comfort, pain manage ch 36

pain

subjective

what pt says it is

always believe pt

unpleasant sensory + emotional experience

unrelieved pain causes

physiologic

• body

psychological

• mental

pain management

relieve pain + improve function

hospital req

• assess pain reg

• assess after intervention

• medication, non-drug

nurse role

• assess pain

• treat

• advocate for pain

pain assessment

location, intensity, duration, quality, triggers

pain scale

type of pain

acute

• short-term

• surgery/injury

• strong physical + behavioral sign

chronic

• long-term

• > 3 mo

• limit daily life

pain management pharmacological

NSAIDs

opioids

adjuvant

pain management non-pharmacologic

relax

music

distraction

positioning

nociception- pain process

transduction

transmission

perception

modulation

transduction

injury → electrical signal

chem released

• histamine

• prostaglandins

• substance P

transmission

signal travel to brain

a-delta fibers → sharp pain, fast, acute

c-fibers → slow, dull, chronic

perception

brain recog pain

pain is conscious

modulation

pain is reduced or blocked

endorphins = natural pain relief

chronic pain pattern

continuous

intermittent

remission → no pain period

exacerbation → pain return

cutaneous pain location

superficial

skin

sharp, burn

deep somatic pain location

muscle, bone

dull, aching

visceral pain location

organ

poorly localized

referred pain

pain felt in different location than where it started

spinal nerve pathway

nociceptive pain

pain from tissue

causes:

• injury

• surgery

• inflammation

neuropathic pain

pain from nerve damage

burn, tingle, electric, shooting

mixed pain

nociceptive + neuropathic

nociplastic

pain with no clear tissue damage

intractable

pain does not respond to treatment

phantom pain

pain in missing limb

brain still perceives it

biopsychosocial model

biological

• injury/illness

• genetic

• age/dev

psychological

• coping skill

• mental health

• past experience

social

• culture

• fam support

• env

pain quality

sharp → stab

dull → aching

diffuse → spread

shifting → move

pain severity

1-3 → mild

4-7 → mod

8-10 → severe

pain periodicity

continuous → constant

intermittent → comes and goes

transient → brief