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Pain
Teresa V. Hurley, MSN, RN
Duration of pain
 Acute
 Rapid in onset, varies in intensity and
duration
 Protective in nature
 Chronic
 May be limited, intermittent, or
persistent
 Lasts for 6 months or longer
 Periods of remission or exacerbation are
common
Gate Control Theory of Pain
 Relationship between pain and
emotions
 Small and large diameter nerve fibers
conduct and inhibit pain stimuli
 Gating mechanism determines
impulses that reach the brain
Factors Affecting Pain Experience
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Culture
Ethnic variables
Family, gender, and age variables
Religious beliefs
Environment and support people
Anxiety and other stressors
Past pain experience
General Assessments of Pain
 Client’s verbalization and description
of pain
 Duration of pain
 Location of pain
 Quantity and intensity of pain
 Quality of pain
 Chronology of pain
General Assessments of Pain
(continued)
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Aggravating and alleviating factors
Physiologic indicators of pain
Behavioral responses
Effect of pain on activities and
lifestyle
Wilda Scale
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Words that describe the pain
Intensity of pain
Location of pain
Duration of pain
Aggravating or alleviating factors
Nursing Interventions for Pain
 Establishing trusting nurse-patient
relationship
 Initiating nonpharmacologic pain
relief measures
 Considering ethical and legal
responsibility to relieve pain
 Teaching patient about pain
Nonpharmacologic Pain Relief
Measures
 Distraction
 Music
 Humor
 Imagery
Nonpharmacologic Pain Relief
Measures
 Relaxation
 Acupuncture
Nonpharmacologic Pain Relief
Measures
 Hypnosis
 Biofeedback
 Therapeutic touch
Pharmacologic Pain Relief Measures
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Analgesic administration
Nonopiod analgesics
Opioids or narcotic analgesics
Adjuvant drugs (enhance the action
of main drug)
Numeric Sedation Scale
 1 — awake and alert, no action necessary
 2 — occasionally drowsy, but easy to
arouse, no action necessary
 3 — frequently drowsy, drifts off to sleep
during conversation, reduce dosage
 4 — somnolent with minimal or no response
to stimuli, discontinue opiod, consider use
of naloxone
Pain Management Regimens
for Cancer or Chronic Pain
 Give medications orally if possible.
 Administer medications around the
clock time rather than prn.
 Adjust the dose to achieve maximum
benefit with minimum side effects.
 Allow client’s as much control as
possible over the regimen.