pain

• pain is what the pt says it is
• women have a lower pain tolerance then males
• different cultures see pain differently and react differently
• different experiences of pain alter what they scale pain as (aka a 10 for one person may not be a 10 to someone else)
• anxiety, fatigue, and coping make pain worse
• acute pain: sudden onset usually the result of injury
• chronic pain: pain lasting over 3 months; persistent or breakthrough pain, cancer pain, nerve pain
• nociceptive pain: pain caused by tissues, bones, joints, muscles, or organs
• somatic pain: deeper tissues, joints, and bones; dull achy pain (cramping, crushing, stabbing)
• visceral pain: organ pain; often referred to other body locations; cramping, achy, dull, pressure, stabbing pain
• neuropathic pain: pain in relation to damage to the nervous system; numbness, tingling, shooting, burning, pins and needles; phantom limb pain
• pain is your 5th vital sign
• reassessed:

  60 minutes after interventions (PO med, fluff pillows, heat)

  30 minutes after IV interventions
• goal for pain: get the pt to a tolerable pain level (NOT zero) and improve function and quality of life
• chest pain is the only time you must get pt pain level to zero
• opioid: depresses the CNS and the perception of pain; severe to moderate pain

  morphine, fentanyl, codeine
• NSAID: decreases inflammation; chronic pain use

  ketorolac, diclofenac, ibuprofen, aspirin, celecoxib
• acetaminophen: mild pain use
• Corticosteroids: decrease inflammation; causes delayed wound healing

  prednisone, hydrocortisone
• atypical: anti depressants and anticonvulsants
• non-pharmacological interventions:

  positioning, heat/cold application, ROM, massage, distraction, prayer, TENS unit
• what is good for joint pain?

  ROM
• what is good for muscle pain?

  heat/cold application
• key points:

  everyone experiences pain differently

  assessments must be done every 4 hours and documented on all pts (even if no pain is reported)

  the goal is not always zero pain (except chest pain)

  reassessment of pain, side effects, and effectiveness is a must

  worsening pain or pain outside the expected should be reported to a provider and documented