Ch.41 PAIN MANAGEMENT
·
ACUTE CHRONIC
1. Not Protective, Lasts 6 + months
1. Protective; Temporary 2. Beyond tissue healing
2. Direct Cause; Resolves w tissue healing 3. Physiological; Depression, Fatigue, Decrease level of
3. Physiological; Fight or flight responce function
4. Behavioral: Grimacing, moaning, flinching 4. Psychosocial; Leads to disability
5. Symptomatic release
5. Treatment of underlying problem
6. Cancer pain or noncancer pain
6. 7. Idiopathic =Unknown
NOCICEPTIVE NEUROPATHIC
1. Arises from damage to or inflammation of tissue 1. Arises from abnormal/ damaged pain nerves
2. Throbbing, aching, localized 2. Phantom limb pain, spinal, diabetic
3. Opioids and non-opioid meds 3. Intense, shooting, burning, pins and needles '/
4. Somatic; Bones, joints, muscle, skin 4. Adjuvant meds= antidepressant, antispasmodic,
5. Visceral; Internal Organs skeletal muscle relaxers
6. Cutaneous; in the skin or subcutaneous 5. Topical Meds; relief for peripheral neuropathic pain
Physiology of P NON-OPIOID OPIOID ADJUVANT
NOCICEPTIVE PAIN H
A • Acetaminophen, • Morphine, Fentanyl, • Depression,
R NSAIDS, Salicylate Codeine
Seizures,
Transduction: conversion of pain stimuli to M • Severe pain
• Mild to Moderate pain • Sedation; Level of inflammation
an electrical impulse through peripheral A
Consciousness
nerve fibers C
• Hepatoxic Affects • Respiratory • Alleviates
O Healthy liver no more Depression: Monitor manifestations
Transmission: occurs as the electrical L than 4g/day before and after that aggravate
impulse travels along the nerve fibers O • Orthostatic
pain
G • Monitor for Salicylism Hypotension: Sit or lie
down; slow movement
Modulation: occurs in spinal cord, moves I • Useful to treated
• Prevent gastric upset • Slowly dilute
body away from painful stimuli C NALOXONE to reverse neuropathic pain
A • Monitor bleed w/ long opioid
L term NSAIDS
Nursing Assessment for PAIN
DRUGS
1. Client report of pain os the most reliable
diagnostic measure of pain 1. Anticonvulsants: Carbamazepine, Gabapentin
2. Assess & document Frequently 2. Anti anxiety Agents: Diazepam, lorazepam
3. Use symptoms analysis to obtain 3. Tricyclic Antidepressants: amitriptyline, nortiptyline
subjective data 4. Anesthetics= infusoinal Lidocaine
5. Antihistamine= hydroxyzine
Q’s to ASK 6. Glucocorticoids= Dexamethasore
7. Antiemetics= ondansetron
8. Bisphosphonates & Calcitonin= for bone pain
1. Where is your pain
2. How does it feel
3. Rate your pain 1-10
4. When did it start? How long does it last? DRUGS ROUTES
5. How does it affect your daily life
6. What other symptoms do you have
7. What makes it better/worse Parental Route: immediate, short term relief of acute pain
Oral Route: for chronic, non-fluctuating pain
·
ACUTE CHRONIC
1. Not Protective, Lasts 6 + months
1. Protective; Temporary 2. Beyond tissue healing
2. Direct Cause; Resolves w tissue healing 3. Physiological; Depression, Fatigue, Decrease level of
3. Physiological; Fight or flight responce function
4. Behavioral: Grimacing, moaning, flinching 4. Psychosocial; Leads to disability
5. Symptomatic release
5. Treatment of underlying problem
6. Cancer pain or noncancer pain
6. 7. Idiopathic =Unknown
NOCICEPTIVE NEUROPATHIC
1. Arises from damage to or inflammation of tissue 1. Arises from abnormal/ damaged pain nerves
2. Throbbing, aching, localized 2. Phantom limb pain, spinal, diabetic
3. Opioids and non-opioid meds 3. Intense, shooting, burning, pins and needles '/
4. Somatic; Bones, joints, muscle, skin 4. Adjuvant meds= antidepressant, antispasmodic,
5. Visceral; Internal Organs skeletal muscle relaxers
6. Cutaneous; in the skin or subcutaneous 5. Topical Meds; relief for peripheral neuropathic pain
Physiology of P NON-OPIOID OPIOID ADJUVANT
NOCICEPTIVE PAIN H
A • Acetaminophen, • Morphine, Fentanyl, • Depression,
R NSAIDS, Salicylate Codeine
Seizures,
Transduction: conversion of pain stimuli to M • Severe pain
• Mild to Moderate pain • Sedation; Level of inflammation
an electrical impulse through peripheral A
Consciousness
nerve fibers C
• Hepatoxic Affects • Respiratory • Alleviates
O Healthy liver no more Depression: Monitor manifestations
Transmission: occurs as the electrical L than 4g/day before and after that aggravate
impulse travels along the nerve fibers O • Orthostatic
pain
G • Monitor for Salicylism Hypotension: Sit or lie
down; slow movement
Modulation: occurs in spinal cord, moves I • Useful to treated
• Prevent gastric upset • Slowly dilute
body away from painful stimuli C NALOXONE to reverse neuropathic pain
A • Monitor bleed w/ long opioid
L term NSAIDS
Nursing Assessment for PAIN
DRUGS
1. Client report of pain os the most reliable
diagnostic measure of pain 1. Anticonvulsants: Carbamazepine, Gabapentin
2. Assess & document Frequently 2. Anti anxiety Agents: Diazepam, lorazepam
3. Use symptoms analysis to obtain 3. Tricyclic Antidepressants: amitriptyline, nortiptyline
subjective data 4. Anesthetics= infusoinal Lidocaine
5. Antihistamine= hydroxyzine
Q’s to ASK 6. Glucocorticoids= Dexamethasore
7. Antiemetics= ondansetron
8. Bisphosphonates & Calcitonin= for bone pain
1. Where is your pain
2. How does it feel
3. Rate your pain 1-10
4. When did it start? How long does it last? DRUGS ROUTES
5. How does it affect your daily life
6. What other symptoms do you have
7. What makes it better/worse Parental Route: immediate, short term relief of acute pain
Oral Route: for chronic, non-fluctuating pain
