MSII Chapt 15 Pain Book notes.txt
Card Set Information
MSII Chapt 15 Pain Book notes.txt
MS II Test Chpt 15 Pain book notes
MS II Test 3 Chpt 15 Pain book notes
Gate control theory assumes that the pain experience reflects
both physical and psychosocial factors
What anesthetic has analgesic properties?
Ketamine; may prolong analgesia for 12-24 hours after surgery
Sympathetic nerve responses to pain
Increase in BP, P, R, dilated pupils, perspiration, pallor
Parasympathetic nerve response to pain
Constipation and urinary retention
Behavior changes in acute pain
restless, thrashing, rubbing body part, pacing, grimacing, and other facial expressions of pain
Behavioral changes in chronic pain
Tired looking, minimal facial expression, quiet, sleeps, rests, attention on other things
Cancer pain may be considered
acute and chronic
Nursing assessment of pain is essential to identify
characteristics and amount of pain, whether pain is acute or chronic, and whether patient has both acute and chronic at the same time
6 steps in pain assessment
Accept pt report, determine status of the pain, describe pain, examine site, identify coping methods, record the assessment, interventions and evaluation of interventions
Possible nursing diagnoses for pain
activity intolerance, anxiety, disturbed sleep pattern, fatigue and self care deficit
How do physical interventions help pain?
Increase pain threshold, reduce muscle spasm, decrease congestion in injured area
How does jaw relaxation help pain?
Effective in reducing mild to moderate pain and as an adjunct to drugs for severe pain
How does simple imagery help pain?
Use when patients express an interest in relaxation; requires 305 minutes of staff instruction
How does music help pain?
Patient preferred and easy listening music are effective in reducing mild to moderate pain
How does imagery help pain?
Effective for reduction of mild to moderate pain; requires skilled personnel
How does educational instruction help pain?
Should include sensory and procedural information and be aimed at reducing activity-related pain; requires 5-10 minutes of staff time
How should pain meds be given when pain is predictable?
Around the clock rather than prn; ATC maintains therapeutic blood levels of analgesics
What properties do nonopioids have?
Antipyretic, analgesic, or anti-inflammatory
Nonopioids are not recommend for people with
liver or kidney disorders; use cautiously with CHF or HTN
Older adults should not use
propoxyphene, meperidine, indomethacin, ketorolac, promethazine
Adverse effects of nonopioids
stomach irritation, fluid retention, increased bleeding time
when pain begins to return, press PCA button; put it down and wait 10-15 minutes; if pain returns, push PCA again and repeat until pain is relieved
What is an herbal remedy for migraine prevention?
Preferred treatment of chronic pain
antidepressants-neuropathic pain; benzos-muscle spasm and anxiety; antihistamine-nausea/anxiety; corticosteroids-spinal cord or nerve compression, bone pain; anticonvulsants-neuropathic pain; local aneth-diabetic neuropathy; clonidine-spinal cord, phantom limb, peripheral nerve; psychostimulants-analgesic effect-cancer pain
When analgesic is not working,
Check order; consider alternative script; collaborate with pt, other nurses, pharmacist and family
Most chronic pain is
neuropathic because of nerve damage