Pain
>
- types of pain >
- nonpharm interventions
• acute - 6 months or less • positioning, heat/cold, healing and
- anticipated or predictable end therapeutic touch, massage, acupuncture,
distraction
• chronic - over 6 months >
- pharm interventions
- constant or recurring • opiod or narcotic analgesics - moderate to
- continous or intermittent severe pain
- no predictable end - morphine, codeine, oxycodone,
• nociceptive pain - felt in tissue, organ, damaged part of hydromorphone, methadone, meperidine
body - asess for sedation and respiratory
• neuropathic - nerve pain, no tissue damage depression
>
-assessment • nonopiod - NSAIDs
• subjective indicators - ask client - acetaminophen and OTCs
- location, duration, aggravating and relieving factors • adjuvant analgesics - enhance effect of
• objective indicators - measurable opiods
- vital signs, pallor, NV, grimacing, restlessness, guarding - antidepressants, anticonvulsants,
- factors influencing clients perception corticosteroids, bisphonates
↳ tolerance - drug not reaching receptors or are
• culture, ethnicity, family, age, past experiences, anxiety
-
PQRST damaged
• precipitating cause - what happened • not getting full effect
↳ dependence - body changing in response to
• quality - aching, stabbing, sharp
• region - location stimulant, withdrawal can occur when stopped
↳ addiction - changes to brain, compulsive use
• severity - pain scale despite consequences
• timing - all the time, occasional • treatment is necessary
>
- scales > patient controlled analgesit (PCA)
-
• numeric • patient controls pump, if need more
- no pain: 0 mecidine
- slight: 1-3 • only patient can press their button
- moderate: 4-7 > complimentary and alternative therapies (CAT/
- severe: 8-10 M)
• nonverbal pain scale (NPS) - out of 10 • eastern medicine
- intubation • optimal health of whole person
>
- osteopathic medicine
- facial expressions, activity/movement, guarding, vitals,
respiratory • paitent centers, holistic approach
• FLACC - out of 10 • physicians can specialize, prescribe, peform
surgeries
- face, legs, activity, cry, consolability ↳ natural products and herbal remidies
• pain assessment in advanced dementia (PAINAD) - out • aloe, chamomile, echinacea, garlic, ginger,
of 10 gingko biloba, ginseng, valerian
- breathing, negative vocalization, facial expression, • FDA does not regulate many, may interfere
body language, consolability with prescription meds
• CRIES - out of 10 - USP supplement verification - indicates product
- infants contains listed ingredients, will break down in
- crying, oxygen, increased vitals, expression, body, made sanitarily
sleeplessness >
- nursing and CAM
• incorporat into care plans, educate,
receptive to learning