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3 types of pain
- Acute Pain
- Chronic cancer pain
- chronic noncancer pain
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Sources of pain that are nociceptive (2 types)
- somatic pain
- visceral pain
there is also neuropathic pain
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Attitudes and practices related to pain
attitudes of health care providers and nurses affect interacts with clients experiences pain
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__% of clients are unable to obtain pain relief from codeine and why.
- 10%
- they have variation in the gene that codes for the enzyme that converts codeine to morphine
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Pain cultural considerations: What are minorities at risk for?
undertreatment of pain: tolerance, physical dependence, and addiction
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Tolerance, dependence and addiction of pain and pain medications
- Tolerance: adaptation in which exposure to a drug induces change in its effect over time
- Physical dependence is the adaptation manifested by a drug class - specific withdrawal syndrome
- Withdrawal symptoms result when dependent use of opioids ceases abruptly
- Addiction: chronic, neurobiologic disease characterized by 1. impaired control over drug use, 2. compulsive drug use 3. continued use despite harm 4. craving
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Define pseudoaddiction
An iatrogenic syndrome created by the undertreatment of pain, characterized by client behaviors such as anger and escalating demands.
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Location of pain (4 types)
- Localized
- Projected
- Radiating
- Referred
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Gate control theory for pain
- Assumes that a mechanism in the spinal cord permits pain impulses to rise to the brain
- This theory has helped nurses and health care professionals recognize the holistic nature of pain, resulting in many cognitive and behavior therapies use to help relieve pain.
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Pain interventions include (non-opioid analgesics)
- acetylsalicyclic acid
- acetaminophen
- nonsteroidal anti-inflammatory drug (NSAIDs)
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Anatomic and physiologic bases for pain: 4 facts
- Pain Stimuli
- Pain Fibers and pathways
- Central nervous system processing
- inhibitory and facilitatory mechanisms: neurotransmitters, neuromodulators, opioid receptors
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Common Opioids include
Codeine, hydrocodone, oxycodone, morphine, hydromorphone, fentanyl, methadone, tramadol, meperidine
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Side effects of opioids:
- Nausea and vomiting
- constipation
- sedation
- respiratory depression
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Routes of administration
- Patient-controlled analgesia (PCA)
- Epidural analgesia
- Intrathecal (subarachnoid) analgesia
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Adjuvant Analgesics
- Antiepileptic drugs
- Tricyclic antidepressants
- topical medication
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Physical measures as an addition or alternative to drug therapy are:
- Transcutaneous electrical nerve stimulation
- application of heat, cold, and pressure
- therapeutic touch
- massage
- vibration
- physical therapy
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Strategies that can be used to relieve pain as adjuncts to drug therapy are: (DIRHA)
- Distraction
- Imagery
- Relaxation Techniques
- Hypnosis
- Acupuncture
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Invasive Techniques for Chronic Pain
- Never blocks
- Spinal cord stimulation
- surgical techniques: rhizotomy and cordotomy
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