med/surg ati chapter 4 pain management

what is acute pain?
Protective, temporary, and usually self-limiting.
fight-or-flight response
grimancing, moaning, finching, guarding
chronic pain
Not protective. Lasting longer than 6months.
May lead to depression, fatigue, and a decreased level of functioning.
Management aims at symptomatic relief.
Nocieceptive pain
Arises from damage to inflammation of tissue other than that of the peripheral and central nervous systems
. (ex: somatic- in bones, joints, muscles, skin or conncective tissue.
visceral- in internal organs such as the stomach, or intestines.
cutaneous- in the skin or subcutaneous tissue. )
Neuropathic pain
Arises from abnormal or damaged pain nerves.
Phantom limb pain, pain below the level of a spinal cord injury and diabetic neuropathy.
Usually responsive to adjuvant medications such as antidepressants, antispasmodic agents, skeltal muscle relaxants.
objective information for pain
facial expressions
moaning, crying
decreased attention span
Pharmacological pain management. Mild-moderate
Nonopiopid analgesics.
Acetaminophen is hepatoxic. Limit 4g/day
Monitor for salicylism (tinnitus)
Moderate-Severe pain
Opioid analgesics
Opioid analgesics adverse effects
Constipation
Orthostatic hypotension, urinary retention(administer bethanechol(Urecholine) and catheterize), Nausea and vomiting, sedation, respiratory depression
Adjuvant analgesics
enhances the effects of nonopioids.
Anticonvulsants:Cabamazepine(Tegretol)
Antianxiety agents: Diazepam(Valium)
TCA: amitriptyline(Elavil)
Antihistamine: hydroxyzine(Vistaril)
Glucocorticoids: dexamethasone(Decadron)
Antiemetics: ondansetron(Zofran)
Naloxone
administer if respiration rate is below 8/min and shallow or the client is difficult to arouse.