pharm 3/13/25 pain

Introduction

• Discussion on the stigma surrounding drug use and its impact on healthcare providers' views.

• Emphasis on the need for non-judgmental care in nursing.

Bias and Substance Use

• There is significant bias against individuals who use substances, leading to clouded judgment among healthcare professionals.

• This bias can affect the quality of care provided to patients who are substance users.

• Importance of understanding that substance use does not define a person's worth; care should focus on health.

Role of Nurses

• Nurses are advocates for their patients and should provide evidence-based care.

• The reality faced when dealing with patients undergoing withdrawal symptoms and its somatic implications (e.g., pain, seizures).

• The critical nature of providing adequate pain relief and managing withdrawal.

Pain and the Nervous System

• Explain how opioids work on the nervous system and the impact of abruptly removing them from a patient accustomed to their use.

• Withdrawal can result in genuine pain due to nervous system reactions, leading to potential serious health risks, including seizures and death.

Trust in Nursing

• Nursing consistently ranks as the most trusted profession.

• The obligation of nurses to uphold this trust through caring practices and patient advocacy.

Non-Pharmacologic Pain Management Techniques

• Discussion on various non-pharmacologic methods to manage pain. Examples include:

  • Sleep: Chronic sleep deprivation can lead to inflammation and increased pain sensitivity.

  • Ice/Heat: Application can alleviate pain and discomfort.

  • Stretching: Effective in pain management and maintaining mobility.

  • Emotional Support: Talking through pain episodes to ease anxiety and stress.

  • Music Therapy: Has significant therapeutic effects; can aid recovery and pain management, especially in special populations like dementia patients.

  • Meditation: Reduces stress, aids in pain management.

  • Guided Imagery & Hypnosis: Have shown benefits in managing pain and achieving relaxation.

  • Acupuncture & Massage Therapy: Both have empirical support for their efficacy in pain relief.

  • Repositioning: Simple adjustments can greatly affect a patient’s comfort level.

  • Pet Therapy: Shown to improve patient mood and lessen perception of pain.

Pain Assessment

• Introduction of the 'OLD CARTS' mnemonic for pain assessment:

  • O: Onset - when did the pain begin?

  • L: Location - Where is the pain?

  • D: Duration - How long has the pain lasted?

  • C: Characteristics - Description of the pain.

  • R: Radiation - Does the pain radiate to other areas?

  • T: Treatments tried - What have they already done for pain?

  • S: Severity - Rating of pain from 0-10.

Pharmacologic Pain Management: NSAIDs and Acetaminophen

• Overview of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs):

  • Used for pain, inflammation, and fever relief.

  • Can cause gastrointestinal bleeding and kidney issues; should be avoided by certain populations (e.g., pregnant women, those with renal impairments).

  • Administration with food is recommended to prevent GI upset.

• Overview of Acetaminophen (Tylenol):

  • Used primarily for pain and fever relief, not for inflammation.

  • Can cause liver damage; avoid in individuals with liver disease or heavy alcohol users.

  • Maximum daily dose is 4 grams; importance of being aware of combination medications containing acetaminophen to prevent overdose.

  • Acetylcysteine is the reversal agent for acetaminophen overdose.

Conclusion

• The necessity for nurses to integrate both pharmacologic and non-pharmacologic strategies for comprehensive pain management.

• The importance of continuous education on pain management and the potential impacts on patient care outcomes.