The document discusses pain management, including defining pain, different pain theories like the gate control theory, differentiating between acute and chronic pain, non-pharmacological and pharmacological interventions. It covers non-opioid analgesics, opioid analgesics according to pain level, opioid side effects, equianalgesic dosing, adjuvants, the WHO pain ladder, routes of opioid delivery, patient-controlled analgesia, and nursing guidelines for patient-centered pain management.
Austin Pain & Relief is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Pain & Relief.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Pain & Relief. Austin Pain & Relief accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of pain and relief.
Austin Pain & Relief strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
a detailed description of pain and therpaeutic options available and clinical assessment of pain, approach to the patient with pain, assessment of intensity of pain, nsaids and opioids, tca. WHO pain ladder, chronic opioid therapy
Austin Pain & Relief is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Pain & Relief.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Pain & Relief. Austin Pain & Relief accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of pain and relief.
Austin Pain & Relief strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
a detailed description of pain and therpaeutic options available and clinical assessment of pain, approach to the patient with pain, assessment of intensity of pain, nsaids and opioids, tca. WHO pain ladder, chronic opioid therapy
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
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Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
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Biological screening of herbal drugs: Introduction and Need for
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Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
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2. OBJECTIVES
• At the end of the session learners will be able to:
I. Define the process of pain (physiological changes)
II. Describe the different theories of pain theory.
III.differentiate between acute and chronic pain
IV.Discuss the non pharmacologic interventions pain
management.
V. identify pharmacologic interventions for pain
management
3. PAIN
“Pain is an unpleasant and highly personal experience
that may be imperceptible to others, while consuming
all parts of an individual’s life”
“an unpleasant sensory and emotional experience
associated with actual or potential tissue damage, or
described in terms of such damage”
Pain management is the alleviation of pain or a
reduction in pain to a level of comfort that is
acceptable to the client.
5. DIFFERENT THEORIES OF PAIN
The foundation for pain management is built on multiple theories and
models. For example, theories in the 17th and 18th century suggested
the existence of specific pain pathways.
In the 19th century, theories specifically outlined the anatomy and
physiology of pain, including receptors sensitive to pain.
In 1965, Melzack and Wall developed the Gate Control Theory, which
expanded the physiologic models of pain and led to the development of
the psychosocial and behavioral theories that are part of current pain
management strategies. Nursing models for the delivery of pain
management continue to evolve (American Nurses Association [ANA]
12. PHARMACOLOGIC INTERVENTIONS
FOR PAIN MANAGEMENT
1. NONOPIOID ANALGESICS FOR MILD PAIN
2. OPIOID ANALGESICS FOR MODERATE PAIN
3. OPIOID ANALGESICS FOR SEVERE PAIN
4. ADJUVANTS
13. NON-OPIOIDS
Nonopioids include acetaminophen, aspirin and nonsteroidal anti-
inflammatory drugs (NSAIDs) such as ibuprofen. All are useful for
the management of acute and chronic pain. Acetaminophen (Tylenol)
does not affect platelet function and rarely causes GI distress. It does,
however, have serious side effects such as hepatotoxicity and possible
renal toxicity, especially with high doses or with long-term use.
Because acetaminophen is so well tolerated, it is often an ingredient in
OTC remedies (e.g., pain, fever, allergy, cough and cold preparations),
so clients must be instructed to read the ingredient list of all OTC
medicines they take.
14. CONTI……
Aspirin is the oldest nonopioid analgesic and is available
OTC. Because it can prolong bleeding time, clients should
stop taking it 1 week prior to any surgical procedure.
Aspirin should never be given to children under 12 years of
age due to the possibility of Reye’s syndrome
NSAIDs have anti-inflammatory, analgesic, and antipyretic
effects.
15. OPIOIDS
An opioid analgesic is a natural or synthetic morphinelike
substance responsible for reducing moderate to severe pain. In
addition to knowing the pharmacodynamics (how the medication
affects the body) of the various opioid analgesics, it is important
for the nurse to be aware of the potential side effects.
Opioid Analgesics for Moderate Pain These include drugs such as
codeine, hydrocodone, and tramadol. Most of these drugs are
combinations of a nonopioid with an opioid. These medicines are
generally 2 to 4 times more potent than nonopioids alone, and share
some of the risks of both drug classes
16. OPIOID SIDE EFFECTS
When administering any analgesic, the nurse must review adverse
effects. Adverse effects of the opioids typically include sedation,
respiratory depression, nausea, vomiting, constipation, urinary
retention, blurred vision, and sexual dysfunction.
The most concerning adverse effect of opioids is respiratory depression.
17. RANGE ORDERS
• Range orders are medication orders in which the selected dose varies over a
prescribed range according to the client’s situation and status. For example, a prn
range order for morphine 2 to 6 mg IV every 2 h for pain or for oxycodone 5 to 10
mg PO every 4 h prn for pain provides flexibility in dosing to meet individual client
analgesic needs.
• In addition, the Guidelines for Safe Electronic Communication of Medication
Information (Institute for Safe Medication Practices, 2019) states the following:
Do not allow single orders for medications with range doses, various frequencies, or
more than one route of administration. If orders for the same drug are prescribed at
different doses, frequencies, or routes, require separate orders for each that specify
objective measures to guide determination of which dose to administer at which
frequency and by which route. Examples of pain assessment measures that may be
used to guide determination of the dose, route, or frequency of medication include
severity, chronicity, quality of pain, and prior response to analgesics).
18. EQUIANALGESIC DOSING
The term equianalgesic refers to the relative potency of
various opioid analgesics compared to a standard dose of
parenteral morphine.
This tool helps professionals individualize the analgesic
regimen by guiding the adjustment of medication, dose,
time interval, and route of administration.
An equianalgesic table can be used to help provide doses of
approximately equal ability to relieve pain.
19. ADJUVANTS
An adjuvant is a medication that is not classified as a pain medication.
However, adjuvants have properties that may reduce pain alone or in
combination with other analgesics, relieve other discomforts, potentiate the
effect of pain medications, or reduce the pain medication’s side effects.
Examples of adjuvants that relieve pain are antidepressants (increase pain
relief, improve mood, and improve sleep), anticonvulsants (stabilize nerve
membranes, reducing excitability and spontaneous firing), and local anesthetics
(block the transmission of pain signals).
20. WORLD HEALTH ORGANIZATION
THREE-STEP ANALGESIC LADDER
• According to the World Health
Organization (WHO, n.d.) guideline
Cancer Pain Relief (2nd ed.), pain
treatment for cancer and noncancer
chronic pain should be prescribed in
three steps
• The WHO first developed the pain
ladder in 1986 and updated it in
1996 as a framework for the
management of cancer-related pain.
It is not an evidence-based guideline
(WHO, 2012).
21. ROUTES FOR OPIOID DELIVERY
Opioids can be given in the
following routes: oral,
transnasal, transdermal,
transmucosal, rectal, topical,
subcutaneous, intramuscular,
IV (bolus and continuous),
and intraspinal (epidural and
intrathecal) and as
continuous local anesthetics.
22. ADMINISTRATION OF PLACEBOS
A placebo is “any sham medication or procedure designed
to be void of any known therapeutic value”.
An example would be a sugar pill or an injection of saline.
In contrast, the placebo effect is “the positive response
some patients/participants experience after receiving a
placebo”
23. PATIENT-CONTROLLED ANALGESIA
Patient-controlled analgesia (PCA) is an
interactive method of pain management that
permits clients to treat their pain by self-
administering doses of analgesics. The IV
route is the most common in an acute care
setting. Its use for postoperative pain has
been well documented. It is also helpful
when oral pain management is not possible.
PCA can be effectively used for clients with
acute pain related to a surgical incision,
traumatic injury, or labor and delivery, and
for chronic pain as with cancer.
24. NURSING GUIDLINES
In the home setting, the nurse needs to inform the client’s support people to
monitor for signs and symptoms of oversedation such as excessive drowsiness,
slowed respiratory rate, or change in mental state. No one should adjust settings
without consulting the appropriate primary care provider.
The caregiver should tape the following emergency contact numbers to the
back of the pump:
emergency medical services, primary care provider, home care agency, and
pump manufacturer.
25. ORAL MEDICATION ON DEMAND
(MOD)
Oral medication on demand (MOD) is another electronic
delivery device that permits client-controlled access to oral
medications prescribed on a prn basis, within preset time
intervals.
The patient controlled oral analgesia device is placed on an
IV pole within easy reach of the client. It has functions
such as keypads allowing clients to input their pain
intensity rating before swiping a radio frequency
identification (RFID) wristband individual to each client.
26.
27. PATIENT-CENTERED CARE: PAIN MANAGEMENT
NURSING GUIDLINES
At discharge or in the home setting, the nurse can provide
helpful information to the client and the caregiver about pain
management. Examples include teaching the client:
• To keep a pain diary to monitor pain onset, activity before
pain, pain intensity, use of analgesics, or other relief measures
and effectiveness of each measure.
• To contact a healthcare professional if planned pain control
measures are ineffective.
• To use preferred and selected nonpharmacologic techniques
such as relaxation, guided imagery, distraction, music therapy,
and massage.
28. CONTI……
• To use pain control measures before the pain becomes
severe.
• The effects of untreated pain.
• Appropriate information about how to access community
resources, home care agencies, and associations that offer
self-help groups and educational materials.