Escolar Documentos
Profissional Documentos
Cultura Documentos
INTRODUCTION
Pain is an unpleasant sensory and emotional experience associated
with actual or potential tissue damage.
It is sometimes referred to as the FIFTH vital sign.
In many aspects, pain is the most common reason for seeking health
care.
Because pain emanates from various modalities such as diagnostics
tests, diseases and treatment procedures, nurses must be
knowledgeable about the pathophysiology of pain and its
management.
Nurses encounter pain in a variety of setting, including acute are,
outpatient, and long term care settings as well as in the home.
The nurse has daily encounters with pain who anticipate pain or who
are in pain.
Understanding the phenomenon of pain and contemporary pain
theories helps the nurse to intervene effectively.
Pain Definition
11.Nociceptors—pain receptors
12.Pain perception—the point which the person becomes aware of the pain
(1)serotonin
(2)histamine
(3)potassium ions
(4)acids
(5)some enzymes
Pain Categories
Easily localized
In general, there are 3 types of stimuli that can stimulate pain receptors-
Mechanical, Thermal and Chemical.
1. Mechanical stimulus- pressure, squeeze, pin prick
3. Chemical stimulus
iii. histamine
Physiology of Pain
Stimulus
Receptor
Neospinothalamic Paleospinothalamic
Tract Tract
Thalamus and/or
Reticular system?
Brain ( Somesthetic
Areas)
Factors affecting the Pain
A. Ethnic/Cultural values
B. Age/Developmental Stage
E. Meaning of pain
Pain Assessment
2 mnemonics
OLDCART
Onset
Location
Duration
Characteristic
Aggravating Factors
Radiation
PQRST
Provoked
Quality
Region/Radiation
Severity
Timing
Pain Scales
In general:
The Advanced Practice Nurse (APN) from the Acute Pain Service
should be consulted in developing a plan for pain assessment and
management in this population.
In general:
Scores of 0-2 indicate minimal pain to no pain
Self reports are valid and preferred for most children > 3 years old
In general:
Use for children > 8 who understand the concept of order and
number
In general:
Scores of 0-4 indicate minimal to no pain
Comfort Scale
In general:
Comfort
Definitions
Kolcaba (1994, 2001, 2003) has defined comfort as "the immediate state
of being strengthened through having the human needs for relief, ease,
and transcendence addressed in four contexts of experience (physical,
psychospiritual, sociocultural, and environmental)"
Types of Comfort
1. Relief
2. Ease
3. Transcendence
2. Coaching
to relieve anxiety,
o instill hope
o Listen
Comfort Therapies
1. Patterned Breathing
2. Water
4. Massage
1. Narcotic Analgesics
4. Pudendal Block
5. Epidural Anesthesia
breathing problems
6. Spinal Block
7. General Anesthesia
After general anesthesia wears off, you will feel woozy and tired
for several hours
IN SUMMARY
Establishing rapport between the nurse and the patient enhances the
effectiveness of pain relief measures
Because patients may not always report pain, the nurse must assess
them regularly
Patients of all ages experience pain, but the way they express pain
differs with age
Educating the patient and family about pain reduces the anticipatory
fear and anxiety, thereby increasing the patient’s tolerance
Intramuscular and intravenous routes are utilized for severe pain and
the intramuscular for moderate pain and oral for mild pain