Multimodal analgesia
More than one method to treat pain
Preemptive analgesia
administration of meds prior to an event
Interventions to treat Pain
Non-opioid analgesics
Opioid analgesics
Non-steroid anti-inflammatory drugs
Pain Assessment
Location
Intensity
Quality
Onset and Duration
Alleviating and relieving factors
Effect of pain on quality of life
Comfort
Factors that can affect pain
-Communication barriers
-Cognitive impairment or disability
-Mental Health Conditions
-Injury or conditions associated with pain (Traumatic, illness, surgery)
Medication Education
-Turn of TV when education
-Make sure patient has hearing aids/glasses
-Teach about medication
Name, dose, why?, when?, side affects
-Provide written instructions
-When to call health care providers
Cardiovascular
A nurse is caring for a client with chronic low back pain. What is the
priority outcome of care for this client?
- The client is able to dress self.
- The client will not experience pain.
- The client will state three ways to cope with anxiety.
- The client’s discomfort will not interfere with sleep.
What should a nurse do to assess the behavioral aspects of a client’s
pain?
- Ask the client to rate pain on a scale of 0-10.
- Watch the client walk down the hall observing impaired mobility related to
pain. - Assess what the client does to relieve the pain.
- Determine if the client avoids participating in conversations with visitors.
Risk Factors for Maladaptive Coping:
-Inability to accurately assess stressor
-Denial or avoidance
-Actual or perceived lack of support
-Non or poor experience in managing stress
Stages of Grief
- Denial – the patient has difficulty believing a terminal diagnosis or loss
- Anger – the patient lashes out at other people or things
- Bargaining – the patient negotiates for more time or a cure
- Depression – the patient is overwhelmingly saddened by the inability to
change the situation - Acceptance – the patient acknowledges what is happening and plans for the
future by moving forward
SOCRATES
Site
Onset
Character
Radiation
Associations
Time Course
Exacerbating/relieving
Severity
Nociceptive
Pain coming from actual tissue damage
Neuropathic
Pain that could be coming from not actual physical source
What to consider with end-of-life care.
- Allow time for grieving process
- Identify expected behaviors (crying, anxiety, etc.)
- Use therapeutic communication
- Use active listening
- Use silence and personal space
- Assist the grieving individual to accept the reality of the loss
- Support efforts to “move on”
- Encourage the building of new relationships
- Provide continuing support
- Assess for evidence of ineffective coping
- Share information about mourning and grieving
- Encourage attendance at support groups
- Refer to psychotherapy for patient’s having a more difficult time with
the grief
Core Services
Chaplaincy, nursing, social services, medicine
Expanded services
Psychosocial support, care coordination, rehabilitation services, expressive therapies, volunteers
