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)
- aggravating and precipitating factors
- relief measures
ask questions to determine the onset, duration, and time sequence of pain
ask patient to describe or point to all areas of discomfort to assess pain location.
most subjective and most useful characteristics for reporting pain
- use pain scale to identify pain intensity
verbal descriptor scale
verbal descriptor scale
visual analog scale
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.
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.
effects of pain on a patient
- behavioral effects
- influence on activities of daily living
when a patient has pain, assess verbalization, vocal response, facial and body movements, and social interaction
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
includes nausea, headache, dizziness, urge to urinate, constipation, depression, and restlessness
- 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
diagnosis related to pain
- activity intolerance
- bathing self-care deficit
- ineffective coping
- impaired physical mobility
- impaired social interaction
- analyze information from multiple sources
- use concept map
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.
- consider the type of pain the patient is experiencing and the effect that it has on their body function
teamwork and collaboration
a comprehensive plan includes a variety of resources from the health care team
- 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
choose therapies suited to a patient's unique pain experience.
nonpharmacological pain-relief interventions
includes cognitive and physical approaches.
- relaxation and guided imagery
- cutaneous stimulation
- reducing pain perception and reception
the most common and effective method of pain relief
what are the 3 types of analgesics
- nonopioids (acetaminophen and nonsteroidal anti-inflammatory drugs)
- opioids (narcotics)
- adjuvants (variety of medications that enhance analgesics)
NSAID's act by
inhibiting the synthesis of prostaglandins and cellular responses of inflammation
aspirin, ibuprofen, naproxen
morphine, codeine, hydromorphone, fentanyl, oxycodone, hydrocodone
how does opioid act to reduce pain
they bind with opiate receptors to modify perceptions of pain
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
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
include prescription and OTC creams, ointments, and patches that are applied to a painful area.
local infiltration of an anesthetic medication to induce loss of sensation to a body part
blocks a group of sensory nerve fibers
perineurial local anesthetic infusion
a type of regional anesthesia. the use of perineurial injections and infusions of local anesthetic agents to relieve pain.
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