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- Pain not relieved by ordinary measures.
- Med-Surg & nursing measure does not reliev pain.
- Psychgenic in nature.
refelctive pain. Pain felt at another part of the body away from the original site.
Skin or Muscle
- Well localized
On the skin surface
Pain in the internal organs
- Poorly localized
Pain in a part of the body that was amputated or missing.
Nerve pain, up a nerve path.
- Pins & needles
Gate Control Theory
The synapses at the point of entry in the spinal cord act as a gate that closes to keep impulses from reaching the brain or open to premit impulses to ascend to the brain.
A-fibers, thick/large, close the gate
- C-fiber, thin/small, open the gate
Activation of autonomic nervous system
It activates, then depress somatic functions.
The sympathetic nervous system becomes dominate.
Fight or Flight
Increased Oxygen, resp, HR, BP, Blood sugar, Muscle tension
Decrease GI motility.
Process of Adaptaion
When pain continues, adaptation take place.
Parasympathic is dominate.
- Gastric functions return like nausea.
- cane be weak and exhausted.
What caused it to start?
In cl own words ( stabbing, pounding, cramping, sharp)
Where is the pain? Does it radiate?
When does it start and how long?
0 = no pain
1-3 mild intensity ( annoying but can fx)
4-6 Moderate (interferes with comfort & fx)
7-10 Severe ( debilitating & affects quality of life)
Acetaminophen (Tylenol) 650mg
- asprin (ASA) 650mg
- ibuprofen (Mortin, Advil) 400-800mg
- naproxen (Naprosyn) 250-500mg
- tramdol (Ultram) 50-100mg
Narcotic (opioid) mild to moderate
- codeine 30mg
- hydrocodone (Hycodan) 10mg
- meperidine (Demerol) 50mg
- oxycodone (OxyIR) 5mg
- fentanyl (Duragesic) patch
- propoxphene 65mg
Hydrocodone 5mg & acetaminophen 500mg
hydrocodone 5mg & ASA 500mg
Oxycodone 5mg & acetaminophin 325mg
oxycodone 5mg & ASA 325mg
codeine 30mg & acetaminophen 300mg
codiene 60mg & acetaminophen 300mg
Oxycodone 5mg & actaminophen 325-500mg
hydrocodone 5mg & acetaminophen 325-500mg
- pain relever
- interferes with platelet function
- linked to Reye Syndrome
- incease GI Upset and bleeding
- 21 & older
- limit to 3 grams per day
- 2 grams if liver disease
reduce pain in the CNS
NON Narcotics affects
the Peripheral nervous system
reveses Versed (midazolom)
- voluntary behavior pattern
- usuing drugs for psychic effects
involuntary physiological changes where cl will experience withdrawal