pain management

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created 2 years ago by Akosua_Ruby
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1

characteristics of pain

allows you to understand the type of pain, its pattern, and the types of intervention to bring relief.

  • timing (onset, duration, and pattern)
  • location
  • severity
  • aggravating and precipitating factors
  • relief measures
2

timing

ask questions to determine the onset, duration, and time sequence of pain

3

location

ask patient to describe or point to all areas of discomfort to assess pain location.

4

severity

most subjective and most useful characteristics for reporting pain

  • use pain scale to identify pain intensity
5

VDS

card image

verbal descriptor scale

6

VDS

card image

verbal descriptor scale

7

VAS

card image

visual analog scale

8

aggravating and precipitating factors

  • describe activities that cause or aggravate pain.
  • demonstrate actions that cause a painful response such as coughing or turning certain way.
9

relief measures

it is useful to know whether a patient has an effective way of relieving pain such as changing position, using ritualistic behavior, eating, meditating, praying, or applying heat or cold to painful site.

10

effects of pain on a patient

  • behavioral effects
  • influence on activities of daily living
11

behavioral effects

when a patient has pain, assess verbalization, vocal response, facial and body movements, and social interaction

12

influence on activities of daily living

the primary goal is to improve patient function.

ask patient whether pain interferes with any activities in their lives

13

concomitant symptoms

includes nausea, headache, dizziness, urge to urinate, constipation, depression, and restlessness

14

nursing diagnosis

  • focus on the specific nature of a patient's pain to identify the most useful type of intervention for alleviating and improving patient's function
  • accurate identification of related factors is necessary in choosing appropriate intervention
15

diagnosis related to pain

  • activity intolerance
  • anxiety
  • bathing self-care deficit
  • ineffective coping
  • fatigue
  • impaired physical mobility
  • insomnia
  • impaired social interaction
16

planning

  • analyze information from multiple sources
  • use concept map
17

goals and outcomes

  • with the patient, determine realistic expectations for pain relief
  • decide on a mutually acceptable level of pain that allows return of function.
  • goals of care promote a patient's optimal function.
18

setting priorities

  • consider the type of pain the patient is experiencing and the effect that it has on their body function
19

teamwork and collaboration

a comprehensive plan includes a variety of resources from the health care team

20

implementation

  • the nurse, patient, and family are partners in pain management
  • the nurse is responsible for administering and monitoring therapies ordered by health care providers for pain relief
  • try the least invasive or safest therapy first
21

health promotion

choose therapies suited to a patient's unique pain experience.

22

nonpharmacological pain-relief interventions

includes cognitive and physical approaches.

  • relaxation and guided imagery
  • distraction
  • music
  • cutaneous stimulation
  • herbals
  • reducing pain perception and reception
23

analgesics

the most common and effective method of pain relief

24

what are the 3 types of analgesics

  • nonopioids (acetaminophen and nonsteroidal anti-inflammatory drugs)
  • opioids (narcotics)
  • adjuvants (variety of medications that enhance analgesics)
25

NSAID's act by

inhibiting the synthesis of prostaglandins and cellular responses of inflammation

26

NSAID drugs

aspirin, ibuprofen, naproxen

27

opioids drugs

morphine, codeine, hydromorphone, fentanyl, oxycodone, hydrocodone

28

how does opioid act to reduce pain

they bind with opiate receptors to modify perceptions of pain

29

nursing principles for administering analgesics

  • know patient's previous response to analgesics
  • select proper medications when more than one is ordered
  • know accurate dosage
  • asses right time and interval for administration
30

patient controlled analgesia

  • a drug delivery method for pain management that many patients prefer
  • allows patients to self-administer opioids with minimal risk of overdose
31

topical analgesic

include prescription and OTC creams, ointments, and patches that are applied to a painful area.

32

local anesthesia

local infiltration of an anesthetic medication to induce loss of sensation to a body part

33

regional anesthesia

blocks a group of sensory nerve fibers

34

perineurial local anesthetic infusion

a type of regional anesthesia. the use of perineurial injections and infusions of local anesthetic agents to relieve pain.

35

epidural analgesia

a form of regional anesthesia

  • effectively treats acute postoperative pain, rib fracture pain, labor and delivery pain, and chronic cancer pain
  • it reduces severe pain and a patient's overall opioids requirement