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Pain

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

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  1. Pain Teresa V. Hurley, MSN, RN

  2. 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

  3. 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

  4. 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

  5. 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

  6. General Assessments of Pain (continued) • Aggravating and alleviating factors • Physiologic indicators of pain • Behavioral responses • Effect of pain on activities and lifestyle

  7. Wilda Scale • Words that describe the pain • Intensity of pain • Location of pain • Duration of pain • Aggravating or alleviating factors

  8. 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

  9. Distraction Humor Music Imagery Nonpharmacologic Pain Relief Measures

  10. Nonpharmacologic Pain Relief Measures • Relaxation • Acupuncture

  11. Hypnosis Biofeedback Therapeutic touch Nonpharmacologic Pain Relief Measures

  12. Pharmacologic Pain Relief Measures • Analgesic administration • Nonopiod analgesics • Opioids or narcotic analgesics • Adjuvant drugs (enhance the action of main drug)

  13. 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

  14. 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.

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