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PAIN Fast Facts: Types: acute versus persistent or chronic (pain for more than 3 months) Mechanisms/Classifications: Nociceptive (surgery injury) Inflammatory (sunburn, infection) Neuropathic (ne...

PAIN Fast Facts: Types: acute versus persistent or chronic (pain for more than 3 months) Mechanisms/Classifications: Nociceptive (surgery injury) Inflammatory (sunburn, infection) Neuropathic (nerve pain, diabetes, chemo induced) Two primary afferent nociceptors: (know the difference bn the fibers) A delta C fiber Treatment of Pain: Nociceptive: Non-pharmacologic: ice, distraction Mild to mod: standard analgesics Mod – severe: combination oral agents Inflammatory: non-pharm: cooling, warming, exercise Mild to mod: NSAIDs Moderate to severe: disease modifying Neuropathic: Pain Alphabet: Non pharm: Cognitive Behavioral Q: Quality (words like stabbing, crushing, dull, achy) Therapy, activity modification R : Region (where is it – does it flare out/) Neuromodulating agents (Anti- S: Severity (Numerical pain scale: Verbal scale – mild, depressants, anti-seizure drugs) moderate, severe; Visual scales) T: Timing: start? Constant? Sporadic? Predictable? U: Usually associated with: eating foods? Exercise? Nausea? V: Very much relieved by; pain meds? Rest? Activity? Ice/heat? Splint? W; Worse with: activity? Fears? Poor sleep? Or COLDSPA or OLDCARTS Non- Pharm Pain Management: CBT, Massage, Reflexology, Relaxation exercises, Guided Imagery, TENs, Distraction, RICE (Rest Ice Compression, Elevate), Psychological Support Nursing Mgmt: Rapport Medicate Educate family of importance of pain (not Provide prn analgesic for Break treating pain will decrease healing process through pain – notify prescriber of and compromise immune system) any NEW PAIN Assess pain, document Assess for sleep disturbance (good sleep decreases pain ratings) Ask patient about goals Assess with ADLs Offer spiritual support Refer to psychologist Listen – offer presence and support BELIEVE the patient pain experience Measurement of Pain: Numerical scale (0-10) Verbal scale (Mild, Moderate, Severe) Analog Scale (Measuring of pain) FACES (children) CRIES (infants) Other Assessment Models: CAPA Model Cleeland Pain Inventory Clinical Findings of Chronic Pain versus Acute Pain Chronic Pain Acute Affect Blunt affect Crying, Angry BP Normal Elevated HR Normal Elevated RR Normal Elevated (Increased O2 demand) Sleep Adversely affected Adversely affected

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