Nursing Responsibilities in PAIN MANAGEMENT

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Nursing Responsibilities in PAIN MANAGEMENT
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Pain Defined

• an unpleasant, subjective sensory and emotional
  experience associated with actual or potential
  tissue damage, or described in terms of such
  damage. (International Association for the Study
  of Pain)

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What is the Nature of Pain

• Much more than a physical sensation caused by a
  specific stimulus
• Involves physical, emotional, and cognitive
  components
• Demands a persons energy
• Can not be objectively measured

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Working Definition of PainAccording to McCaffery

• whatever the experiencing person says it is,
  existing whenever he says it does
• Self report of pain is the single most reliable
  indicator of pain intensity

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Factors That Influence Pain

• Physiological
• Age
• Fatigue
• Genes
• Neurological function
• Social
• Attention
• Previous experience
• Family and social support

• Spiritual Factors
• Psychological Factors
• Anxiety
• Coping style
• Cultural Factors
• Meaning of Pain
• Ethnicity

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Responsibility of the Nurse

• To accept the clients report of pain
• Do not make client prove that they are in pain.
• To use knowledge and skills to alter the clients
  response to pain
• Alleviate pain
• Decrease pain perception

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How do Knowledge, Attitudes, and Beliefs limit a
care providers ability to offer pain relief?
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How Does a Care Provider Approach Pain Management?
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Assessment

• 5th Vital Sign
• Determine clients perspective
• History
• Meaning
• Physical, emotional, and social effects
• Objectively measure the characteristics of
  clients pain

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Characteristics of Pain(Comprehensive Pain
Assessment)

• Onset and duration
• Location
• Intensity
• Quality
• Pain pattern
• Relief measures
• Contributing symptoms
• Effects of pain on client
• Client expectations

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Nursing Diagnosis

• Acute Pain
• Chronic Pain
• What other Nursing Diagnoses would be appropriate
  for a client experiencing pain?

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Planning

• Identify interrelated problems
• Determine goals/Outcomes
• Involve family
• Select Interventions
• General
• Nonpharmacologic interventions
• Pharmacologic interventions

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Implementation

• General Comfort Measures
• Positioning
• Anxiety reduction
• Distraction
• Treat interrelated problems

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Implementation

• Nonpharmacologic Interventions
• Relaxation and guided imagery
• Biofeedback
• Cutaneous stimulation
• Herbals
• Reducing pain perception

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Implementation

• Pharmacologic Interventions
• Analgesics
• NSAIDS
• Opiods
• Adjuvants
• Patient Controlled Analgesia
• Local Analgesic Infusion Pumps
• Topical Analgesics and Anesthetics
• Local and Regional Anesthetics

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Evaluation

• Why is evaluation so important?
• When do you evaluate?

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Frequent and comprehensive follow-up is essential
to identifying and treating a persons pain
appropriately.