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Chapter 20 Pain Management

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Chapter 20 Pain Management * Bader EL Safadi BSN , MSc Fundamental of Nursing - A Feb,05,2012 pain Pain is The major cause of physical distress ... – PowerPoint PPT presentation

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Title: Chapter 20 Pain Management


1
  • Chapter 20 Pain Management

2
pain
  • Pain is
  • The major cause of physical distress among
    clients.
  • An unpleasant sensation usually associated with
    disease or injury.
  • The process of pain
  • Transduction-Phase
  • Conversion of chemical information at the
    cellular level into electrical impulses that move
    toward the spinal cord.
  • Transmission-Phase
  • During which stimuli move from the peripheral
    nervous system to the brain

3
  • The process of pain (contd)
  • Perception-Phase
  • Conscious experience of discomfort when the pain
    threshold is reached.
  • Modulation-Phase
  • Brain interacts with the spinal nerves in a
    downward fashion to alter the pain experience

4
TYPES OF PAIN
  • Cutaneous pain
  • Discomfort that originates at the skin level
  • Visceral pain
  • Discomfort arising from internal organs
  • Referred pain
  • Discomfort perceived in a general area of the
    body, usually away from the site of stimulation (
    appendicitis )
  • Neuropathic pain
  • Pain with atypical characteristics also called
    functional pain
  • Example phantom limp pain

5
TYPES OF PAIN (contd)
  • Acute pain
  • Lasts a few seconds to less than 6 months
  • Associated with tissue trauma, surgery, or recent
    identifiable etiology.
  • Gradual reduction in pain promotes coping
  • Chronic pain
  • Discomfort that lasts longer than 6 months
  • Physical and emotional distress
  • Depression

6
PAIN ASSESSMENT STANDARDS
  • Pain is the fifth vital sign
  • Should be assessed with temperature, pulse,
    respirations, and blood pressure
  • Pain should be regularly assessed throughout the
    healthcare delivery
  • Healthcare workers should be educated on pain
  • Clients and families should be educated on
    effective pain management
  • Clients choices regarding pain management is
    respected

7
PAIN ASSESSMENT DATA
  • Onset
  • Time under which the pain became apparent (
    e.g. after surgery)
  • Quality
  • Degree of suffering ( e.g. throbbing, crushing)
  • Intensity
  • Magnitude of pain ( e.g. mild ,moderate, sever)
  • Location
  • Anatomic site ( e.g. chest, abdomen)
  • Duration
  • Time span of pain ( e.g. continuous,
    intermittent, weeks)

8
NONVERBAL PAIN INDICATORS
  • Moaning
  • Crying
  • Grimacing
  • Guarded position
  • Increased vital signs
  • Reduced social interactions
  • Irritability
  • Difficulty concentrating
  • Changes in eating and sleeping

9
PAIN MANAGEMENT TECHNIQUES
  • DRUG THERAPY
  • Nonopioids (non-narcotic drugs). e.g. Aspirin
  • Opioids (narcotic drugs), e.g. Morphine sulfate,
    Codeine sulfate
  • Adjutants drugs that assist in accomplishing the
    desired effect of a primary drug.( e.g.
    antidepressant, anticonvulsant)
  • SURGICAL APPROACHES
  • Intractable pain-Pain unresponsive to other
    methods of pain management

10
PAIN MANAGEMENT TECHNIQUES (contd)
  • Nondrug/ Nonsurgical interventions
  • Education
  • Educate client about pain and methods for pain
    management
  • Imagery
  • Intentional daydreaming
  • Meditation
  • Concentrating on a word that promotes tranquility
  • Distraction
  • Intention diversion of attention to switch focus
    from unpleasant sensory experience
  • Relaxation
  • Technique for releasing muscle tension and
    quieting the mind

11
PAIN MANAGEMENT TECHNIQUES (contd)
  • Nondrug/ Nonsurgical interventions
  • Heat and Cold
  • Thermal therapy for pain relief
  • Acupuncture
  • Pain management technique in which long, thin
    needles are inserted into the skin
  • Acupressure
  • Technique that involves tissue compression rather
    than needles to reduce pain
  • Hypnosis
  • Therapeutic technique in which a person enters a
    trancelike state

12
Nursing Implications-Nursing Diagnoses
  • Acute pain
  • Chronic pain
  • Anxiety
  • Fear
  • Ineffective Coping
  • Deficient Knowledge Pain Management
  • Placebo an inactive substance sometimes
    prescribed as a substitute for analgesic drugs
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