pain
* the body's signal of distress
* warning that tissues are being damaged
* subjective symptom
causes of pain
* trauma
* excesses of pressure, heat and cold
* lack of oxygen to tissue
* muscle spasm
* chemicals released when tissues are damages or destroyed
nociception
pain transmission and interpretation
(messages from the brain that it hurts!)
Four phases of nociception
* transduction
* transmisson
* perception
* modulation
types of pain
* acute pain: sudden onset (< 6 months)
* referred pain: pain perceived at a location other than the site of the painful stimulus (reflective pain)
* cancer pain
* chronic/neuropathic pain: pain lasting over 6 months (arthritis)
* intractable pain: intens
pain cycle
Pain ? Immobilization ? Disability ? Loss of Self Esteem ? Depression ? Isolation Withdraw ? Stress ? Muscle Tension
results of chronic pain
* loss of control
* decreased self esteem and communication
* inappropriate life decisions
* changes in relationships, sexual activity
* decreased activity and endurance
* feelings of anger from significant others and co-workers over inability to complete
factors that affect pain perception
* pain threshold
* pain tolerance
* endorphins
pain threshold
the lowest intensity of stimulation at which pain is experienced
pain tolerance
the maximum amount and duration of pain that an individual is willing to endure
endorphins
* natural, opiatelike neurotransmitters linked to pain control and to pleasure
* released during exercise as well
COLDSPA
C: Character
O: Onset
L: Location
D: Duration
S: Severity
P: Pattern
A: Associated Factors
managing chronic pain
* exercise
* nutrition
* recreation
* relaxation
* support
* hobbies
* rest/sleep
pharmacologic pain therapy
* analgesics: medicines that slow or halt pain transmission
- NSAIDS, opiods/narcotics, adjuvant drugs (antidepressants and anticonvulsants)
* ointments/linaments
surgical pain therapy
* surgery needed to provide relief from the pain
- herniated disk
- tumors
- pinched nerves
- ablation surgery
nursing interventions for pain
* comfort measures (clean ben, clean face/hands, warm room)
* encourage nutritious diet and plenty of fluids
* offer ordered medications
* monitor elimination and assist when necessary
* massage
* exercise
* distraction and diversion
* deep relaxation and
alternative pain management
* acupuncture or acupressure
* chiropractic care
* hypnosis
* massage
* music therapy
* homeopathy
* herbal remedies
documenting pain
* COLDSPA
* use subjective AND objective data (what the client tells you AND what you observe)
* after intervention, reassess within one hour
can the brain feel pain?
There are no pain receptors in the brain itself. But the meninges (coverings around the brain), periosteum (coverings on the bones), and the scalp all have pain receptors. Surgery can be done on the brain and technically the brain does not feel that pain.
Transduction
nervous system changes painful stimuli in the nerve ending pulses
Transmissition
impulse travel from their original site to to the brain
Perception
Pain recognize, responds, to pain
Modulation
Body activates needed inhibitory responses to the effects of pain.
Acute Pain
usually a sensation that occurs abruptly most often in response to some sort of trama
Referred pain
originated in one body part but is percieved in another part of the body
Cancer pain
result of some sort of malignancy. very severe may be consider intractable and chronic
Chronic pain or neuropathic pain
discomfort for longer than 6 months and may exist for the patient's whole life.
intractable pain
chronic pain that resist therapeutic interventions.
Pain intensity scale or distress scale
Children older than 7
Wong Baker Faces Oaub Scake
Between the ages 3 and 7FLA
FLACC
Younger than 3
NIPS
Neonatal/infant
Analgestics
medications that relieve pain
NSAIDs
Asprin, Ibuprofen, naproxin
nonopioid analgestics
Tylenol
Opoids/Narcotics
Morphine
Adjuvant drugs
For other purposes but may help pain.
Anitconvulsants and antidepressants
Help improve the clients moods, which assist in muscle relaxation.
Abalation surgery
nerves transmitting the pain sensation may be cut
Empathetic nursing care
diversion, music, changing the client's position, bathing, back rubs, massages.
TENS
a technique that allows the client to wear an electronic device and trigger an electrical stimulation when he or she feels pain.