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Pain. Teresa V. Hurley, MSN, RN. Duration of pain. Acute Rapid in onset, varies in intensity and duration Protective in nature Chronic May be limited, intermittent, or persistent Lasts for 6 months or longer Periods of remission or exacerbation are common. Gate Control Theory of Pain.
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Pain Teresa V. Hurley, MSN, RN
Duration of pain • Acute • Rapid in onset, varies in intensity and duration • Protective in nature • Chronic • May be limited, intermittent, or persistent • Lasts for 6 months or longer • Periods of remission or exacerbation are common
Gate Control Theory of Pain • Relationship between pain and emotions • Small and large diameter nerve fibers conduct and inhibit pain stimuli • Gating mechanism determines impulses that reach the brain
Factors Affecting Pain Experience • Culture • Ethnic variables • Family, gender, and age variables • Religious beliefs • Environment and support people • Anxiety and other stressors • Past pain experience
General Assessments of Pain • Client’s verbalization and description of pain • Duration of pain • Location of pain • Quantity and intensity of pain • Quality of pain • Chronology of pain
General Assessments of Pain (continued) • Aggravating and alleviating factors • Physiologic indicators of pain • Behavioral responses • Effect of pain on activities and lifestyle
Wilda Scale • Words that describe the pain • Intensity of pain • Location of pain • Duration of pain • Aggravating or alleviating factors
Nursing Interventions for Pain • Establishing trusting nurse-patient relationship • Initiating nonpharmacologic pain relief measures • Considering ethical and legal responsibility to relieve pain • Teaching patient about pain
Distraction Humor Music Imagery Nonpharmacologic Pain Relief Measures
Nonpharmacologic Pain Relief Measures • Relaxation • Acupuncture
Hypnosis Biofeedback Therapeutic touch Nonpharmacologic Pain Relief Measures
Pharmacologic Pain Relief Measures • Analgesic administration • Nonopiod analgesics • Opioids or narcotic analgesics • Adjuvant drugs (enhance the action of main drug)
Numeric Sedation Scale • 1 — awake and alert, no action necessary • 2 — occasionally drowsy, but easy to arouse, no action necessary • 3 — frequently drowsy, drifts off to sleep during conversation, reduce dosage • 4 — somnolent with minimal or no response to stimuli, discontinue opiod, consider use of naloxone
Pain Management Regimens for Cancer or Chronic Pain • Give medications orally if possible. • Administer medications around the clock time rather than prn. • Adjust the dose to achieve maximum benefit with minimum side effects. • Allow client’s as much control as possible over the regimen.