Pain is anunpleasant sensory and emotional experience associated withactual or potential tissue damage.
a personal private sensation of hurt. a harmful stimulus that signal current or impending tissue damage. a pattern of responses to protect the organism from burn.
whatever the experiencing person says it is existing wheneverthe person say it is
1. Pain is a part of aging2. If a person is asleep, they are not in pain3. If pain is relieved by non- pharmaceutical pain relief techniques, the pain was not real anyway4. Real pain has an identifiable cause5. It is better to wait until a client has pain before giving medications
6. Very young or very old people do not have as much pain7. Some clients lie about the existence or severity of their pain8. Addiction occurs with prolonged use of morphine or morphine derivatives9. The same physical stimulus produces the same pain intensity, duration and distress in different people
10. Clients experience severe pain only when they have had major surgery.11. The nurse or other health care professionals are the authorities about a client’s pain12. Visible or physiologic or behavioral signs accompany pain and can be used to verify its existence.
Radiating pain perceived at the source of the pain and extends to the nearby tissues Referred pain felt in a part of the body that is considerably removed or far from the tissues causing the pain
the amount of pain stimulation a person requires before feeling pain least level of pain that the patient is able to detect
Includes the ANS and behavioural responses to paintypes:ANS response autonomic reaction of the body that often protect the individual from further harm. (automatic withdrawal of hand from hot object.)Behavioural response is a learned response used as a method of coping with pain.
maximum amount and duration of pain that an individual is willing to endure greatest level of pain that the patient is able to tolerate
thepointwhich the personbecomesaware ofthe pain
Pain Fibers Fibers PainThere are twoseparate pathwaysthat transmit painimpulses to thebrain:(1) Type A-delta fibersare associated with fast, sharp, acute pain and2) Type C fibersare associatedwith slow, chronic,aching pain
Categories of pain according to its1. Origin2. Onset3. Cause or etiology
1. Superficial Cutaneous Pain occurs over body surface or skin segments.2. Deep Somatic Pain occurs in the skin, muscles and joints (musculoskeletal – muscle, bone, periosteum, cartilage, ten dons, deep fascia, ligaments, joints, blood vessels and nervous)3. Visceral Pain
Acute pain following acute injury, disease or some type of surgery Chronic malignant pain associated with cancer or other progressive disorder Chronic nonmalignant pain in the persons whose tissue injury is non progressive or healed
Mechanical trauma blockage of body duct tumor muscle spasmThermal or cold extreme heatChemicalTissue ischemia Blocked artery Stimulation of pain receptors accumulation of lactic acid
Factors influencing reaction to painPsychological Physiological Cultural
Infant: perceive pain and respond to its increasing sensitivityToddler: respond by crying and anger because they perceive it as a threat to security or sense that pain is a punishmentSchool age: try to be brave and not to cry or express much pain so parents and nurse will not be angry with themAdolescent: may not want to report pain in front of peers because they perceive complaints of pain as weaknessAdult: may not report pain for fear that it indicates poor diagnosis. Nurse may mean weakness and failure
A drug delivery system which is a safe method for post operative, trauma & obstetrics, burns, terminal care pediatrics and cancer pain management Involves self IV drug administration Goal : to maintain a constant plasma level of analgesic so that the problems of client with needed dosing (PRN) are avoided Client preparation & teaching is important Check IV line & PCA device regularly
Easy access for clients for medication Allows self administration with no risks Pain relief without depending on nurses Small doses of medications at short intervals for sustained pain relief Stabilized serum drug levels Decreased anxiety
Patient becomes dependent on PCA If mobility is contraindicated, client may move due to decreased or no pain by PCA Respiratory depression Side effect may be constipation Mechanical failure of pump Relatives may press button for client Wrong programming parameters Incorrect placing of syringe can cause infusion of excessive drug doses Costly & if client may not understand the system
Goals: to provide comfort to correct physical dysfunctions to alter physiological responses to reduce fears associated with pain related immobilityExamples:1. Acupressure / acupuncture2. Cutaneous stimulation (massage, heat application, TENS)3. Binders, Chiropractic
Visual Score 0 1-2-3 4-5-6 7-8 9-10 Verbal Score No Hurts Hurts a lot Really hurts Extremely pain little a lot hurtsObserver Appears Comfortable Uncom- Distressed Distressed scoring pain free except on fortable can be movement comforted