gate control theory of pain
pain have emotional and cognitive components, in addition to a physical sensation
acute pain
new onset with cause
chronic pain
slow onset with no event causing and usually lasts longer than 3 months
breakthrough pain
severe transitory increase in pain on baseline of moderate intensity or less
social pain
financial, security, and relationships
psychological or emotional pain
fear, anger, depression
spiritual pain
god, church, meaning of life
unrelieved pain can cause what
prolonged stress response, reduced immune function, cardiovascular instability, respiratory dysfunction, genitourinary disturbances, metabolic imbalance, developmental issues
who is at greatest risk for pain
- older adults
- one’s unable to communicate
assessment
location, intensity, quality, onset, alleviating factors, effect of pain on quality of life, and comfort goal
ABCDE
- ask about pain regularly
- believe the patient and family in their reports of pain and what relieves it
- choose pain control options appropriate for the patient, family, and setting
- deliver interventions in a timely, logical, coordinated fashion
- empower patients and families by enabling their control over their course to the greatest extent
diagnosis
- activity intolerance
- anxiety
- ineffective coping
- fatigue
- fear
- insomnia
- hopelessness
- imbalanced nutrition
outcomes
- continue to obtain patient self report of pain
- consider patient condition or exposure to painful procedure
- observe for behavioral signs of pain
- conduct analgesic trail
side effects of opioids
- constipation
- nausea
- vomiting
- urinary retention
- altered renal function
- itch/rash
- dry mouth
- respiratory depression
non-pharmacologic interventions
- massage
- positioning
- body alignment
- splinting
- thermal interventions
- mind-body therapies
- distraction
- music
- exercise
