Pain Assessments - Week 3

Analgesics and Pain Management

• Spinal analgesics act by delivering drugs adjacent to the opioid receptors in the dorsal horn of the spinal cord.
• One of the rare adverse effects of opioids is respiratory depression.
• An example of adjuvant therapy in pain management is co-analgesics.

Opioid Delivery and Side Effects

• The less common route of opioid delivery is the intrathecal route.
• A less frequent side effect of opioids is urinary retention.

WHO Analgesic Ladder

• The second step of the WHO analgesic ladder includes moderate strength narcotics such as Codeine and Oxycodone.

Pain Management Myths and Consequences

• A common myth about opioid use is that they are highly addictive.
• One consequence of uncontrolled pain not listed in the text is anxiety.
• Uncontrolled pain can impact healing by delaying recovery.

Nursing Role in Pain Management

• The primary role of nurses in pain management is to assess and manage pain effectively.
• Nurses are responsible for developing and implementing pain management strategies.
• The primary nursing diagnosis for Andrea's pain related to her arthritic knee and ankle joints is pain.

Pain Assessment and Strategies

• The three top tips for pain assessment mentioned in the text are to assess pain regularly, use a pain rating scale, and prioritize pain management.
• The Canadian Pain Society considers effective pain treatment a human right.
• A key strategy in pain management is to use a multidisciplinary approach.

Types of Pain

• Nociceptive pain is described as poorly understood with physical, emotional, and cognitive components.
• Match the type of pain to its description:
  • Nociceptive pain: poorly understood with physical, emotional, and cognitive components
  • Neuropathic pain: related to nerve damage
  • Visceral pain: related to organs and viscera

Epidural Pain Management

• The purpose of maintaining strict aseptic techniques when managing an epidural catheter is to prevent infection.
• The tubing, infusion bag, and pump should be labeled as 'EPIDURAL' to prevent accidental injection.
• A key nursing intervention to maintain catheter integrity in an epidural delivery system is to secure the catheter properly.
• Alcohol should not be used in caring for the catheter or insertion site of an epidural delivery system because it can cause skin irritation and infection.
• A nurse should assess hourly for 24 hours and then every 4 hours the following parameters when managing a patient with an epidural infusion: level of sedation, pain score, and vital signs.
• Narcan (naloxone) should be readily available when managing patients with an epidural infusion to reverse respiratory depression.

Pain Assessment

• When Andrea rates her pain as a 6/10, which increases to 9 when she moves, she is using a numerical rating scale to assess her pain.
• A nurse should convey the need to understand the patient's experience of pain, including their emotional and psychological responses.