Podcast
Questions and Answers
Which of the following are considered nonverbal indicators of pain? (Select all that apply)
Which of the following are considered nonverbal indicators of pain? (Select all that apply)
Effective and timely pain assessment is best achieved by using any pain assessment tool available.
Effective and timely pain assessment is best achieved by using any pain assessment tool available.
False
A treatment initiated before the surgical procedure in order to reduce sensitization is known as pre-emptive ___.
A treatment initiated before the surgical procedure in order to reduce sensitization is known as pre-emptive ___.
analgesia
What must be initiated by the nurse according to the content?
What must be initiated by the nurse according to the content?
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What is pain according to the content?
What is pain according to the content?
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Which factor influences how a person perceives pain based on the content?
Which factor influences how a person perceives pain based on the content?
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Persistent/Chronic pain is always experienced for a short duration.
Persistent/Chronic pain is always experienced for a short duration.
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The role of the nurse in pain management includes assessing, documenting, and communicating findings to ______ members of the healthcare team.
The role of the nurse in pain management includes assessing, documenting, and communicating findings to ______ members of the healthcare team.
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Which classes of drugs are considered adjuvant therapy for pain relief?
Which classes of drugs are considered adjuvant therapy for pain relief?
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What is the term for a progressive decrease in responsiveness to a drug resulting in the need for a larger dose of the drug to achieve the effect originally obtained?
What is the term for a progressive decrease in responsiveness to a drug resulting in the need for a larger dose of the drug to achieve the effect originally obtained?
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Define pain tolerance.
Define pain tolerance.
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Opioid withdrawal is associated with signs and symptoms due to increased usage of opioids.
Opioid withdrawal is associated with signs and symptoms due to increased usage of opioids.
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Match the side effects of opioid agonists with their respective systems:
Match the side effects of opioid agonists with their respective systems:
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Study Notes
Factors Influencing the Pain Experience
- Age and developmental stage: determines how children and older adults perceive and react to pain
- Gender: women have a higher threshold and experience more intense pain than men
- Previous experience with pain: affects the pain experience and how a patient adapts
- Meaning of pain: influences the pain experience and how a patient adapts (e.g., threat, loss, punishment, or challenge)
- Heredity: genetic disposition influences pain sensitivity, metabolism of pain medication, and susceptibility to chronic pain
- Emotional status: anxiety, depression, and other emotional states affect the pain experience
- Social factors: attention, experience, family, and social support influence pain perception
- Culture and ethnic values: shape individual responses, behaviors, and attitudes about pain
- Environment and support persons: influence the pain experience
- Spiritual factors: religion, spirituality, and hope affect pain perception and coping
Pain Management
- Definition: an unpleasant, subjective, sensory, and emotional experience associated with actual or potential tissue damage
- Significance: unrelieved pain is a major health issue, leading to disability, lost productivity, and negative economic impacts
- Barriers: lack of knowledge, misconceptions, inadequate information, and long wait times
- Principles: assess pain, manage pain, and minimize suffering
- Types of pain:
- Acute pain: sudden onset, usually has an identifiable cause, and resolves with treatment
- Chronic pain: gradual or sudden onset, persists past normal healing time, and may be intermittent or persistent
Role of the Nurse in Pain Management
- Understand multiple dimensions of pain to assess and manage pain effectively
- Act as planner, educator, patient advocate, interpreter, and supporter
- Goals: describe pain experience, identify patient goals, and conduct accurate assessments
- Nursing roles: assess, document, communicate, ensure pain relief, monitor adverse effects, teach, and address concerns
Pain Assessment
- Knowledge of pain physiology and factors influencing pain informs effective pain management
- Nursing process: provide a systematic approach to understanding and treating pain
- Assessment: initiate, consider frequency, use validated tools, and assess intensity, location, and descriptors
- Errors: bias, unclear questions, unreliable tools, and lack of consideration of cultural variations
Pharmacological and Non-Pharmacological Interventions
- Pharmacology: use the WHO Step Ladder Approach
- Non-pharmacological interventions:
- Physical: cutaneous stimulation, immobilization, and transcutaneous electrical nerve stimulation
- Psychological: cognitive-behavioral therapy, relaxation, and meditation
- Alternative: acupuncture, massage, and herbal remedies
Lived Experience of Clients with Pain
- Types of pain: visceral, cutaneous, somatic, neuropathic, phantom, and intractable
- Differentiate pain threshold, pain sensation, pain reaction, and pain tolerance
- Nursing diagnoses: pain, activity intolerance, anxiety, body image disturbance, and coping difficulties### Planning for Pain Management
- Includes both pharmacological and non-pharmacological methods
- Know how, what, and when to use each method
- Actively involve healthcare teams (HCT) in improving pain assessment and management
- Offer complementary therapy pain treatment modality to supplement healthcare practices
- Facilitate access to prescription monitoring programs
- Engage patients in treatment decisions about pain management
- Provide referrals to treatment programs for patients with addiction
Pain Management Interventions
- Non-pharmacological interventions:
- Physical (massage, exercise, turning, and repositioning, heat/cold therapy, acupuncture)
- Cognitive (distraction, relaxation, guided imagery, self-management)
- Pharmacological therapy:
- World Health Organization (WHO) Analgesic Ladder
- Medications are given based on the intensity and severity of pain
- Step 1: Mild pain (non-opioid analgesics)
- Step 2: Mild to moderate pain (opioid analgesics)
- Step 3: Moderate to severe pain (opioid analgesics)
Pain Management Goals
- High priority is to control and manage pain at a level acceptable to the patient
- Individualized approach should be used
- Multidisciplinary approach is best
- Break down barriers and reduce misconceptions
Key Terms
- Equianalgesic dose: dose of one analgesic that produces pain-relieving effects equivalent to those of another
- Titration: dosage adjustment based on assessment of effectiveness of analgesic effect
- Adjuvant therapy: medications originally developed to treat other conditions but have shown analgesic properties
- Pain tolerance: amount of pain an individual can endure before outwardly responding to it
- Addiction: strong psychological and physical dependence on a drug, usually resulting from habitual use
- Opioid withdrawal: signs and symptoms associated with abstinence from, withdrawal of, or reduction of an opioid analgesic
- Tolerance: progressive decrease in responsiveness to a drug resulting in the need for a larger dose to achieve the original effect
Patient and Caregiver Teaching
- Goals of patient and caregiver teaching include:
- Keeping a record of pain intensity and effectiveness of treatment
- Not waiting until pain intensifies to treat
- Pain medications may need adjustment over time to ensure effectiveness
- Potential side effects of opioids
- Informing HCP if pain is not relieved by current treatment plan
Barriers to Pain Management
- Fear of addiction or tolerance
- Concern about adverse effects
- Fear of injections
- Desire to be a good patient
- Desire to be stoic
- Forgetting to take analgesic
- Fear of disease progression
- Sense of fatalism
- Ineffective treatment
- Inadequate HCP education
- Lack of institutional support
Age-Related Considerations and Pain
- Persistent pain is common, associated with physical disability and psychosocial problems
- Musculoskeletal conditions are the most common source of pain in older adults
- Pain in older adults is inadequately assessed and treated
- Barriers to pain management in older adults:
- Cognitive changes
- Hearing changes
- Vision changes
- Metabolizing drugs slower
- Increased risk of toxic/adverse effects
- NSAIDs have high frequency GI bleeds
- Multiple drug interactions
- Cognitive impairment and ataxia can worsen with analgesic use
Ethical Issues in Pain Management
- Fear of hastening death by administering analgesics
- Use of placebos in pain assessment and treatment
Evaluation
- Continually evaluate and re-evaluate pain management interventions
- Assess effectiveness of interventions and make changes as needed
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Description
This study guide covers the factors that influence the pain experience for PNUR124 Week 6 at Centennial College. It's part of Practical Nursing Theory 2 course.
