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QuestionAnatomy and Physiology

PAIN M H P S 1 1 4 0 WHAT IS PAIN? AN UNPLEASANT SENSORY OR EMOTIONAL EXPERIENCE. ACHE, HURT, SORE, DISCOMFORT, ETC JUST BECAUSE CAN’T BE “DIAGNOSED” DOESN’T MEAN IT’S NOT REAL ONLY THE PERSON CAN STATE WHAT THE PAIN IS FOR THEM . (REMEMBER THERE ARE MANY WAYS PEOPLE CAN FEEL PAIN SUCH AS EMOTIONAL, PHYSICAL ETC.) WHY DO WE NEED TO FEEL PAIN? ➢ body’s early warning system ➢ may cause us to stop activities that can cause further injury ➢ can be a sign of return of function TYPES OF PAIN • Sudden, or develops in short time span • Usually lasts less than 6 months • Caused by injury, disease, trauma, surgery • Decreases with healing Acute • Pain that lasts greater than 6 months • Constant or intermittent Chronic (Persistent) TYPES OF PAIN • pain that is felt beyond the site of tissue damage that extends to nearby areas Radiating • Disruption of nerve endings in stump • Pain is felt in limb that is no longer there Phantom Limb Factors that Affect the Experience and Expression of Pain • Past experiences • Anxiety • Rest & sleep • Attention given to the sensation of pain • Support • Meaning • Culture • Age • Gender • Many more.. THE EFFECT OF AGE ON PAIN ➢ neonate may be less able to localize pain ➢ infant less able to express so others will understand ➢ individuals with expressive disorders less able to express ➢ individuals with dementia may be less able to localize or understand meaning ➢ may be some decreased sensitivity with advanced age, i.e. receptors in skin “AGE RELATED” FACTORS… ➢ Major factor is that of the caregiver who fails to recognize or respond to the individual (infant or adult) who has an inability to verbalize or describe his or her pain. ➢ Look for: ➢ non - verbal expressions ➢ vocalizations ➢ behavior changes SIGNS & SYMPTOMS OF PAIN SEE BOX 23.1 ON P. 517 subjective reports changes in speech, e.g. pattern, volume non - verbal, e.g. grimacing body language • Guarding or protecting the body part that is painful • Rubbing, pressing change in mood change in behaviour SIGNS & SYMPTOMS OF PAIN change in vital signs • tachycardia • tachypnea • increased BP pale skin nausea and/or vomiting diaphoresis PAIN ASSESSMENT : PQRSTU ADAPTED FROM SORRENTINO’S P.516 - 517 P : Provoking causes • how did it start? Q : Quality of pain • what symptoms are they having? • mild, moderate, or severe pain? R : Region of pain and does it radiate? • where is the pain? Can they point to it? S : Severity of the pain • ask client to describe the pain (see box 23.2 p. 518) T : Timing of the pain • when did it start? U : Client’s understanding of the pain • what do you think is causing the pain? • is the pain new? Worse than usual? ASSESSMENT/REPORTABLE DATA ➢ Location : where is the pain, ask the client to point to the area ➢ Onset and duration : when did the pain start and how long did it last ➢ Intensity : how does the client describe it mild, moderate, severe etc. ➢ Description: ask the client to describe , use clients own words — do not interpret ➢ Factors causing the pain: such as movement, ask what the client was doing just before ➢ Vital signs: can increase sometimes with pain ➢ Other signs or symptoms: such as nausea, vomiting, dizziness etc. ASSESSING INTENSITY ➢ Ask! ➢ Pain rating scales ➢ 1 - 10 ➢ 1 - 5 may be simpler for children or adults with cognitive disorders ➢ Face Pain Scale ➢ Verbal descriptions ➢ Give simple choices if client can’t come up with own IMPACT OF PERSISTENT PAIN IN OLDER ADULTS Activity – become less mobile Sleep – have more episodes of disrupted sleep Mood – increases of depression, anxiety and social isolation MEASURES TO PROMOTE COMFORT & RELIEVE PAIN Wait 30 minutes after pain medications to provide care Good positioning Help with elimination needs Provide warm blankets Provide extra support for painful areas – do not rush them MEASURES TO PROMOTE COMFORT & RELIEVE PAIN Distractions Encourage support from family Gentle, slow movements Promote rest and sleep strategies CARING FOR A PERSON IN PAIN ➢ provide a calm environment ➢ darken the room ➢ respond to the person’s needs ➢ adjust the room temperature as necessary ➢ use gentle touch ➢ wait until the pain has subsided before carrying out procedures or routine care HOW WILL YOU KNOW YOUR PAIN - REDUCING STRATEGIES HAVE BEEN SUCCESSFUL? Decreased signs and symptoms Client looks relaxed, comfortable Client states relief Assess pain before and after pain relief measures, and report effectiveness. REMEMBER… • Medications are not the only way to relieve pain. • Pain relief starts with pain assessment. • You, as a HC A, can do so much for your client to prevent and relieve pain. REFERENCES Wilk, M.J. et al. (2022) Sorrentino’s Canadian textbook for the support worker. 5 th edn . Toronto, Ont.: Elsevier.