Managing Pain & Related Nursing Care – Quick Review

Pain

Subjective, unpleasant sensation; often warning sign but can occur without tissue damage.

What are two key pain physiology theories/concepts?

The gate-control theory and endorphins.

Acute pain

Intense, short (

Chronic pain

Continuous or intermittent pain lasting more than 6 months, which is not protective.

List four classifications of pain based on type.

Nociceptive, Visceral, Neuropathic, and Cancer pain.

What is the Joint Commission's stance on pain assessment?

Pain is considered the fifth vital sign according to the Joint Commission.

What mnemonic is used for pain assessment?

HILDA: How feels, Intensity, Location, Duration, Aggravating/Alleviating factors.

Name at least four non-pharmacologic pain interventions.

Massage, TENS, Hot/Cold therapy, Guided imagery, Biofeedback, and Acupuncture.

What are two main types of non-opioid medications used for mild-moderate pain?

Acetaminophen (max 4000\,mg/24\,h) and NSAIDs (Aspirin, Ibuprofen, Naproxen, Ketorolac, Celecoxib).

Name at least three opioids used for moderate-severe pain.

Morphine, Hydromorphone, Fentanyl, and Demerol.

List side effects of opioids using the 'DESIGNER' mnemonic.

Dry mouth, Euphoria, Sedation, Itch, GI constipation, Nausea, Eyes (miosis), Respiratory depression.

What are two types of adjuvant medications used for pain?

Antidepressants (e.g., increasing serotonin) and anticonvulsants (e.g., Carbamazepine) for neuropathic pain.

Key safety precautions for Patient-Controlled Analgesia (PCA).

Only the patient should press the button, and there is a lockout mechanism to prevent overdose; pre-operative teaching is essential.

Special pain management considerations for older adults.

Increased GI bleeding risk (NSAIDs), increased renal/liver toxicity risk, and polypharmacy concerns.

Consequences of sleep deprivation.

Decreased reflexes, impaired memory, mood swings, and irritability.