 1. A condition or feeling of pleasurable ease, well-being, and contentment.2. Solace in time of grief or fear.3. Help; assistance: 4. One that brings or provides comfort.5. The capacity to give physical ease and well-being.
Concepts related to Pain Pain-symptom of disease Pain-now considered a separate disease Pain-subjective Pain-highly individualized Pain-highly feared. The fear of pain is second only to the fear of death
Causes of pain Thermal Chemical Mechanical
Processes of Pain Transduction Transmission Perception Modulation
Transduction Transduction-energy from stimuli converted to electrical energy Begins in the periphery with stimulus Pain impulse via nerve fibers Transduction completed results in transmission
Transmission Transmission involves neurotransmitters Intact pain fibers-ECF & Spinal Cord Message received by cerebral cortex Interpretation by CNS
Perception Message received-awareness Limbic system determines how one feels about the pain
Modulation Message interpreted and received Release of inhibitory neurotransmitters Modulation is the inhibitory/analgesic effect
Gate-Control Theory p.1053 Emotional Cognitive Gate-keepers Pain threshold Pain tolerance
Types of Pain p.1055 Acute/Transient Chronic/Persistent Chronic Episodic Cancer Idiopathic Inferred
Misconceptions/Biases The person experiencing the pain is the best indicator of the characteristics of pain Assess pain Believe the person
Factors Affecting Pain p. 1056-1060 Age Culture Gender Genetic Neurological functioning Social Spiritual
Nursing Assessment No pain meter available Must rely on patient Nurse must ascertain subjective data Expression of pain
Characteristics of Pain Onset/Duration Location Quality Pattern Relief measures Contributing symptoms Behavioral effects Effects on ADL’s
Pain Assessment Pain scales p. 1065 Oucher scale Wong-Baker Pneumonic-P,Q,R,S,T Assessment of pain is considered the fifth vital sign!
Questions/Statements R/T Pain Be a reporter-who, what, when, where, why Ask opened-ended questions Avoid leading statements Observe nonverbal cues Congruent nonverbal actions and verbal comments Remember to assess drug allergies