Pain Management Concepts and Categorization

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Questions and Answers

What defines breakthrough pain?

  • Pain that is continuously present after surgery
  • Pain that persists for more than six months
  • Pain that occurs unexpectedly in chronic conditions (correct)
  • A type of mixed pain

Which factor is NOT considered a risk factor for undertreatment of pain?

  • Cultural and societal attitudes
  • Lack of knowledge
  • Fear of addiction
  • Age of the client (correct)

What type of pain is defined by the pathology involved?

  • Chronic pain
  • Acute pain
  • Nociceptive pain (correct)
  • Breakthrough pain

Which condition is NOT typically associated with mixed pain?

<p>Spinal cord injury (D)</p> Signup and view all the answers

What behavioral indicator can assist in assessing pain in nonverbal clients?

<p>Facial expressions (B)</p> Signup and view all the answers

Which of the following best describes neuropathic pain?

<p>Pain arising from nerve damage or dysfunction (D)</p> Signup and view all the answers

How does cognitive function impact the pain experience?

<p>Cognitively impaired clients may report pain inaccurately (C)</p> Signup and view all the answers

In which population is there a heightened risk for undertreatment of pain?

<p>Older adults (C)</p> Signup and view all the answers

What is the primary role of adjuvant analgesics?

<p>To enhance the effects of non-opioids and alleviate conditions that aggravate pain (A)</p> Signup and view all the answers

Which of the following interventions is recommended for managing opioid-induced constipation?

<p>Administer more fluids and increase fiber intake (C)</p> Signup and view all the answers

What should be done in response to a patient experiencing orthostatic hypotension after opioid administration?

<p>Instruct the patient to remain still and lie down if feeling lightheaded (C)</p> Signup and view all the answers

How should respiratory depression due to opioid use be initially addressed?

<p>Reduce the opioid dose given (C)</p> Signup and view all the answers

Which medication should be considered for managing nausea caused by opioid use?

<p>Ondansetron (C)</p> Signup and view all the answers

What is a significant advantage of using patient-controlled analgesia (PCA) systems?

<p>Ensures consistent plasma levels and gives patients a sense of control (D)</p> Signup and view all the answers

What is the purpose of monitoring respiratory rate prior to opioid administration?

<p>To establish a baseline for detecting respiratory depression (A)</p> Signup and view all the answers

Which of the following is NOT a recommended approach for managing urinary retention in opioid users?

<p>Manually stimulate bladder contraction (C)</p> Signup and view all the answers

Flashcards

Acute Pain

Short-term pain, usually lasting less than 3 months

Chronic Pain

Pain lasting for more than 3 months

Breakthrough Pain

Sudden increase in acute pain in clients with chronic pain conditions, needing further pain relief.

Mixed Pain

Cannot be easily categorized as either acute or chronic or nociceptive or neuropathic.

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Pain Assessment

Evaluating a patient's pain, combining self-report with observable behaviors

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Untreated Pain

Pain that isn't adequately managed.

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Pain Risk Factors

Situations increasing risk of pain being undertreated, including lack of knowledge, societal attitudes, and fear of addiction.

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Pain Categories

Pain is categorized by duration (acute or chronic) and pathology (nociceptive or neuropathic).

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Opioid Side Effect: Constipation

Common side effect of opioid use, characterized by difficulty passing stools. Can be managed with preventive measures like increased fiber intake, fluids, and stool softeners.

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Opioid Side Effect: Orthostatic Hypotension

A sudden drop in blood pressure upon standing, causing dizziness or lightheadedness. Can be managed by changing positions slowly and sitting or lying down if symptoms occur.

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Opioid Side Effect: Urinary Retention

Difficulty emptying the bladder. Managed by monitoring urine output, assessing for bladder distention, administering medications to stimulate urination, and potentially using a catheter.

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Opioid Side Effect: Nausea/Vomiting

Feeling sick to your stomach and throwing up. Managed by antiemetics, lying still, moving slowly, and reducing exposure to strong odors.

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Opioid Side Effect: Sedation

Drowsiness or sleepiness. Monitored by checking the level of consciousness and taking safety precautions. Can often precede respiratory depression.

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Opioid Side Effect: Respiratory Depression

Decreased breathing rate or effort. Monitored closely. Treatment involves reducing the opioid dose or administering naloxone to reverse the effects.

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Adjuvant Analgesics

Medications used in combination with opioids to enhance pain relief, manage other pain-related symptoms, and treat neuropathic pain.

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Patient-Controlled Analgesia (PCA)

A system that allows patients to self-administer pain medication for better control and reduced pain.

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Study Notes

Pain Categorization

  • Pain is categorized by duration (acute or chronic) or by pathology (nociceptive or neuropathic).
  • Mixed pain is possible and difficult to categorize, arising from conditions like fibromyalgia, HIV, and Lyme disease.
  • Breakthrough pain is an exacerbation of acute pain, requiring additional relief, especially in clients with chronic conditions.

Risk Factors for Untreated Pain

  • Cultural and societal attitudes can affect pain management.
  • Lack of knowledge regarding pain management can lead to undertreatment.
  • Fear of addiction can prevent adequate pain relief.
  • Exaggerated fear of respiratory depression can hinder pain management decisions.
  • Populations at risk for undertreatment include infants, children, older adults, and clients with substance use disorders.

Causes of Acute and Chronic Pain

  • Trauma
  • Surgery
  • Cancer (tumor invasion, nerve compression, bone metastases, associated infections, immobility)
  • Arthritis
  • Fibromyalgia
  • Neuropathy
  • Diagnostic or treatment procedures (injection, intubation, radiation)

Factors Affecting the Pain Experience

  • Age:
    • Infants cannot communicate pain.
    • Older adults often have multiple conditions contributing to pain and reduced function.
  • Fatigue: Increases sensitivity to pain.
  • Genetics: Can influence pain tolerance.
  • Cognitive function: Impaired cognitive function may lead to inaccurate pain reporting.
  • Prior experiences: Past pain experiences affect sensitivity.
  • Anxiety and fear: Increase pain sensitivity.
  • Support systems: Can decrease pain sensitivity.
  • Culture: Influences how pain is expressed and perceived.

Expected Findings/Assessment

  • Pain assessment includes both self-report and observed behaviors.
  • Behaviors:
    • Facial expressions (grimacing, forehead wrinkling)
    • Body movements (restlessness, pacing, guarding)
    • Moaning, crying
    • Decreased attention span
  • Physiological indicators (blood pressure, pulse, respiratory rate): Increase temporarily during acute pain, but not a reliable long-term measure of pain intensity.

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