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Pain Management In Nursing4 With K I W I N

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Pain Management

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Acute and chronic pain Contemporary and alternative treatments
Pain—the definition…. ,[object Object],[object Object],[object Object],[object Object]
Is there a problem? ,[object Object],[object Object],[object Object],[object Object]
Pain assessment: ,[object Object],[object Object]
Common Misconceptions among Elderly and Nurses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Descriptions of pain: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pain threshold : amount of pain stimulation a person requires before feeling pain. Pain tolerance : the highest intensity of pain that the person is willing to tolerate.
The categories of pain: ,[object Object],[object Object],[object Object],[object Object]
Effects of acute pain: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Effects Chronic Pain: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology of pain ,[object Object],[object Object],[object Object],[object Object]
Pathophysiology of pain: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nociception (or pain perception) can be divided into four phases: ,[object Object],[object Object],[object Object],[object Object]
[object Object]
Gate-control theory
[object Object]
Descending control system: ,[object Object],[object Object],[object Object],[object Object]
Spinal Cord Modulation: How can the gate be closed? ,[object Object],[object Object],[object Object],[object Object]
Gate-control theory: may decrease amount pain medication needed
What alternative therapies can close the gate? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Let’s try an experiment…. ,[object Object],[object Object]
Why have a pain scale? ,[object Object],[object Object],[object Object],[object Object],[object Object]
So how do we deal with the problem of pain? ,[object Object],[object Object]
Other pain scales are just numeric
Alternative therapies which may close the gate: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pharmacological management: ,[object Object],[object Object],[object Object],[object Object],[object Object],Taken from Alexander, L. L. (2006). Pain management, palliative care and treatment of the terminally ill
WHO Analgesic ladder
Analgesic ladder in action: ,[object Object],[object Object],[object Object],Alexander, L. L. (2006). Pain management, palliative care and treatment of the terminally ill
WHO 3-step Analgesic ladder COX-2, Aspirin, Acetaminophen, Diclofenac, Ibuprofen, Tenoxicam, Panadeine, Nurofen. Pain rating 1-2-3 Non-opioid (mild pain) +/- adjuvant Opioid (mild to moderate pain) +/- non-opioid adjuvant +/- adjuvant Codeine, Propoxyphene, Tramadol, Sevredol, DHC Continus, Dihydrocodeine tartate. Pain rating: 4-5-6 Opioid (moderate to severe pain) +/-non-opioid, +/-adjuvant Step 1 Step 2 Step 3 Oxycodone, Morphine, Fentanyl, Pethidine Ketamine Pain rating 7-10
Breakthrough pain ,[object Object],[object Object],[object Object],[object Object],Alexander, L. L. (2006). Pain management, palliative care and treatment of the terminally ill
Pain management through medication and/or neurosurgery ,[object Object],[object Object],[object Object],[object Object],Kastinias, P., S.E. Kianda, Robinson, S. (2006).
Manage side-effects opiates: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Alexander, L. L. (2006). Pain management, palliative care and treatment of the terminally ill
Narcotic analgesics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
KIWIN™ Classification PROBLEM IDENTIFICATION Domain: Physiological domain Problem: 24. Pain Priority: High Modifier: Individual Modifier: Actual Signs and Symptoms: 01. expresses discomfort/pain 04. restless behaviour 05. facial grimaces
KIWIN™ Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
KIWIN™ Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Pain Management In Nursing4 With K I W I N

  • 1. Acute and chronic pain Contemporary and alternative treatments
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  • 7. Pain threshold : amount of pain stimulation a person requires before feeling pain. Pain tolerance : the highest intensity of pain that the person is willing to tolerate.
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  • 19. Gate-control theory: may decrease amount pain medication needed
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  • 24. Other pain scales are just numeric
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  • 29. WHO 3-step Analgesic ladder COX-2, Aspirin, Acetaminophen, Diclofenac, Ibuprofen, Tenoxicam, Panadeine, Nurofen. Pain rating 1-2-3 Non-opioid (mild pain) +/- adjuvant Opioid (mild to moderate pain) +/- non-opioid adjuvant +/- adjuvant Codeine, Propoxyphene, Tramadol, Sevredol, DHC Continus, Dihydrocodeine tartate. Pain rating: 4-5-6 Opioid (moderate to severe pain) +/-non-opioid, +/-adjuvant Step 1 Step 2 Step 3 Oxycodone, Morphine, Fentanyl, Pethidine Ketamine Pain rating 7-10
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  • 34. KIWIN™ Classification PROBLEM IDENTIFICATION Domain: Physiological domain Problem: 24. Pain Priority: High Modifier: Individual Modifier: Actual Signs and Symptoms: 01. expresses discomfort/pain 04. restless behaviour 05. facial grimaces
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