Concepts Ii Pain (Learning Outcomes)

Front 1

1. Common misconceptions about pain:
(1-3 [7 total])

Back 1

1. Doctor have given me pain-relieving medications, which I will be given routinely.
2. If I ask for something for my pain, I may become addicted to the medication.
3. Sometimes it is better to put up with the pain than to deal with the side effects of pain medication.

Front 2

1. Common misconceptions about pain:
(4-7 [7 total])

Back 2

4. I should somehow control my pain. It is immature to talk about pain.
5. It is better to wait until the pain gets really bad before asking for help. If i take medication now for moderate pain, it won't relieve severe pain later on.
6. I don't want to bother anyone, I know how busy they are.
7. Its natural for me to have pain after surgery. After a few days, I should notice it lessening.

Front 3

2. Describe the Physiology of pain and identify the components of the pain experience:

Back 3

2.1 Reception
2.11 Neuroregulators
2.12 Gate Control Theory/Theory of pain

2.2 Perception

2.3 Reaction
2.3.1 Physiological Response
2.3.2 Behavioral Response

Front 4

2.1 Reception

Back 4

Nociceptors are the peripheral nerves fibers that transmit pain.
Afferent fibers (A slow, C fast) carry signal towards brain.

Front 5

2.11 Neuroregulators

Back 5

Endorphins (produced at neural synapses along the CNS) are powerful pain blocking chemicals that have analgesic effects.
Dynorphin - most potent
Enkephalins - less potent (widespread throughout the brain)

Front 6

2.12 Gate Control Theory

Back 6

Pain is transmitted along small (excitatory) and large (inhibit signal from spinal to brain) nerve fibers.
There are gating mechanisms in the dorsal horn that process exciting and inhibiting signals. When too much information is sent through spinal cells interrupt the signal as if closing a gate.

Front 7

2.3 Perception

Back 7

Perception of pain involves the sensory process that occurs when a stimulus for pain is involved.
Threshold is the point where pain is felt.
Tolerance is when intervention is needed.

Front 8

2.3 Reaction

Back 8

Reflex arch is activated - muscles contract removing oneself from pain. (arm, leg, etc.)

Front 9

2.3.1 Physiological Response

Back 9

Inc/Dec BP
Inc Respiratons
Fight/Flight
Prostration (Exhaustion)
Moaning
Etc.

Front 10

2.3.2 Behavioral Responses

Back 10

Posture Activities
Facial Expressions
Verbal Expressions

Front 11

3. Describe the sensory pain components that must be included in the nursing database.

Back 11

Purpose to assess pain are to eliminate guesswork, understand what they are experiencing and improve outcomes.

Characteristics of Pain Assessment:

Pt. Description of pain
Duration
Location
Intensity
Chronology of Pain
Aggravating/Alleviating Factors
Physiological/Behavioral Indicators
Effect of pain on Lifestyle

Pain Scales

Front 12

4. Explain how Cultural and developmental factors influence the pain experience.

Back 12

Some cultures control their expression to pain to appear stoic.

In families children may grow up to "ignore pain.

In Religious beliefs pain can be looked as a lack of goodness or deserved suffering.

Front 13

5. Examine Nonpharmacological Methods of pain relief based on individual needs.
5.1 Physical
5.2 Cognitive
5.3 Behavioral

Back 13

Imagery - happy place
Hypnosis
Music Therapy - inc endorphins
Biofeedback (monitor physio changes)
Acupuncture
Therapeutic Touch
Distractions - TV
Relaxation - inc effect of pain med.
Humor
Cutaneous Stimulation

Front 14

6. Describe the types and adverse effects of analgesics along with nursing implications.

Back 14

Opioids - produce analgesia by attaching to the opioid receptors. Side effects: sedation, nausea, constipation, respiratory depression.

Implement Narcan (opioid antagonist)

Front 15

7. Develop a nursing plan of care for a client experience pain:

Back 15

Nursing Diagnosis: Ineffective Coping related to discomforts in premenstrual symptoms.

Expected Outcome: by 10/30/11 pt will use relaxation techniques during periods of premenstrual symptoms.

Nursing Intervention: Assess pts knowledge of relaxation techniques + motivate to use them.

Front 16

8. Describe Cutaneous Stimulation

Back 16

Related to Gate Control Theory. When the skin is stimulated, pain is believed to be controlled by closing the gating mechanism in the spinal cord which will decrease pain impulses to the brain.

Massage
Heat/Cold
Acupressure
TENS