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Chapter 16

Terms in this set (17)

The nurse should pursue methods to assist the patient in achieving relief from discomfort
Actively listen to the patient.
Recognize discomfort signals even when the patient cannot verbalize.
Be diligent in efforts to relieve patient's discomfort.
If interventions are not successful, pursue alternative interventions.
Regardless of age, patients typically receive comfort and sense of well being from gentle touch and proper eye contact.
Nature of Pain
a complex, abstract, personal subjective experience
Pain is subjective.
Only the person who is bearing the pain is an expert about that pain. - its location, intensity, quality and pattern, as well as the degree of pain relief obtained from therapy
Pain assessment guide:
Location - where is the pain?
Quality - desribe the pain
Severity - scale from 1 - 10
Timing - when did the pain starts?
Duration - how long have you been experiencing the pain?
Types of Pain
Mild or severe,Chronic or acute,Intermittent or intractable (constant),
Burning, dull, or sharp,Precisely or poorly localized,
Referred - pain felt at a site other than the injured or diseased organ or part of the body.
Example - pain of coronary artery insufficiency that will in some cases be felt in the left shoulder or the jaw.
Acute pain
Intense and of short duration, Usually lasts less than 6 months, Pulse, blood pressure
and respirations increase temporarily
Chronic Pain
Pain longer than 6 month, *It is possible that fatigue, sleep disturbance and depression act in a type of synergistic (the action of two or more substances or organs to achieve an effect of which is individually incapable) relationship
Endorphin
The body produces a natural supply of morphine-like substances
People who have less pain than others from a similar injury have higher endorphin levels
Gate control theory of pain
Theory suggests that pain impulses can be regulated or even blocked by gating mechanisms located along the central nervous system (CNS)
TENS UNIT (Transcutaneous electrical nerve stimulation)
A pocket sized battery-operated device, a Patient with cardiac pacemaker device is not a candidate to use TENS unit
PCA (Patient controlled analgesia
Allow patients to self administered analgesics whenever needed
Each doses 1ml/1mg every 6 to 12 minutes
Epidural analgesis
Monitor respiratory rate every 15 minutes during infusion
Collecting of subjective data
Characteristics and description
Assess site, severity, duration, and location of pain.
Ask the patient what relieves the pain, what causes the pain to be worse, and what does not relieve the pain.
If medications are taken for relief of pain, the name, the dosage, the frequency and the effect of the drugs must be determined
Collecting of objective data
Changes in facial expressions—frowning or gritting teeth
Clenched fists
Withdrawal
Crying, moaning, or tossing in bed
Fetal position
Clutching at the affected body part
Pacing
Measures can be performed by nurse to assist in pain control
Tighten wrinkled bed linens.
Reposition drainage tubes or other objects on which patient is lying.
Place warm blankets for coldness.
Loosen constricting bandages.
Change moist dressings.
Check tape to prevent pulling on skin.
Position patient in anatomic alignment.
Check temperature of hot or cold applications, including bath water.
Guidelines for individualizing Pain therapy
Use different types or variety of pain relief measures. Combine physical and psychological approaches (analgesics and relaxation)
Provide pain relief measures before pain becomes severe. Giving an analgesic at least 30 minutes before a patient walks or performs an activity.
Use measures the patient believes are effective. The patient is the expert on pain.
Choose pain relief measures appropriate for the severity of the pain as reflected by the patient's behavior.
If a therapy is ineffective at first, encourage the patient to try it again before abandoning it.
Nurse understanding Pain
If a therapy is ineffective at first, encourage the patient to try it again before abandoning it.
Keep an open mind about what may relieve pain.
Keep trying.
Protect the patient.
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