Barriers to Effective Pain Management

What is tolerance?
1. A state of adaptation in which exposure to a drug induces changes in its effect over time.
2. The client requires an increased opioid dose to maintain the same degree of pain control
What should the nurse consider if their patient has become tolerant to an opioid medication?
Consider rotating to a different opioid
What is physical dependence?
The adaptation manifested by withdrawal symptoms resulting when dependent use of opioids ceases abruptly.
What are early signs of dependence?
Anxiety, diaphoresis, anorexia, shaking/chills/tremors
What are late signs of dependence?
Excitation, diarrhea, fever, N/V, HTN, tachycardia, insomnia
What is addiction?
A complex, neurobiologic condition characterized by a drive to take substances for other than the prescribed therapeutic value.
List 5 barriers of effective pain management
1. Fear of Addiction or Tolerance
2. Concern about side effects
3. Fear of Injections/needles
4. Desire to be a “good” patient
5. Forgetting to take meds
List 3 reasons why older patients might be at greater risk for under-treatment
1. Cognitive impairments
2. Higher risk of GI bleeding from NSAIDS
3. Risk of drug interactions
Why might older patients be at risk for over-treatment?
Medications have a higher peak effect and longer duration.
List 3 signs of possible addictive behavior
1. Repeated requests for medications
2. Refusal to try oral medications
3. Continued high doses well after surgery date
The clinical use of placebo drugs is considered ___________.
Unethical
3 states that support assisted suicide
Oregon, Washington, Montana
Does the American Nursing Association support assisted suicide?
No.