Comfort

Comfort

Unit 5

Module 5A

Jill Huffman, MSNed, RN

Learning Outcomes

• Collaborate with the interprofessional team to provide high-quality care for patients with fibromyalgia.

• Use clinical judgement to plan care for the patient with fibromyalgia.

• Discuss alternative therapies that can be used to manage chronic pain across the lifespan.

• Apply knowledge of anatomy, physiology, pathophysiology, and psychosocial needs of patients and family at end of life to plan care across the lifespan.

Learning Resources

• Ignatavicius, D. (2021). pp. 72-73, 1005-1006, & Chapter 8.

• Perry & Hockenberry (2023). Chapter 30

• ATI RN Adult Medical Surgical Nursing 11.0 – Chapters 4 & p. 581

• ATI Fundamentals for Nursing 10.0 – Chapters 36, 41, & 42.

• ATI Engage Fundamentals: (Review)

• Foundational concepts for Nursing Practice - Complementary and Integrative Health

• Physiological Concepts for Nursing Practice - Pain; End of Life

• Websites:

• https://medlineplus.gov/complementaryandintegrativemedicine.html

• https://www.cdc.gov/arthritis/basics/fibromyalgia.htm

Pain

• Defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage.

• Subjective - Pain is what the patient says it is

• Self reporting is always the most reliable indication of pain.

• Considered the fifth vital sign

• Use a focused data tool to collect data about the pain (OLDCARTS or PQRST)

• Perception of pain is individualized

Pain in Children

• Young Infant

• Loud cry

• Rigid body

• Expressions of pain

• Older Infant

• Loud cry

• Deliberate withdrawal from pain

• Facial expression of pain

• Toddler

• Loud cry or screaming

• Verbal expression of pain

• Thrashing of extremities

• Attempt to push away or avoid stimulus

• Clinging to significant person

• Request physical comfort

• School-Age Child

• Stalling behavior

• Muscular rigidity

• Same behaviors as the toddler

• Adolescent

• More verbal expressions of pain with less protest

• Muscle tension with body control

Types of Pain

• Acute pain - temporary, has a sudden onset, and is easily localized.

• as the injured area heals the pain goes away

• ex: pain from surgery

• Chronic pain - aka persistent pain - lasts for more than 3 months

• gradual onset and may or may not have a cause

• ex: fibromyalgia and cancer

• Nociceptive pain - result of actual or potential tissue damage or inflammation.

• Somatic pain - pain that arises from the skin and musculoskeletal structures

• described as sharp throbbing, dull, aching, cramping

• Visceral pain - pain that arises from organs

• described as deep cramping or pressure, sharp, stabbing

• Neuropathic pain - result of damage or dysfunction of the nervous system

• distinctive descriptors include: burning, shooting, tingling, feeling pins and needles

Effects of Unrelieved Pain

• Acute pain can turn into chronic pain if left untreatedThis text discusses the management of fibromyalgia and end-of-life care. Medications such as amitriptyline, cyclobenzaprine, and NSAIDs are used to manage mild to moderate pain in fibromyalgia patients. Opioids are avoided to prevent tolerance and addiction. Nursing interventions for fibromyalgia patients include education on disease management, exercise, yoga, stretching, relaxation techniques, and healthy diet. The text also discusses end-of-life care, including hospice and palliative care, assessment findings at the end of life, and managing symptoms of distress such as pain, weakness, breathlessness, nausea and vomiting, and agitation and delirium. The text also touches on religious beliefs and practices related to end-of-life care for Roman Catholics, Christians, Jews, and Muslims.