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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.
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Chapter 43-Pain ManagementPart 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·forts1. 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 • P. 1056 • The person experiencing the pain is the best indicator of the characteristics of pain • Assess pain • Believe the person
Factors Affecting Painp. 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