Study Guide Question #13

Pain
a. What should be included in a pain assessment tool?

Pattern
onset and duration

Area
precise location, general area or not able to localize (hurts all over, diffuse), referred pain, radiation of pain
1) describe the site
2) point to pain
3) mark on pain map

Intensity
Pain scales: (Figure 9-7, page 140)
Numeric
Simple Descirptive
Visual

Nature
quality and characteristics

Effects on sleep, daily activities, relationships, physical activity, emotional well being
How does person express pain
Strategies used to control

See Table 9-6, p. 140

b. What is the rationale for each step in administering trandermal pain relief?
Why do you take off the old patch and wipe the area clean?
What would you check before administering pain meds via patch? (Hint: blood pressure would be one, resp another, poss pain levels)
Do you put the patch is the same place every time? Why or why not?
What would you do if your client developed itching at the site of the patch or told you they had an allergy to adhesive?
I am sure you can think of others that should be checked too.
Five rights of med admin come to mind too.

c. How do non-pharmacological therapies, including a TENS unit, work?

TENS: transcutaeous electrical nerve stimulation
delivery of an electric curent through electrodes applied to the skin surface over the painful region, a trigger points or over a peripheral nerve
Scrambles the nerve conduction so it can't conduct pain impulses

Massage:
superficial or deep
accupressure
trigger point massage

Vibration:
poss provides relief by activating mechanoreceptors in muscles

Percutaneous ENS:
stimulates deeper peripherial tissues through insertion of a needle, to which a stimulator is attached, near a large peripheral or spinal nerve. Can be surgically implanted for long term use.

Accupuncture:
insersion of needles at designated points

Heat:
moist or dry heat to skin
superficial or deep

Cold:
Moist or dry cold to skin
Icing with ice cubes
Believed to be more effective and longer lasting than heat

Exercise:
Enhances circulation and cardiovascular fitness, relieves pain through conditioning.
(Exercise is good for everything, sort of like oxygen.)

Cognitive:
Distraction
Hypnosis
Relaxation