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Chapter 43-Pain Management Part I

Chapter 43-Pain Management Part I. Ouch! That hurts! I’m hurting! OMG! It’s killing me. I can’t live any longer! Can’t you do anything?. The Concept for this unit is.

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Chapter 43-Pain Management Part I

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  1. Chapter 43-Pain ManagementPart I Ouch! That hurts! I’m hurting! OMG! It’s killing me. I can’t live any longer! Can’t you do anything?

  2. The Concept for this unit is com·fort  (k m f rt) tr.v.com·fort·ed, com·fort·ing, com·forts1. To soothe in time of affliction or distress.2. To ease physically; relieve.n.1. A condition or feeling of pleasurable ease, well-being, and contentment.2. Solace in time of grief or fear.3. Help; assistance: 4. One that brings or provides comfort.5. The capacity to give physical ease and well-being.

  3. Concepts related to Pain • Pain-symptom of disease • Pain-now considered a separate disease • Pain-subjective • Pain-highly individualized • Pain-highly feared. The fear of pain is second only to the fear of death

  4. Causes of pain • Thermal • Chemical • Mechanical

  5. Processes of Pain • Transduction • Transmission • Perception • Modulation

  6. Transduction • Transduction-energy from stimuli converted to electrical energy • Begins in the periphery with stimulus • Pain impulse via nerve fibers • Transduction completed results in transmission

  7. Transmission • Transmission involves neurotransmitters • Intact pain fibers-ECF & Spinal Cord • Message received by cerebral cortex • Interpretation by CNS

  8. Perception • Message received-awareness • Limbic system determines how one feels about the pain

  9. Modulation • Message interpreted and received • Release of inhibitory neurotransmitters • Modulation is the inhibitory/analgesic effect

  10. Gate-Control Theory p.1053 • Emotional • Cognitive • Gate-keepers • Pain threshold • Pain tolerance

  11. Types of Pain p.1055 • Acute/Transient • Chronic/Persistent • Chronic Episodic • Cancer • Idiopathic • Inferred

  12. Misconceptions/Biases • P. 1056 • The person experiencing the pain is the best indicator of the characteristics of pain • Assess pain • Believe the person

  13. Factors Affecting Painp. 1056-1060 • Age • Culture • Gender • Genetic • Neurological functioning • Social • Spiritual

  14. Nursing Assessment • No pain meter available • Must rely on patient • Nurse must ascertain subjective data • Expression of pain

  15. Characteristics of Pain • Onset/Duration • Location • Quality • Pattern • Relief measures • Contributing symptoms • Behavioral effects • Effects on ADL’s

  16. Pain Assessment • Pain scales p. 1065 • Oucher scale • Wong-Baker • Pneumonic-P,Q,R,S,T • Assessment of pain is considered the fifth vital sign!

  17. Questions/Statements R/T Pain • Be a reporter-who, what, when, where, why • Ask opened-ended questions • Avoid leading statements • Observe nonverbal cues • Congruent nonverbal actions and verbal comments • Remember to assess drug allergies

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