Acute pain

* The level of comfort
* Response to treatment
* Pain Management

NIC intervention (classification of nursing interventions)
Suggested NIC Labels

* Analgesic Administration
* Sedation
* Pain Management
* Patient-controlled analgesia Help

Nanda: Determination of unpleasant sensory and emotional experience of the actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain), sudden or slow action by the intensity from mild to severe with an expected and predictable end and a duration of less than 6 months

Pain is a subjective condition in which a variety of unpleasant feelings and many other factors on the survival of the patient. Pain can be a symptom of an illness or injury. Pain may also be due to emotional, psychological, cultural and spiritual suffering. Pain can be very hard to explain, because it is unique to the individual, the victim must be taken to describe pain. Evaluation of the pain can be challenging, especially in elderly patients with cognitive impairment and sensory deficits often.

* Defining characteristics: the patient reports pain
* Conduct security, protection of body parts
* Self-centered
* Reduction of focus (eg changes in the perception of time, withdrawal from social or physical contact)
* Release diffusion behavior (eg, moaning, crying, pacing, looking at other people or activities, and anxiety)
* Facial pain
* Changes in muscle tone, sleepiness or flaccidness, constant voltage or
* Organic reactions (eg, excessive sweating, changes in blood pressure [BP], heart rate, dilated pupils, changes in breathing, paleness, nausea)

* Related factors: postoperative pain
* Cardiovascular Pain
* Muscle pain
* Obstetric pain
* Pain due to health problems
* Pain diagnostic procedures or treatment
* Pain due to trauma
* The pain of emotional, mental, spiritual and cultural needs

* Expected results said patient adequate pain relief, or the ability to deal with incomplete pain relief.


* Evaluation of pain characteristics:
the quality (eg sharp, burning, photo)
severity (scale of 1 to 10, 10, as the most serious) and other methods, such as visual analogue scale or descriptive scales can be used to determine the degree of pain is identified.
the location of (anatomical description)
, Survey (gradual or sudden)
the duration (how long, intermittent or continuous)
triggers or mitigating
Take or follow the signs and symptoms associated with pain, such as BP, pulse, temperature, humidity, color, care and concentration. Some people deny the experience of pain, when it is available. Watch for signs of nursing to assist in the evaluation of the pain.
* Rating probable cause pain. Various etiologic factors should respond to different therapies.
* Evaluation of patient knowledge or a preference for a variety of strategies, pain management available. Some patients may be unaware of the pharmacological effect and would be willing to try, or instead of traditional painkillers. Often a combination of therapies (eg analgesics, and low heat dissipation) may prove the most effective.
* Evaluates patient's response to the pain and the treatment or therapy to eliminate or alleviate pain. It is important to help patients speak as objectively as possible (ie without the influence of mood, emotion, or anxiety), the effect of pain measures. Differences between the behavior or appearance, and the patient's pain (or lack thereof) may be more a reflection of different methods to treat patients only as a relief.
* Assess the extent to which cultural, environmental, interpersonal and intrapsychic factors may contribute to pain, or pain. These variables can change the expression of patient care. For example, some cultures feelings openly, while others like the word limit. This should not stereotype all responding patients, but caregivers to assess each patient's unique response.
* Evaluate what it means pain of the individual. The importance of the pain will directly affect the response of the patient. Some patients, especially the dead feel that "the act of suffering," the spiritual needs.
* Comments patient expectations for pain relief. Some patients can reduce the pain of that content, and more will complete elimination of pain is expected. This affects their knowledge of effective treatment method, and their willingness to participate in further treatment.
* Comments patient's desire or the ability of a variety of techniques aimed at controlling the pain to explore. Some patients are uncomfortable exploring alternative methods for pain management. However, patients are informed that there are several ways to alleviate pain.
* Assessment of the suitability of the patient as a patient controlled analgesia (PCA) candidate: no history of drug allergy is not the narcotic analgesics, bright blue, cooperation and motivation for their use, no history of kidney, liver, or respiratory disease, crafts, and have no history of major psychiatric disorders. PSO is an intravenous (IV) infusion of drug (usually morphine or Demerol) via an infusion pump to control the patient. This allows the patient's pain within the prescribed limits. The hospice or home needs to be a nurse or carer, be patient, to help manage the infusion.
* Monitor changes in condition that may cause changes in pain leads method. For example, a patient and not be confused with the PCA PCA or a successful transport is sufficient to relieve pain, as in the rest breathing.
* If a patient has a PCA assessment is:
the pain, the basement or outside the service increases to cover the patient's pain.
the integrity of the line IV IV, if not a patent, the patient will receive pain medication.
The amount of pain medication the patient was asked whether the request for medication is very often the patient's dose should be increased. If the requirements are very low, another patient well instructed to use PCA.
about possible complications, such as excessive sedation PCA, respiratory distress, urinary retention, nausea / vomiting, constipation, pain and IV redness, swelling and mild allergic reactions in patients characterized by a general anesthetic itching, nausea and vomiting.
* If the patient receives epidural analgesia provides the following:
epidurals for pain do next dose intermittent intervals. Changes in anatomy can lead to "patch effect.
The numbness, tingling in the extremities, metallic taste in the mouth These symptoms may indicate an allergic reaction to anesthesia or misplacement of the catheter.
Possible complications of epidural analgesia as excessive sedation, respiratory distress, urinary retention or catheter migration, respiratory depression and intravascular injection of anesthetic (due to catheter migration) could potentially life-threatening.

Therapeutic intervention

* Expect the need for pain relief. "One can most effectively deal with the pain prevents you. Early intervention is the total amount of analgesics required reduction.
* Responds quickly to complaints of pain. On Wednesday, the painful experience of the patient's perception of time can be forged. Quick response to complaints can lead to a reduction in patient anxiety. He expressed concern about the health of the patient comfort and the development of a reliable connection.
* Removal of other stressors and resources where possible discomfort. Patients may have an exaggeration of pain or a reduced ability to tolerate painful stimuli to the environment, interpersonal or intrapsychic factors further underline that.
* Provide comfort and relaxation breaks to sleep easier. Experience of pain may be exaggerated due to fatigue. The cyclic method can lead to pain, fatigue, which can cause excessive pain and fatigue. A quiet area, dark room and a separate phone, all measures aimed at facilitating peace.
* Identification of appropriate methods of pain relief.
1st Pharmacological methods include the following: Nonsteroidal anti-inflammatory drugs (NSAIDs) given orally or parenterally (to date, is only available parenteral NSAID ketorolac).
2nd Drug use that can be orally administered intramuscularly, subcutaneously, intravenously, systematic, patient-controlled analgesia (PCA) or epidural (either bolus injection or continuous infusion). The drug is indicated for severe pain, especially in the hospice or at home.
3rd Local anesthetics.
1st Non-pharmacological methods include the following: cognitive-behavioral strategies as follows:
Using images of a mental image or hypothetical cases involving the use of five senses to distract attention from painful stimuli.
Stories about the techniques for increasing concentration of people and nonpainful stimulus person experience pain relief. Some methods are breathing and changes in nerve stimulation.
a relaxation exercise techniques are used to monitor the state of the physical and spiritual awareness and peace. The purpose of these techniques to reduce stress, reduce pain.
of biofeedback, breathing exercises, music therapy
2nd Skin stimulation is as follows:
A massage of the affected area, if necessary massage reduces muscle tension and increase comfort.
Trans electrical nerve stimulation (TENS) units
heat or cold compresses warm, wet compresses has a strong influence. Heat a rush of blood to the affected area to promote healing. Cold compresses can reduce swelling and promote the common perception of sedation and therefore comfort.
* Give painkillers as ordered evaluation of the effectiveness and compliance with signs and symptoms of unintended consequences. Pain medication is absorbed and metabolized differently in patients, so their effectiveness must be assessed from patient to patient. Painkillers can cause side effects ranging from mild to life threatening.
* Ask your doctor or interventions are unsuccessful or if the event is a significant change in the patient's experience of pain. Patients who want painkillers at shorter intervals than prescribed may actually need higher doses or stronger analgesics.
* If possible, reassure the patient what pain is limited and that more than one approach to pain relief. If pain is considered eternal and insoluble to give the patient tries to cope with feelings of hopelessness and loss of control and experience.

* If the patient is in the SOP: Exclude the use of intravenous PCA system for counseling pharmacist before mixing with the drug flow. IV incompatibility is possible.

* If the patient epidural analgesia: Label all tubes (eg, epidural catheter, IV tubing with epidural catheter) clearly inadvertent administration of inappropriate medications or fluids to avoid the epidural space.

* In patients with PCA or epidural analgesia, or Narcan Like other narcotic reversal agent is available. In the case of respiratory depression, these drugs back on the narcotic effect.
* Post "There is no additional analgesia" sign above the bed. This prevents an overdose of anesthetic.

Education / Continuity of care

* Providing education is expected from the pain, appropriate measures for prevention and mitigation.
* Explain the reason for pain or discomfort, if known.
* Assignment of patients reporting pain. Mitigation measures can be taken.
* The task of patient assessment and reporting of outcomes measures used.
* Teach patient effective dose during treatment with the embarrassing actions and to avoid peak pain.

* For patients receiving PCA or epidural analgesia Receiver: Learn the patient before surgery. Anesthesia reactions that may not apply to education.
* Teach the patient the purpose, benefits, equipment operation / action is needed in line (PCA only), other alternatives for pain relief, and the need for alerting sisters machine and the prevention of unintended consequences over time.

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