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Health & Physical Assessment in Nursing First Edition

Health & Physical Assessment in Nursing First Edition. Donita D’Amico and Colleen Barbarito. Chapter 8 Pain Assessment. LEARNING OBJECTIVE ONE. LEARNING OBJECTIVE ONE . Pain and Assessment. LEARNING OBJECTIVE ONE. Pain - Highly Unpleasant and Personal Sensation. LEARNING OBJECTIVE ONE.

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Health & Physical Assessment in Nursing First Edition

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  1. Health & Physical Assessment in NursingFirst Edition Donita D’AmicoandColleen Barbarito Chapter 8 Pain Assessment

  2. LEARNING OBJECTIVE ONE

  3. LEARNING OBJECTIVE ONE • Pain and Assessment

  4. LEARNING OBJECTIVE ONE • Pain - Highly Unpleasant and Personal Sensation

  5. LEARNING OBJECTIVE ONE • Pain - Must be Assessed Most Accurately for Treatment to Be Successful

  6. LEARNING OBJECTIVE ONE • Pain - Definitions • Comes from the Greek word meaning “penalty” • McCaffery-Pain is “whatever the person says it is, existing whenever he or she says it does” • Can be the primary problem or associated with a specific diagnosis, treatment, or procedure • No two people experience pain in the same way • Pain is subjective; however, it can produce objective changes in the individual

  7. LEARNING OBJECTIVE TWO

  8. LEARNING OBJECTIVE TWO • Pain Physiology and Theories • Specificity • Pattern • Gate control

  9. LEARNING OBJECTIVE TWO • Specificity Theory

  10. LEARNING OBJECTIVE TWO • Pattern Theory

  11. LEARNING OBJECTIVE TWO • Gate Control Theory

  12. Figure 8.1 Gate control theory. A. open gate, B. closed gate.

  13. LEARNING OBJECTIVE TWO • Nociceptors • Mechanical • Thermal • Chemical

  14. LEARNING OBJECTIVE TWO • Nociception

  15. Table 8.1 Sites of referred pain.

  16. LEARNING OBJECTIVE TWO • Nociception • Transduction • Transmission

  17. Figure 8.2 Substance P assists the transmission of impulses across the synapse from the primary afferent neuron to a second-order neuron in the spinothalamic tract.

  18. Figure 8.3 Physiology of pain perception.

  19. LEARNING OBJECTIVE TWO • Nociception • Perception • Modulation

  20. LEARNING OBJECTIVE TWO • Transduction - Tissue Injury Triggers the Release of Biochemical Mediators That Sensitize Nociceptors

  21. LEARNING OBJECTIVE TWO • Transmission - Pain Impulse Travels from the Peripheral Nerve Fibers to the Spinal Cord, Then Ascends to the Brain Stem and Thalamus, and Then to the Somatic Sensory Cortex

  22. LEARNING OBJECTIVE TWO • Perception - Client Becomes Conscious of the Pain

  23. LEARNING OBJECTIVE TWO • Modulation - Neurons in the Brain Stem Send Signals Back Down to the Dorsal Horn of the Spinal Cord

  24. LEARNING OBJECTIVE TWO • Responses to Pain • Physiological • Psychosocial

  25. Figure 8.4 Proprioreceptive reflex to a pain stimulus.

  26. LEARNING OBJECTIVE THREE

  27. LEARNING OBJECTIVE THREE • Pain • Duration • Location • Etiology

  28. LEARNING OBJECTIVE THREE • Acute Pain • Mild to severe

  29. LEARNING OBJECTIVE THREE • Chronic Pain • Prolonged • Recurring • Persisting

  30. Table 8.2 Comparison of Acute and Chronic Pain

  31. LEARNING OBJECTIVE THREE • Cutaneous Pain • Skin • Subcutaneous tissue

  32. LEARNING OBJECTIVE THREE • Somatic Pain • Ligaments • Tendons • Bones • Blood vessels

  33. LEARNING OBJECTIVE THREE • Visceral Pain • Structures in the abdomen, cranium, or thorax

  34. LEARNING OBJECTIVE THREE • Radiating Pain

  35. LEARNING OBJECTIVE THREE • Referred Pain

  36. Figure 8.5 Sites of referred pain.

  37. LEARNING OBJECTIVE THREE • Intractable Pain

  38. LEARNING OBJECTIVE THREE • Neuropathic Pain

  39. LEARNING OBJECTIVE THREE • Phantom Pain

  40. LEARNING OBJECTIVE FOUR

  41. LEARNING OBJECTIVE FOUR • Factors That Influence Pain • Developmental stage • Psychosocial development • Environment

  42. LEARNING OBJECTIVE FOUR • Age and Developmental Stage • Pediatrics • Geriatrics

  43. Table 8.3 Age Variations in the Pain Experience

  44. Table 8.3 (continued) Age Variations in the Pain Experience

  45. LEARNING OBJECTIVE FOUR • Psychosocial Considerations • Family • Culture • Gender

  46. LEARNING OBJECTIVE FOUR • Environmental Factors • External considerations • Clothing • Items in the environment • Support systems • Role expectations • Internal considerations • Individual perceptions • Experiences related to pain • Anxiety

  47. LEARNING OBJECTIVE FIVE

  48. LEARNING OBJECTIVE FIVE • Pain Assessment Is Considered the Fifth Vital Sign

  49. LEARNING OBJECTIVE FIVE • Pain Assessment • Pain history • Direct observation of behavioral and physiological responses of the client

  50. LEARNING OBJECTIVE FIVE • Pain History Questions • Questions regarding location • Questions regarding intensity • Questions regarding quality • Questions regarding pain pattern • Questions regarding pain relief • Questions regarding the impact on activities of daily living • Questions related to coping strategies • Questions related to emotional responses

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