302-- Comfort/Pain

  1. In this era, most people have never truly experience ______
    human trauma
  2. The ______ Bears the _____
    (Physically and Psychologically)
    Body; Burden
  3. Sometimes, the most pain someone in is _____
    NOT seen
  4. Centralitity of _______ is a key characteristic for a nurse managing someone's pain
  5. We must be _______ to a patient. Meaning, we need to take an open stance and recognize that we do not know the other person and his/her subjective world.
    Authentically present to a patient
  6. Pain is derived from...
    ¨Derived from Old French “peine” and from Latin “poena” [meaning punishment or penalty]; from Greek “poine” [meaning penalty]
  7. What does it mean when pain is involving the total person rather than only the mind or only the body
    Mind-Body experience
  8. What important statement did Margo McCaffery make about pain?
    Pain is WHAT the person experiencing it SAYS it is
  9. Dictionary Definitions of Pain
    • ¨- “An unpleasant sensation occurring in varying degree of severity as a consequence of injury, disease, or emotional disorder.”
    • - ”Suffering or Distress”
    •     ex: papercut = pain without suffering
    • - “The pains of Childbirth”
    • - “Great care or effort”
    •    ex: going to nursing school
    • -  “Nuisance” or “Source of annoyance”
    • - “Subject to the penalty of a given punishment
  10. By definition all pain is ____ and ____
    Invisible and Private

    (though the relief of the pain relies on the sharing of the private information)

    (for pain to be made visible, it needs to be given VOICE)
  11. Pain is a result of _____ and  ______ abstraction
    • Integration and Abstraction
    • (past experiences, culture, beliefs, what other people believe about pain, etc…)
  12. Physical Responses to Pain
    • ¨Stage of adaptation may occur (shock)
    • - ^ pulse, dilated pupils, ^muscle tension, well coordinated, clamped sphincters, ^BP
    • [[Everything soon decreases to prevent your body from having a stroke, and you may faint]]

    • ¨In the early stages from mild to moderate pain,
    • sympathetic responses generally occur (and ^ glucose)

    ¨If you can treat the pain without it getting worse, you can generally avoid the parasympathetic response

    Moderate to Severe pain = Parasympathetic
  13. What may help pain management in amputation situations ?
    Contralateral stimulation  (ie: moving existing leg to help the “other” leg pain go away)
  14. Reception requires ____ to be in tact
  15. Point at which the person is aware of the pain...
    Gives awareness and meaning to pain so that a person can react
  16. Reception
    • -very few receptors in the brain and in the lung
    • -we feel pain in the brain by pressure
    • (ie: from tumor)
  17. Difference between Pain Threshold/Tolerance
    • *Threshold- ex: when they first felt pain
    • *Tolerance- ex: how long someone can handle the pain
  18. Noxious Stimuli can be:
    1.Thermal   2. Mechanical  3. Chemical  4. Electrical
  19. Response
    • -Physiological and behavioral responses that occur after the pain is perceived
    • Ex: moving hand off of the stove, things that you do to
    • “keep” the pain down
  20. T/F

    Full Term baby has the ability to feel pain
    • TRUE
    • (ex: circumscision)
  21. T/F

    Geriatric patients can feel just as much pain as someone else
    • TRUE
    • (but they may not want to "burden" you)
  22. Average level of reading/hearing/understanding
    5th Grade
  23. Psychological Variables
    • Developmental Status/Age
    • Body Image
    • Personality
    • Perception
    • Past Experience
    • Expectations about Pain
    • Significance of Pain
    • Control Over Pain
    • Anxiety Level
    • Anticipatory Pain
  24. Sociocultural Variables Affecting Pain
    • Gender
    • Birth Order (1st born talk about pain more)
    • Education Levels
    • Religion
    • Culture
    • Philosophy, Values, Attitudes
  25. Environmental Factors Affecting Pain
    • Sensory Input (brigh lights, cold, noise, motion, restriction)
    • Setting (OBGYN, Psychiatric Units)
    • Time of Day (when pain is most intense)
  26. Management of ACUTE pain
    • -Pain presence and intensity along with pain relief must be assessed and reassessed at regular intervals
    • -A patient/client’s self-report of pain is the single most reliable indicator of the existence and intensity of pain and any related discomfort
    • *have them SHOW you specific area of pain (it varies with different people)
    • ¨S- Site (where are you hurting the most)
    • O- Other (when did the pain begin, sudden or gradual,
    • type of med to relieve pain)
    • C- Character (Quality– describe the pain/what does it feel like)
    • R- Radiation (Spread? Referred to another body part?)
    • A- Association (can we associate with any other thing?)
    • T- Timing (the time of the day/Patterns/when is pain most intense)
    • E- Exacerbating  (Relieving Factors)
    • S- Severity
    • (scale of 1-10)
  28. Steps for acute pain management

    • Ask about pain
    • Control pain before it becomes severe
    • Prevention = better than treatment
    • Relate/relationship with client and families
    • Believe the patient/family
    • Involved-- include patient and family in assessment
    • Reduce pain to acceptable levels
    • Deliver interventions in a coordinated manner
  29. When assessing for pain scale, considere the patient's:
    • AGE
    • Level of Understanding
    • Reading Ability
    • *Visual Acuity
  30. Nursing Interventions for Pain Management
    ¨Don’t lean on the bed (shifts the pain level)

    • ¨Move things back to how they were
    • (ie: phone, call light, etc…)

    ¨Believe in yourself!!! (even if you don’t have a clue as to what may help them, try to do anything you can)
Card Set
302-- Comfort/Pain
Exam 2