NUR 2392 / NUR2392 Final Exam: Multidimensional Care II / MDC 2 Final Exam Review
(2021/2022) Rasmussen
Assessment and Care of Patients with
... [Show More] Pain
Concepts
• The priority concept in this chapter is comfort
• The interrelated concepts in this chapter are cognition sensory Perception
Pain The Scope of the Problem
• Pain is a major economic problem and a leading cause of disability that changes the lives
of many people, especially older adults.
• Chronic non-cancer pain such as osteoarthritis, rheumatoid arthritis, and diabetic
neuropathy is the most common cause of long-term disability, affecting millions of
Americans and others throughout the world.
• Universal, complex personal experience
• Is an impairment in comfort; major economic concern; leading cause of disability
• Failure to manage pain is a worldwide health problem
• Inter-professional pain initiatives help patients receive best treatment
Definitions of Pain
• Unpleasant sensory and emotional experience associated with actual or potential tissue
damage
• Whatever person experiencing it says it is; exists whenever person says it does
• Self-report always most reliable indication of pain
Categorization of Pain by Duration
• Acute pain
- Short-lived
- Results from sudden, accidental trauma; surgery; ischemia; acute inflammation
• Chronic (persistent) pain
- Can last a person‘s lifetime
- Chronic cancer pain
- Chronic non-cancer pain
• Pain is treated inadequately in almost all health care settings.
• Populations at the highest risk in medical-surgical nursing are older adults, patients with
substance use disorder, and those whose primary language differs from that of the health
care professional.
• Older adults in nursing homes are at especially high risk because many residents are unable
to report their pain. In addition, there often is a lack of staff members who have been
educated to manage pain in the older-adult population.
Acute Pain
• Acts as warning sign
• Activation of sympathetic nervous system
• ―Fight-or-flight‖ reactions
- Increased vital signs
- Sweating
- Dilated pupils
- Restlessness
- Apprehension
- Distress of varying degrees
agradestuvia
NUR 2392 / NUR2392 Final Exam: Multidimensional Care II / MDC 2 Final Exam Review
(2021/2022) Rasmussen
Acute Pain (Cont.)
• Absence of physiologic and behavioral responses does not mean absence of pain
• Usually temporary with sudden onset, and easily localized
• Sensory perception of pain changes as injured area heals
Chronic (Persistent) Pain
• Lasts or recurs for indefinite period (more than 3 months)
• Gradual onset
• Character and quality often change over time
• Serves no biological purpose
• Can result in emotional, financial, and relationship burdens, as well as
depression/hopelessness
Chronic Cancer Pain
• Usually result of tumor growth, nerve compression, tissue invasion, metastasis
• Cancer treatment can also cause acute pain (e.g., procedures, surgery, toxicities from
chemo and radiation)
Chronic Non-Cancer Pain
• Global health issue for people > 65 years old
• Formerly called chronic nonmalignant pain
• Neck, shoulder, low back
• Over half of veterans of recent wars have this condition
- Can cause depression, decreased sense of well-being
Categorization of Pain by Underlying Mechanisms
• Nociceptive pain
- Somatic
- Visceral
• Neuropathic pain
Pain Transmission
• Painful stimuli often originate in extremities
• If pain is not transmitted to the brain, person feels no pain
• Two specific fibers transmit periphery pain:
- A delta fibers
- C fibers
Assessment: Noticing
• Patient‘s self-report is ―gold standard‖ for assessment
• Nurse‘s role
- Accept patient self-report
- Serve as advocate
- Act promptly to relieve pain
- Respect patient values and preferences
Pain Assessment (Cont.)
• Location
• Intensity
• Quality
• Onset and duration
• Aggravating and relieving factors
• Effect of pain on function and quality of life
agradestuvia
NUR 2392 / NUR2392 Final Exam: Multidimensional Care II / MDC 2 Final Exam Review
(2021/2022) Rasmussen
• Comfort-function ou [Show Less]