Pain Assessment

Pain Assessment vn

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1.Pain interventions/therapies: -medications
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-positioning
-heat/ice
-support
2.The definition of pain: an unpleasant sensory and emotional experie
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nce asso-vn

vnciated with actual or potential tissue damage, or described in terms o
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f such damage
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sometimes there is no tissue damage but the patient is still having pa
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n
3.What is the purpose of pain?: -warns us of imminent/
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actual tissue damage vn vn

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elicits coordinated reflex and behavioural responses to keep injury to
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nminimum
4.Key principles to manage pain: -GOAL: reduction
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-INVOLVE: goals setting and negotiating analgesic strategies
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THOROUGH ASSESSMENT is critical: assess for type(s) of pain (shootin
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, stab- bing, throbbing)
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-DO NOT DELAY
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-MULTI-MODAL APPROACH to treatment: vn vn vn


5.Goal=reduction: Reduce the pain to an acceptable level (level is defi vn vn vn vn vn vn vn vn vn vn

ned by the patient NOT the nurse)
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6.INVOLVE: goals setting and negotiating analgesic strategies
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-involve patient, care workers and other service providers
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7.Thorough assessment is critical: without knowing what type of pain i
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t is, can't manage pain properly
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8.Do not delay: -ESPECIALLY if it is severe
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don't assume nothing is wrong even if they don't look like they are in
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pain
9.A multi-modal approach to treatment: -not just medications
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-may need several medications
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, Pain Assessment
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10.Nociception:
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-Process of stimulus starting the phase
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-Neuroplasticity has to do with how long the pain lasts
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11.Phases of nociception: -transduction
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-transmission
-perception
-modulation
12.Nociceptors: pain sensing nerve cells
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skin, muscle, connective tissue, circulatory system, abdomen, pelvic a
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d thoracic
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viscera
-described as "aching" or "throbbing" vn vn vn vn


13.What are nociceptors activated by: INJURY or secondarily by chemica
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l med- itators that are released from the site of tissue damage
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-mechanical (touch/pressure) vn

-thermal (hot/cold) vn

-chemical (exogenous (external)/endogenous (internal))
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14.3 types of pain: -nociceptive
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-neuropathic
-referred
15.Nociceptive pain: Characteristics: vn vn

-well-localized
-more diffuse if deeper structures or if viscera involved
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-aching, sharp, dull, throbbing vn vn vn




Causes:
-direct stimulation of peripheral nociceptors
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-usually associated w tissue damage as well as inflammatory processe
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16.2 types of pain nociceptive pain sources: -visceral
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-somatic
17.Visceral pain: 2 types vn vn vn

1.From direct injury or stretching of larger interior organs
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2.Result of: tumor, ischemia, distension or contraction
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FROM ORGAN DAMAGE vn vn

18.Somatic pain: 2 types: vn vn vn

1.Superficial somatic: from invasion or ulceration of the skin and s
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ubcutaneous tissue (cutaneous pain) vn vn vn

2.Deep somatic: from joints, tendons, soft tissue, muscles or bone
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19.Neuropathic pain: Caused by lesion, dysfunction or disease affe
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cting so- matosensory nervous system
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-results from damage to the nerve pathway
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caused by direct nerve trauma, infections, metabolic problems, may b
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ndrug in- duced vn vn

-described as "burning" or "shooting" vn vn vn vn

-manifestations vary among patients vn vn vn

-abnormal processing of sensory input by the PNS or CNS
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20.Referred pain: originates in one location but is felt in another site
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