This document discusses pain from a nursing perspective. It defines pain, explains the physiology of pain including pain receptors and signal transmission, and outlines the types of pain such as acute, chronic, idiopathic, and psychogenic pain. The document also discusses pain assessment and management in nursing, including using pain scales, relieving pain through measures like rest, relaxation, analgesia, and diversional therapy.

1. FUNDAMENTALS OF
NURSING
UNIT 4:2
PAIN
BY JONES H.M- MBA/DMS
1

2. PRESENTED BY:
BY JONES H.M- MBA/DMS
2

3. GENERAL OBJECTIVE
At the end of the
lecture/discussion students
should be able to acquire
Knowledge and understanding
of pain.
3

4. SPECIFIC OBJECTIVES
At the end of the lecture/discussion students should be
able to;
• Define pain.
• Explain the simple physiology of pain.
• State the causes of pain.
• State the types of pain.
• Explain the management of pan.
4

5. INTRODUCTION
• Pain occurs in all clinical settings, among different
groups of patients thus, the nurse has a central role in
pain assessment and management. To perform this
role, the nurse should have a thorough understanding
of the physiological and psychosocial dimensions of
pain.
5

6. DEFINITION OF PAIN
Pain is a sensation where a
person experiences discomfort,
distress or suffering due to
overstimulation of sensory
nerves.
6

7. OR
• “Unpleasant sensory and emotional
experience associated with actual or
potential tissue damage, or
described in terms of such damage
7

8. PHYSIOLOGY OF PAIN
• Pain begins with stimulation of specialized
sensory nerve endings located on the body
surface or in deeper structures. Some
areas of the body are richly supplied with
more pain receptors example; the skin ,
arterial walls, periosteum and joint surfaces.
8

9. • The receptors produce impulses that are carried
to the spinal cord and the thalamus. At this point
the person becomes aware of the pain. The
interpretation of the site of stimulus, quality and
intensity of pain is made at the cortical level in
the cerebral cortex.
9

10. • . In addition to interpretation
impulses are initiated which
activate the physical response to
pain.
10

11. TYPES OF PAIN
Acute pain
• Pain of short duration, usually less than 6 months
• It usually protective and has an identifiable cause
• It has limited tissue damage
• Physical manifestations include-increased heart rate,
respiratory rate, blood pressure, and anxiety .
11

12. Chronic Pain
• May start as acute pain but last longer beyond the normal time
of recovery usually more than 6 months
• Cause may not be known
• Physical manifestations include flat affect, reduced physical
movement/activity, fatigue and withdraw from others and social
interactions.
12

13. Idiopathic Pain
Chronic pain in the absence of an identifiable physical
or emotional cause.
Referred Pain
• Form of visceral pain which is felt in an area distant
from the from the site of stimulus
13

14. Psychogenic Pain
• Pain not caused by nociception but by psychological
factors.
• Patient will usually report pain that does not match the
underlying disorder
• Its diagnosed after ruling out all the other causes of pain.
14

15. MANAGEMENT OF PAIN
• Pain is subjective, no two persons experience pain in
the same way and no two painful events create
identical responses or feelings in a person.
• In order to be able to manage pain there is need to
conduct a pain assessment. Accurate pain
assessment is an essential element in effective pain
management
15

16. • Pain assessment mainly involves direct interview and
observation of the patient.
• The use of pain scales and physical examination
completes the assessment.
• Before assessment remember that the pt may use
other words other than pain to denote pain e.g.
aching.
16

17. During assessment, consider the following
characteristics of pain.
Pattern of pain.
• Ask the patient about the onset of pain-for acute pain
the patient may know exactly while for chronic pain the
patient may not precisely identify the time of onset.
• Knowledge of onset can guide in identifying possible
cause and treatment strategies.
17

18. Location of Pain
• The area or location of pain assists in
identifying the possible cause and
treatment too. Some individuals may
specify the precise location while others
may simply say it’s hurting all over .
18

19. Quality of pain
• Quality refers to the nature of pain e.g.
neuropathic pain may be described as
burning, shooting or stabbing while
nociceptive pain may be described as
sharp. Throbbing and cramping.
19

20. Associated symptoms
• Associated symptoms such as anxiety, fatigue or
depression may exacerbate or may be exacerbated by
pain. Ask for activities that improve or worsen the pain
e.g. in musculoskeletal pain movement and
ambulation may worsen pain while resting and
immobilization of the affected part may decrease the
pain.
20

21. Intensity of Pain
• Assessing the severity and intensity of pain helps in
identifying the treatment strategies.
• Pain scales can be used to help the patient
communicate the intensity of pain.
Such scales include:
• Numerical pain intensity scales. On a scale of 0-10,
patient rates his pain. 0 stands for no pain, 5 moderate
pain and 10 Worst possible pain.
21

22. • Descriptive pain intensity Scale-
describes pain in terms of no
pain, mild pain, moderate pain,
severe pain, Very severe pain
and worst possible pain.
22

23. NURSING CARE OF A PATIENT IN
PAIN.
• A widely used method of providing effective care is
the nursing care plan. With the use of a care plan the
nurse is able to diagnose the problem, plan for
expected outcomes, implement interventions, state
reasons for the interventions, and evaluate the
outcome.
23

24. NURSING DIAGNOSIS.
• Acute pain – Related to tissue injury from an incision
site.
• Activity intolerance—Related to unrelieved pain.
• Ineffective coping—Related to lack of knowledge of
possible methods of coping.
24

25. OUTCOMES.
• Outcomes and goals should be determined. A realistic
outcome should be established to control or maintain
the client at desired levels of pain and functioning.
Desired outcomes are that:
• Report acceptable pain levels.
• Perform daily activities without limitation related to
pain.
• Increased patient comfort
25

26. NURSING MEASURES TO RELIEVE
PAIN.
• Rest and relaxation
• To promote rest and relaxation ensure that there is no
noise in the environment.
• Plan your work in a way that procedures are carried
out at almost the same time.
• Alley anxiety
• Explain procedures to the patient. Encourage the
patient to verbalize their pain and fears. Reassure the
patient that everything possible is being done to
minimize or provide relief .
26

27. • Position
• Change of position may provide relief ( this depends
on the cause of pain) for the patient by reducing the
pressure on the site.
• Diversional Therapy
• Can be done by providing books, news paper to
music or television. This will help in keeping the
patients mind off the pain.
•
27

28. Local application
• A Warm or Cold compress can be applied. But care
must be taken as to not add further injury.
Analgesia
• Give the prescribed analgesics and document on the
patient treatment chart.
28

29. SUMMARY
In today’s lecture we have discussed pain. The
definition, and causes of pain. We have also been
able to look at the simple physiology of pain, types of
pain and the management of a patient in pain.
29

30. CONCLUSION
We have come to the end of our lecture. Thank you for
your attention and participation.
30

31. REFERENCES
• Anne W and Allison G (2010),Ross and Wilsom, Anatomy and
Physiology in health and Illness,11th edition, Edinburgh,
London.
• Black,Hawks, (2005) Medical Surgical Nursing, Clinical
Management for positive outcomes, 18th Edition,Saunders,
Elsevier inc. pages 276-301.
• Elaine N. Marieb (1989), Human anatomy Physiology,3rd
edition, redwood city, California.
•
• 4. Potter and Perry (2009),Fundamentals of Nursing 6th
edition, st Louis University School of Nursing,st Louis, Missouri.
•
31

32. THANK YOU.
32