Ch. 18 Pain and Management, Comfort, Rest, and Sleep

What is meant by the subjectivity of pain?
Subjective pain is whatever the experiencing person says it is, existing whenever he says it does
Describe the difference between acute pain and chronic pain.
Acute pain is intense and short duration, usually lasting less than 6 months
Chronic pain is generally characterized as pain lasting longer than 6 months, sometimes the pain is continuous and sometimes it is intermittent, at times it may be as intense as acute pain
Explain the gate control theory.
Suggest that pain impulses are regulated and even blocked by gating mechanisms located along the central nervous system (CNS) proposed location of the gates is in the dorsal horn of the spinal cord. If other cutaneous stimuli besides pain are transmitted the ” gate” through which the pain impulse must travel is temporarily blocked by the stimuli when gates are open, pain impulse flow freely when gates are closed, pain impulses become blocked.
Summarize the essential message about pain assessment.
The essential message about pain assessment is easy to summarize, ask Pt’s about their pain , accept and respect what they say, intervene to relieve their pain and ask them again about their pain. It is a circle of assessment, intervention, and reassessment. W/O assessment of the Pt. with pain, none of the pain relief measures will be useful.
What are the emotional consequences of unrelieved pain?
Possible emotional consequences of unrelieved pain include anxiety, depression, irritability, and an inability to enjoy life, guidelines for individualizing pain therapy.
List the guidelines for individualizing pain therapy.
1) Use different types of pain relief measures
2) provide pain relief measures befor pain becomes severe
3) Use measures the pt. believes are effective
4) Consider the Pt;s ability or willingness to participate in pain relief measures.
5) Choose pain relief measures.
6) If therapy is ineffective at first, encourage the Pt. to tryu it again before abandoning it.
7) Keep an open mind about what has potential to relieve pain
8) Keep trying
9) Protect the patient
Why are repeated intramuscular (IM) injections not recommended?
IM injections are often painful and traumatic, also have the potential to cause fibrosis of muscle and soft tissue, as well as sterile abscesses
Name the three methods of administering epidural analgesia.
Three Methods of adminstering epidural analgesia:
1)By bolus doses
2) Continuous infusion
3) Patient controlled epidural analgesia
List the factors that affect sleep.
Physical Illness
Anxiety and Depression
Drugs and substances
Lifestyle
Sleep patterns
Stress
Environment
Exercise and Fatigue
Nutrition
What are the emotional consequences of unrelieved pain?
anxiety, depression, irritability and inability to enjoy life