Ch 55 Client Comfort And Pain Management

Front 1

Pain

Back 1

Body's signal of distress.

Is a subjective symptom that only client can describe.

Main purpose is to protect as acting as a warning. Accepted as nursing diagnosis

Front 2

Relieving pain

Back 2

Is a common and ongoing nursing challenge along with providing comfort

Front 3

Cause of pain

Back 3

Determining cause is key, so treatment may begin asap.

Cause vary, may be difficult or impossible to determine.

Front 4

Physical causes of pain

Back 4

Include mechanical stress of trauma, surgical incision, or tumor growth. Excess pressure, hot and cold, also lack of oxygen. Muscle spasms.

Front 5

Fatigue

Back 5

Fatigue with lack of knowledge about pain management can cause further muscle tightening. Without intervention pain may follow.

Front 6

Existence of pain

Back 6

Pain exist even if no definite physical cause can be found. If they feel it, it is real.

Front 7

Nociception

Back 7

Term to describe normal pain trasmission and interception. Has 4 phases

Front 8

Trasduction

Back 8

Nervous system changes painful stimuli in the nerve endings to impulses

Front 9

Transmission

Back 9

Impulses travel from original site to the brain

Front 10

Perception

Back 10

Brain recognizes, defines, and responds to pain

Front 11

Modulation

Back 11

Body activates needed inhibitory response to the effects of pain

Front 12

Types of pain

Back 12

Identified in several categories

Acute, referred, cancer, and chronic

Front 13

Acute pain

Back 13

Usually a sensation that occurs abruptly, most often in response to some sort or trauma. Exist for 6 months or less. Aka nociceptive pain

Front 14

Referred pain

Back 14

Is pain that originates in one body part, but is perceived in another part of the body. Often originates in internal organs.

Front 15

Cancer pain

Back 15

Result in some sort of malignancy. Often very severe and considered untreatable. Hospice care is often involved.

Front 16

Chronic pain

Back 16

Aka neuropathic pain, is defined as discomfort that comtinues for a long time (6 months or longer) and may exist for client entire life. Cause often unknown

Front 17

Neuropathic pain syndromes

Back 17

Very difficult to treat, and the extract mechanisms involved are not fully understood.

Front 18

Intractable pain

Back 18

Chronic pain that resists therapeutic interventions. This type of pain may have a known cause, such as inoperable invasive tumor, or cause may be unknown

Front 19

Depression

Back 19

Caused when person fails to express feelings, suppressed anger may turn and cause depression. Symptoms include fatigue, sleeplessness, to much sleep, lack of interest.

Front 20

Results of chronic pain experience

Back 20

Loss of control

Decreased self esteem

Decreased communication

Inappropriate life goals

Change in relationships

Anger at friends

Decreased activity

Decreased endurance

Front 21

Pain threshold

Back 21

Lowest intensity of a stimulus that causes the subject to feel pain.

Front 22

Pain tolerance

Back 22

Denotes the point at which a person can no longer endure pain

Front 23

Endorphins

Back 23

Produced by CNS, are naturally occurring substances that relieve pain.

Front 24

Educating patient

Back 24

Teach then about

Meds

Exercise

Nutrition

Recreation

Relaxation

Support

Hobbies

Rest/sleep

Front 25

Meds & other interventions

Back 25

Help increase a clients threshold and pain tolerance

Front 26

Pain as fifth vital sign

Back 26

Pain is to be assessed when doing other vital signs

Front 27

Documentation of pain

Back 27

Level of pain

Description of pain

Actions taken

Results

Front 28

Rating pain

Back 28

Using a scale, helps client determine their level of pain

Front 29

Pain intensity scale/ pain distress scale

Back 29

Usually reserved for children older than 7 yr and adults.

Chose number or location on linear scale

Front 30

McGill melzack pain questionare

Back 30

Method for rating pain by questionare

Front 31

Wong-baker face pain scale

Back 31

Has faces and used for children 3-7. Even adults that have difficulty expressing themselves.

Front 32

FLACC

Back 32

Rates pain by nurse visually observing child's face, legs, activity, cry, consolability

Front 33

NIPS

Back 33

Same as FLACC

Front 34

Coldspa

Back 34

Used to gather info of pain.

Character

Onset

Location

Duration

Severity

Pattern

Associated factors

Front 35

Analgesics

Back 35

Medications that relieve pain. Usually more effective when given on regular basis or very onset of pain.

Front 36

Preventive approach

Back 36

Give analgesic immediately after surgery or before painful treatment. If med is given before pain occurs, it's usually easier to control

Front 37

Analgesic work?

Back 37

Provide pain relief by altering body's sodium and potassium levels, thus slowing or halting pain transmission

Front 38

3 classes of analgesic

Back 38

Nonopiod nonsteriod anti inflammatory drugs,

Opioids/narcotic, adjuvant drugs

Front 39

Nonopiod NSAID

Back 39

Include asprin, ibuprofen, naproxen. Use for mild to moderate pain

Front 40

Opioids

Back 40

Most common is morphine, used for moderate to severe pain

Front 41

Adjuvant drugs

Back 41

Used for other purposes but may help with pain. Examples are anticonvulsant and antidepressants

Front 42

Ointments and liniments

Back 42

May contain local anesthetics that may provide pain relief

Front 43

Dependence of pain meds

Back 43

Doesn't usually occur during acute pain. However, these meds, especially opioids, shouldn't be used long term

Front 44

Surgery

Back 44

May be necessary to alleviate certain types of chronic pain. However, more less invasive technique are available, making surgery rarely used today.

Front 45

Nursing intervention

Back 45

Empathic nursing care can help improve pain. Client positioning, bathing, backrubs.

Front 46

Comfort measures

Back 46

Clean bed, clean face, warm room, important to assist with elimination to monitor vioding.

Front 47

Physical measures

Back 47

May be used in addition to pharmacologic pain management interventions.

Front 48

TENS

Back 48

Technique that allows client to wear an electronic device and trigger electrical stimulation when they feel pain.

Front 49

Body cues

Back 49

Teach client to read their own body rythms.

Front 50

Distraction & diversions

Back 50

Activities such as visiting, games, tv, crafts can divert attention away from pain

Front 51

Guided imagery

Back 51

Process through which client receives a suggestion to concentrate on an image to control pain.

Front 52

Support groups

Back 52

Can help individuals in pain by giving opportunity to express their feelings and talk about pain. Client and family members can both benefit

Front 53

Stress managment

Back 53

Stress may aggravate pain.

Front 54

Alternative & complementary techniques

Back 54

Client may use nonphamacologic measure to manage pain. Such as chirpractic care, acupuncture, acupressure, hypnosis. Flower essences, aromatic oils.

Front 55

Nursing alert

Back 55

Client with chronic pain is vulnerable to unscrupulous practitioners becuz client is desperate and often willing to try anything to help with pain. People may take advantage of this.