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What is pain?
Unpleasant, sensory and emotional experience associated with damage tissue.
A physiological response that warns us of danger
- The process that involves the nociception
Stimulus detected by nociceptive receptors'
pain receptors that are exposed to stimuli when tissue damage and inflammation occurs as a result from trauma, surgery, inflammation, infection and ischemia
found int skin, muscle, connective tissue, bone, joints, visceral organs-liver, GI tract.
- *primary afferent fibres
- *Small diameter
- *slow conducting
Receptor respond to more than one types of stimuli
- *primary afferent fibres
- *large diameter
- *fast conducting
high-threshold receptor that respond to stimuli over a certain intensity
Messages relayed from receptors to CNS
Brain perceives the sensation of pain
Messages modified by other activity
Involved changing or inhibiting transmission of pain impulse in spinal cord by the release of neurotransmitters that act by inhibiting pain sensation at the opioid receptor sites.
Pain that continues beyond the expected time of healing (3-6mths) and has a major impact on quality of life. Sometimes a specific cause cannot be found and it can be difficult to treat.
*Pain from muscle, soft tissue or ones and is described as sharp, hot or stinging
- *Usually well localized
- *surrounding tissue is often tender
- *pain from organs or surrounding tissues
- *often less localised and can radiate
- *described as deep aching, cramping or squeezing pain
- *may be associated with symptoms
Where nerve transmit pain signals in a normal way to the brain in response to tissue damage.
Stimili - extremes temperature, pressure and chemicals.
- *abnormal stimulation of the nerves, which can originate from a dysfunction
- * described as burning, shooting or prickling pain
- * often accompanied other sensations - pins and needls, allodynia, hyperalgesia
eg. post-herpetic neuralgia or peripheral neurophathy.
Nursing assessment for pain?
Using noticing to see how the client is reacting. Observe what is different in mobilising, facial expression and behaviour
PQRST method of pain
Provoking , palliating- what starts the pain?
Quality- what does the pain feel like?
Region/radiation - where is the pain?
Severity- how strong is the pain on a scale 1-10?
Time and duration - when did the pain start?, how long have you had the pain?
How does an RN complete a pain assessment on a 2 years old?
The RN ask the mother questions regarding the child and observe the child reaction, movement, facial expressions and behaviours.
Nursing assessment subjective data
Location- where does it hurt?
Intensity- on a scale of 1-10 how much does it hurt?
Quality- Can you describe the pain to me?
Onset- What were you doing when pain started?
Effects- How does it affect you?
Treatment- What treatment did you have or used?
Medication used for pain?
Paracetamol, Ibuprofen and asprin
Any NSAID's (non-steroidal anti-inflammatory drug)
Why is pain the 5th vital sign
Pain is a warning of potentially health threatening condition
Pain is the most common reason people seek medical healthcare
Pain affects the whole body
unwelcome and uncomfortable
why is effective pain management essential in relation bipolar affective disorder
Pain management is essential as people with bipolar experience sleep deprivation which is a contributing factor of relapse.
Factors that may trigger a relapse of Bipolar
Stress, pain, and sleep deprivation can trigger a relapse
Factors that influence a person's perception of pain
- Previous experience
- meaning of pain
- attention to pain
- peer influence
Tramadol analgesic for main
- used to treat moderate to severe pain
- Binds to mu receptors, and inhibits reuptake of norepinephrine and serotonin
- Nausea, vomiting, headache, constipation, drowsiness, dizziness