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UNIT 1: Jarvis Ch. 10 (Pain Assessment)
Health Assessment
28
Nursing
Undergraduate 3
09/21/2010

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Cards

Term
Neuropathic Pain
Definition

-most difficult type of pain to assess and treat

-Pain percieved long after site of injury heals

-injury or improper function of CNS or peripheral nerves

Burning or stabbing pain

Term
Visceral Pain
Definition

-originates from the larger interior organs (i.e., kidney, stomach, intestine, gallbladder, pancreas)

-poorly localized

-originates in cranium, thorax, abdomen

-results from direct injury to organ, or from strething of the organ from tumor, ischemia, distention, or severe contraction

Term

somatic pain

(AKA deep somatic pain!)

Definition

-diffuse or scattered pain

-originating in ligaments, tendons, bones, nerves, blood vessels, joints

Term
Cutaneous
Definition

-superficial sharp pain usually involving the skin or SQ

-sharp or burning sensation

Term
Referred pain
Definition

-originates from another location but is felt at a particular site

-MI refers to neck, left arm

Term
Suffering
Definition

To bear or undergo pain, distress or injury

-suffering is an overwhelming experience

-human suffering is directly related to pain

Term
Pain is...
Definition

-whatever the client says is pain

-whenever the client says they are in pain

-we cannot even begin to est. the pain of another person (emotional or physical)

Term
Emotional Context of pain
Definition

-primary consideration of client and family entering the HC environment

-TOTALLY subjective experience

-meaningful (labor pains=new life); (intractable pain from cancer=end of life)

-previous experience with pain (first time or chronic?)

Term
When pain control is not controlled th pt will experience...
Definition

-fatigue

-fear

-anxiety

-depressession (hopelessness, powerlessness, withdrawl)

Term
Generalized affects of pain on the body
Definition

 

Hyperglycemia
Immune system dysfunction
Altered coagulation
GI ileus
Urinary retention
Decreased lung volume
Psychological distress
Term
Physical Responses to Pain
Definition

 

Grimacing, moaning, restlessness
Pallor, fainting, rapid breathing
BP, HR
Muscle tension
Pupil dilatation
N/V, anorexia
Blood glucose

  (stress response)

Term
Acute Pain
Definition

-lasts less than 6 mo

-rapid onset

-moderate to severe

-self-limiting,

-often follows a predictable trajectory,

-dissipates after an injury heals

-warns individual of actual or potential tissue damage

ex. surgery, trauma, kidney stones

Term
chronic pain
Definition

-longer than 6 mo.

-intermittent (1 time per day, 3 time per day) or persistent

-ex. cancer, progressive disorders

 

-malignanat (cancer related) or nonmalignant

-does not stop when injury heals, persists after the predicted trajectory

Term
Intractable pain
Definition

-resistant to therapy

-difficult to assess accuratly

-may lead to withdrawl, anger, depression

 

45-80% nursing home residents have pain

40% cancer pt have pain

Term
Role of Pain in Healing
Definition

-healing occurs at a faster rate if the client is not in excessive pain (ex. elevated blood glucose due to stress response)

-pt should be encouraged to utilize any pain management interventions necessary to reduce pain and decrease healing time

Term
Protective function of pain
Definition

-body's defense mechanism that indicates the person is experiencing a problem

-alters activitiy and behaviors (garding)

Term
Neuromodulators
Definition

-regulate the sensation of pain thru release of endogenous opioid compounds

-naturally present

-morphine-like chemical compund in spinal cord and brain-analgesic activity

-pain and fear activate the system 

Term
Endorphins
Definition

 

Produced at neural synapse in the CNS pathway
Powerful pain blocking chemicals
Have prolonged analgesic effect
Can produce euphoria
Term
Enkephalins
Definition

Widespread throughout the brain and spinal cord
Less potent than endorphins
Thought to reduce pain by inhibiting release a substance from the terminal afferent neuron
Term
Pain as the 5th Vital Signs
Definition

 

Pain management is a priority
Pain assessment included in routine vital sign collection
Always requires re-assessment after nursing intervention

Client education

Term
Componenent of a pain assessment
Definition

 

Duration of pain - continuous, intermittent, transient
Location of pain - actual location or referred
Intensity of pain - 0-10 scale, Faces Pain Scale or mild, moderate, severe
Quality of pain - sharp, dull, stinging, cramping, gnawing
Term
Component of pain assessment
Definition

 

Chronology of pain - when did pain begin, time it changed
Aggravating factors - things which make pain worse
Alleviation factors - things which make pain better
Physiologic indicators of pain - HR,   BP
Behavioral responses - grimacing, crying, guarding
Term
Pain Intervention
Definition

 

Pharmacologic measures
Repositioning
Distraction
TV, conversation
Guided imagery
Massage
Effleurage
Music therapy
Physical presence
Term
Position of HC on pain
Definition

 

Nearly every type of human pain can be controlled
Term
Position of HC on Pain
Definition

JCAHO supports client’s right to pain management

JCAHO recommends:
Teaching pain rating scale
Developing a pain-rating expected outcome
If a facility does not have the resources to manage a client's pain adequately, the client MUST be transferred to a facility that does
Term
Nurses Role on Pain Management
Definition

-competance in assessing pain

-develop effective pain management regiments w/ the pt

-Requires specialized nursing abilities to promote comfort and relieve pain

Term
Angels of Mercy
Definition

-public image of nurses

-clients need to trust caregiver to control pain

-greatest act a nurse can carry out is management of pain safely and sensitvly

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