114 NUR chap 5 pain the fifth vital sign
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. What would you like to do?
- most common reason people seek medical care
- alters quality of life more than any single health related problem
what is the nurse's role with patient's pain
- Believe the patient's reports of pain
- Advocate for the Patient
- Understand there is no diagnostic test for pain, onle subjective reports are available
when is pain a good thing
warning to stop before injury is caused
Definition of Pain
unpleasant sensory and emotional experience associated with actual or potential tissue damage
Whatever the person experiencing says it is and exists whenever he or she says it does
what is the physical impact of pain?
- prolongs stress response
- increase Heart Rate, BP, and O2 demands
- decreases GI motility
- causes immobility
- decreases immune response
- delays healing
- increases risk for chronic pain
how does pain impact the quality of life?
- interferes with ADLs
- causes anxiety, depression, fear, anger and sleeplessness
- impairs family, work and social relationships
what are the characteristics of ACUTE Pain?
- Short duration
- well defined cause
- decreased as healing occurs
- ranges from mild to severe
what are the characteristics of CHRONIC Pain
- lasts at least 3 months
- may not have well defines cause
- begins gradually and persists
- often accompanied by depression, fatigue, and decreased functional ability
- "Exhausting and Useless"
different categories of Pain
- Chronic cancer pain
- Chronic non-cancer pain
acute pain is
you fix the problem and the pain goes away
to perceive pain....
- the stimulus must be sent through the spinal cord to the brain and the brain sends an impulse back the body part.
- if stimulus cannot make there and back you donot feel the impulse
what are A delta fibers?
myelinated fibers that carry SHARP, or PIERCING sensations.
they are localized and easily defined
What are C fibers?
poorly myelinated fibers. Pain conduction is slow and diffuse causing pain perception as dull, diffuse, burning, and achy this pain is persistant.
(inpulse gets lost or misplaced because the poorly myelinated fibers)
what is the gate control theory
- to feel pain the nerve impulse has to travel from limb to spinal cord to the brain. there is a gate at the spinal cord. if gate is open impulse travels.
- Endorphins can cause the gate to close
- we know use cognitive therapy to help with pain because happy thoughts and emotions cause release of Endorphins and closes the gate
- pain from surface areas
- road rash, bite
- pain from smooth muscles and organs
- hard to dx kidney stone, gallbladder
chronic pain that cannot be managed by standard therapies
pain of skeletal muscle. ligaments and joints
- pain from vascular or perivascular tissues contributing to migraines or headaches.
- Sharp and Throbbing
pain from nerve fibers, spinal cord and CNS
confined to site of origin
pain along specific nerve or nerves
- diffuse pain around the site of origin
pain perceived in an area distant form painful stimuli
- cultural or society attitudes regarding use of opiates
- physician fear of regulations
- Pt fear of becoming addicted
vasoconstriction is not what causes brain freeze pain it is ...
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