K A T E B L A C KK A T E B R A Z Z A L E

L I S A M O L O N Y

PAIN

PAIN

• Aetiology • Disorder/Disease • Clinical Manifestations • Pathophysiology • Diagnosis • Pharmacological Management • Non-Pharmacological Management • Complications • Implications for Nursing Practice

AETIOLOGY

AETIOLOGY

DISORDER/DISEASE

DISORDER/DISEASE

CLINICAL MANIFESTATIONS

CLINICAL MANIFESTATIONS

PATHOPHYSIOLOGY

PATHOPHYSIOLOGY

DIAGNOSIS

• Diagnosis of Pain is complicated.

• To diagnose pain, Nurses rely on• Objective Data.• Visual signs.

• Subjective Data.• Patients

descriptions.

• Characteristics of Pain.

DIAGNOSIS

• Characteristics of Pain• OPQRST Mnemonic• Onset• Provocation • Quality• Region/Radiation• Severity• Time

DIAGNOSIS

1. Onset• What was the patient doing at the time?• What precipitated the pain?

2. Provocation • Aggravating Factors:• What causes the Pain to increase?

• Alleviating Factors:• What makes it better or worse?

DIAGNOSIS

3. Quality • Get the patient to describe their pain to you in specific terms.• What does it feel like?

4. Region/Radiation• Where is the pain?• Where does the pain radiate? • Is it in one place? • Does it go anywhere else? • Did it start elsewhere and now localised to a different spot?

DIAGNOSIS

5. Severity • Pain Rating• On a scale of 1 to 10, 10 being the worst pain you have experienced,

what number would you assign to your discomfort?

• Does their pain change with medication?

• Wong-Baker Faces Pain Rating Scale.• Used for• Children• People whose first language is not English.

DIAGNOSIS

DIAGNOSIS

6. Time• When did the pain start?• How long has the patient has this pain?

• Are there any Associated Phenomena?• Factors consistent with pain e.g. Anxiety• Physiological responses• Sympathetic stimulation• Parasympathetic stimulation• Vital signs, skin colour, perspiration, pupil size, nausea, muscle

tension, anxiety

• Behavioural Responses• Posture, gross motor activities

DIAGNOSTIC TESTS

Tests to verify pain.• CT/CAT scan • Computed Tomography or Computed Axial

Tomography• X-rays to produce an image of a cross-

section of the body.

• MRI Scan• Large magnet, radio waves and a computer

produces detailed images of the body.

• Discography/Myelograms• A contrast dye is injected into the spinal disk

to enhance the X-Ray.

DIAGNOSTIC - TESTS

• EMG (Electromyography)• Evaluate the activity of the muscles.

• Bone Scans• Diagnose and monitor infection and

fracture of the bone

• Ultrasound Imaging• High frequency sound waves to develop an

image of the affected area.

DIAGNOSTIC TESTS

• Psychological Assessment• Psychosocial involvement.• Questionnaires.

PHARMACOLOGICAL MANAGEMENT

PHARMACOLOGICAL MANAGEMENT

NON-PHARMACOLOGICAL MANAGEMENT

NON-PHARMACOLOGICAL MANAGEMENT

TENS MACHINE

TENS MACHINE

TENS MACHINE

COMPLICATIONS

COMPLICATIONS

IMPLICATIONS FOR NURSING PRACTICE

IMPLICATIONS FOR NURSING PRACTICE

REFERENCES

REFERENCES