PAIN


 

OVERVIEW

Pain is an individual unique experience which is difficult to describe & also difficult for other to recognize & asses. It is an unpleasant feelings & entirely subjective. Pain intensity is differ from person to person for a same type of pain.

TYPE OF PAIN

1.     Acute/Transient Pain:-

        Usually associated with an injury, medical condition or surgical procedure; which lasts hours to a few days.

2.     Chronic/Persistent noncancer pain:-

Usually associated with long term or chronic illness which may continue for months or even years.

3.     Chronic/ Episodic Pain:-

Occurs sporadically over an extended period of time. Pain episodes last for hours, days or weeks. Example-Migraine headaches.

4.     Cancer Pain:-

Cancer pain is usually caused by tumor progression & related pathological progresses, invasive procedures, treatment toxicities, infection & physical limitations.

5.     Idiopathic pain:-

This is a chronic pain in the absence of an identifiable physical or psychological cause.

ASSESSMENT

·        Pain is a highly individual experience .

·        Ask the client to describe pain in term of timing, location, severity, quality, aggravating & precipitating factors & relief measures.

·        Pain experienced by the older client manifested differently then the other age groups. E.g. sleep disturbance, depression & change in gait & mobility.

·        A client with dementia or a comatose client may not able to describe their pain experience so nurse should use non verbal indicators of pain like crying, irritability, restlessness, inability to sleep, increase heart rate, BP or respiratory rate, nausea & diaphoresis.

·        Use of the FLACC (face, legs, activity, cry, consolability) scale or FACES pain scale for the client who cannot communicate their pain verbally

 

 

 



MANAGEMENT OF PAIN:-

NON-PHARMACOLOGICAL MANAGEMENT:-

1.     RELAXATION :- It reduce the muscle tension, oxygen consumption, maintain all vital signs. Ex- Meditation, deep breathing,

2.     Distractions:- It help the client to focus  attention  other then pain.(Game, music, photos)

3.     Guided imagery:- Patient create an image  on her mind and concentrate on that image & less focus on pain.(Chronic pain)

4.     Acupuncture:-  It is believe that life  energies  move through the body in a specific path & the path are called meridians. Various sizes of needled used  to prick specific part of body  to produce insensitive to pain.

5.     Massage:- It stimulate the circulatory system  & lymphatic system , lower BP, relieve  joint pain.

6.     Music therapy:- It reduce anxiety, depression  and mood diversion

7.      Laughter therapy:- It help in breathing deep, digestion, lower BP & may cause brain to make endorphins. So it relax and let the go off stress, pain.

8.     Thermotherapy:- Hot  therapy promote circulation, relax muscles, relive pain and cold treatment cause vasoconstriction, remove cellular debris from injured area & relive pain and inflammation.

9.     Hypnosis:- It is a technique that produce subconscious state accomplished by suggestion made by hypnotist.

10.Aromatherapy:- Its uses plant materials & aromatic plant oils  for improving psychological & physiological well beings.

PHARMACOLOGIC MANAGEMENT:-

1.     Analgesic:-

a.     Non Opioid analgesics:- It interfere with enzymes and reduce inflammation and pain.

     Ex-Aspirin, ibuprofen.

b. Opioid analgesics:-It inhibit ascending pathway of pain perception & activate descending pathways. Ex-Morphine, Fentanyl.

2. Patient controlled analgesia:-

     Here medication is administered by the help of battery operated pump. Here  a medication filled in  syringe is connected  with the pump. Medication is pushed according to the time set.

3. Epidural analgesia:- It is given in spinal epidural space to block the pain transmission. Most commonly give in post operatively.

4. Placebo Response:- Hear an non drug substance given to the patient to relive pain. It has only psychological effect.

6. Local anaesthesia:- Anaesthetics block action potential transmission by interfering  sodium and potassium channel in the cell membrane.  It work by  chemically blocking the nerve  pathway involve in the pain sensation & responses.

ROLE OF NURSE:-

  • Assess the pain include location, characteristics, onset, duration, frequency, quality & intensity.
  • Eliminate the additional stressor interfering pain.
  •  Provide rest period to facilited comfort sleep, relaxation.
  •  Eliminate factors which increase pain experience like fear, lack of knowledge.
  •  Provide relaxation therapy

 


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