what are the 5 different types of pain?

Describe them

Referred– pain that is perceived in an _area_distant form the site of the stimuli (i.e. pain in a shoulder following an abdominal laparoscopic procedure, see next slide)

Somatic – originates in the _skin, muscles, joint, bone, or connective tissue; usually well localized and aching or throbbing in quality

Intractable – a pain state (generally severe) for which there is no cure possible after accepted medical evaluation and treatments have been implemented; the focus of treatment turns from cure to pain reduction i.e. cancer

Phantom limb– pain syndrome that occurs following surgical or traumatic amputation of a limb; pain may be a result of stimulation of severed nerves at the site of amputation and this pain requires treatment just like any other type of pain

Peripheral neuropathy – is caused by _nerve damage; often causes numbness and pain in the hands and feet; clients describe the pain as tingling or burning (trauma, pressure, infections or diabetes)

What is a TENS unit and why is it used?

A method of applying low-voltage electrical stimulation directly over identified pain areas, at an acupressure point, along peripheral nerve areas that innervate the pain area, or along the spinal column.  Used for acute and postoperative pain.

Pain tolerance

Is the maximum amount of painful stimuli that a person is willing to withstand without seeking avoidance of the pain or relief; this varies considerably from person to person, even within the same person at different times and in different circumstances

Pain perception

Is the point at which a person is _aware of pain; this involves the sensory process that occurs when a stimulus for pain is present

Pain threshold

Is the lowest intensity of a stimulus that causes the subject to recognize pain; this may vary slightly from person to person, and may be related to age, gender, or race, but it changes little in the same individual over time

Physical dependence

Expected response to ongoing exposure to pharmacologic agents manifested by withdrawal syndrome when blood levels drop abruptly; to avoid withdrawal, drug should be tapered

Pseudo-addiction –HEALTHCARE PROVIDER

Occurs when a patient’s signs and symptoms of existing pain are misinterpreted by staff causing a failure in adequate pain relief provision; signs and symptoms of a person diagnosed with pseudo-addiction are usually associated with the behaviors displayed by drug addicts seeking to receive analgesia.

Typical behaviors include the constant request for pain relief, knowing exactly when pain relief is due or can be taken, even causing clock-watching and knowing in-depth information about different types of pain relief  - Misinterpreted as addict

Drug tolerance

Need for increased dose to maintain same degree of pain control

What are the cultural aspects of pain:

African American

Chines, Japanese, Filipino, Native Americans, Mexican Americans, Puerto Rican's and Arab Americans

African American - denial and avoidance

Chinese silence

Japanese - stoic May refuse pain meds

Filipino "it's god's will" may refuse pain meds

Native Americans - Less expressive verb/nonverb high tolerance

Mexican Americans - Pain is a part of life a sign of strenght

Puerto Ricans - Loud and outspoken

Arab Americans - Private may lead to conflicting perceptions btwn family and HC workers

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

“Pain is whatever the person experiencing the pain says it is, existing whenever the person says it does”.

What is the nursing care required to care for a client who has bulimia?

Antidepressants are helpful for some but not all patients with bulimia. Education and emotional support for the patient and family are vital. Support groups such as the National Association of Anorexia Nervosa and Associated Disorders (ANAD)