Pain- 5th vital sign

  1. What is pain?
    Unpleasant, sensory and emotional experience associated with damage tissue.
  2. Acute pain
    A physiological response that warns us of danger

    • The process that involves the nociception 
    • *transduction
    • *transmission
    • *perception
    • *modulation
  3. Transduction
    Stimulus detected by nociceptive receptors'
  4. Nociceptor receptors
    pain receptors that are exposed to stimuli when tissue damage and inflammation occurs as a result from trauma, surgery, inflammation, infection and ischemia

    found int skin, muscle, connective tissue, bone, joints, visceral organs-liver, GI tract.
  5. C Fibers
    • *primary afferent fibres
    • *Small diameter
    • *Unmyelinated
    • *slow conducting

    Receptor respond to more than one types of stimuli
  6. A-Delta fibres
    • *primary afferent fibres
    • *large diameter
    • *myelinated 
    • *fast conducting

    high-threshold receptor that respond to stimuli over a certain intensity
  7. Transmission
    Messages relayed from receptors to CNS
  8. Perception
    Brain perceives the sensation of pain
  9. Modulation
    Messages modified by other activity

    Involved changing or inhibiting transmission of pain impulse in spinal cord by the release of neurotransmitters that act by inhibiting pain sensation at the opioid receptor sites.
  10. Chronic pain
    Pain that continues beyond the expected time of healing (3-6mths) and has a major impact on quality of life. Sometimes a specific cause cannot be found and it can be difficult to treat.
  11. Somatic Pain
    *Pain from muscle, soft tissue or ones and is described as sharp, hot or stinging

    • *Usually well localized
    • *surrounding tissue is often tender
  12. Visceral pain
    • *pain from organs or surrounding tissues
    • *often less localised and can radiate
    • *described as deep aching, cramping or squeezing pain
    • *may be associated with symptoms
  13. Nociceptive pain
    Where nerve transmit pain signals in a normal way to the brain in response to tissue damage.

    Stimili - extremes temperature, pressure and chemicals.
  14. Neuropathic pain
    • *abnormal stimulation of the nerves, which can originate from a dysfunction
    • * described as burning, shooting or prickling pain
    • * often accompanied other sensations - pins and needls, allodynia, hyperalgesia

    eg. post-herpetic neuralgia or peripheral neurophathy.
  15. Nursing assessment for pain?
    Using noticing to see how the client is reacting. Observe what is different in mobilising, facial expression and  behaviour
  16. PQRST method of pain
    Provoking , palliating- what starts the pain?

    Quality- what does the pain feel like?

    Region/radiation - where is the pain?

    Severity- how strong is the pain on a scale 1-10?

    Time and duration - when did the pain start?, how long have you had the pain?
  17. How does an RN complete a pain assessment on a  2 years old?
    The RN ask the mother questions regarding the child and observe the child reaction, movement, facial expressions and behaviours.
  18. Nursing assessment subjective data
    Location- where does it hurt?

    Intensity- on a scale of 1-10 how much does it hurt?

    Quality- Can you describe the pain to me?

    Onset- What were you doing when pain started?

    Effects- How does it affect you?

    Treatment- What treatment did you have or used?
  19. Medication used for pain?
    Paracetamol, Ibuprofen and asprin

    Any NSAID's (non-steroidal anti-inflammatory drug)
  20. Why is pain the 5th vital sign
    Pain is a warning of potentially health threatening condition

    Pain is the most common reason people seek medical healthcare

    Pain affects the whole body

    unwelcome and uncomfortable
  21. why is effective pain management essential in relation bipolar affective disorder
    Pain management is essential as people with bipolar experience sleep deprivation which is a contributing factor of relapse.
  22. Factors that may trigger a relapse of Bipolar
    Stress, pain, and sleep deprivation can trigger a relapse
  23. Factors that influence a person's perception of pain
    • Previous experience
    • age
    • gender
    • meaning of pain
    • attention to pain
    • peer influence
    • stress
    • anxiety 
    • personality
  24. Tramadol analgesic for main
    • used to treat moderate to severe pain
    • Binds to mu receptors, and inhibits reuptake of norepinephrine and serotonin
    • Nausea, vomiting, headache, constipation, drowsiness, dizziness
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Pain- 5th vital sign