Chapter 42 Comfort Mosby items and derived items
![Chapter 42 Comfort Mosby items and derived items © 2005 by Mosby, Inc. Chapter 42 Comfort Mosby items and derived items © 2005 by Mosby, Inc.](https://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-1.jpg)
Chapter 42 Comfort Mosby items and derived items © 2005 by Mosby, Inc.
![Nature of Pain • • Physical Emotional Cognitive Subjective Mosby items and derived items Nature of Pain • • Physical Emotional Cognitive Subjective Mosby items and derived items](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-2.jpg)
Nature of Pain • • Physical Emotional Cognitive Subjective Mosby items and derived items © 2005 by Mosby, Inc.
![Physiology of Pain • • Transduction Transmission Perception Modulation Mosby items and derived items Physiology of Pain • • Transduction Transmission Perception Modulation Mosby items and derived items](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-3.jpg)
Physiology of Pain • • Transduction Transmission Perception Modulation Mosby items and derived items © 2005 by Mosby, Inc.
![Neurotransmitters • Substance P • Serotonin • Prostaglandins Mosby items and derived items © Neurotransmitters • Substance P • Serotonin • Prostaglandins Mosby items and derived items ©](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-4.jpg)
Neurotransmitters • Substance P • Serotonin • Prostaglandins Mosby items and derived items © 2005 by Mosby, Inc.
![Neuromodulators • Endorphins and dynorphins • Bradykinin Mosby items and derived items © 2005 Neuromodulators • Endorphins and dynorphins • Bradykinin Mosby items and derived items © 2005](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-5.jpg)
Neuromodulators • Endorphins and dynorphins • Bradykinin Mosby items and derived items © 2005 by Mosby, Inc.
![Gate-Control Theory of Pain • Gating mechanisms along the CNS • Pain relief measures Gate-Control Theory of Pain • Gating mechanisms along the CNS • Pain relief measures](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-6.jpg)
Gate-Control Theory of Pain • Gating mechanisms along the CNS • Pain relief measures to close the gate • Pain threshold Mosby items and derived items © 2005 by Mosby, Inc.
![Client Responses • Physiological responses • Behavioral responses Mosby items and derived items © Client Responses • Physiological responses • Behavioral responses Mosby items and derived items ©](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-7.jpg)
Client Responses • Physiological responses • Behavioral responses Mosby items and derived items © 2005 by Mosby, Inc.
![Types of Pain • • • Acute pain Chronic pain Cancer pain Pain by Types of Pain • • • Acute pain Chronic pain Cancer pain Pain by](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-8.jpg)
Types of Pain • • • Acute pain Chronic pain Cancer pain Pain by inferred pathology Idiopathic pain Mosby items and derived items © 2005 by Mosby, Inc.
![Knowledge, Attitudes, and Beliefs • Subjective nature of pain • Nurse’s response to client’s Knowledge, Attitudes, and Beliefs • Subjective nature of pain • Nurse’s response to client’s](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-9.jpg)
Knowledge, Attitudes, and Beliefs • Subjective nature of pain • Nurse’s response to client’s report of pain • Prejudices and misconceptions Mosby items and derived items © 2005 by Mosby, Inc.
![Factors Influencing Pain • Physiological – Age – Fatigue – Genes – Neurological function Factors Influencing Pain • Physiological – Age – Fatigue – Genes – Neurological function](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-10.jpg)
Factors Influencing Pain • Physiological – Age – Fatigue – Genes – Neurological function Mosby items and derived items © 2005 by Mosby, Inc.
![Factors Influencing Pain (cont'd) • Social – Attention – Previous experience – Family and Factors Influencing Pain (cont'd) • Social – Attention – Previous experience – Family and](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-11.jpg)
Factors Influencing Pain (cont'd) • Social – Attention – Previous experience – Family and social support • Spiritual Mosby items and derived items © 2005 by Mosby, Inc.
![Factors Influencing Pain (cont'd) • Psychological – Anxiety – Coping style • Cultural – Factors Influencing Pain (cont'd) • Psychological – Anxiety – Coping style • Cultural –](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-12.jpg)
Factors Influencing Pain (cont'd) • Psychological – Anxiety – Coping style • Cultural – Meaning of pain – Ethnicity Mosby items and derived items © 2005 by Mosby, Inc.
![Assessment of Comfort Level • Client’s expression of pain • Characteristics of pain – Assessment of Comfort Level • Client’s expression of pain • Characteristics of pain –](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-13.jpg)
Assessment of Comfort Level • Client’s expression of pain • Characteristics of pain – Onset and duration – Location – Intensity – Quality – Pattern Mosby items and derived items © 2005 by Mosby, Inc.
![Assessment of Comfort Level (cont'd) • Characteristics of pain (cont'd) – Relief measures – Assessment of Comfort Level (cont'd) • Characteristics of pain (cont'd) – Relief measures –](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-14.jpg)
Assessment of Comfort Level (cont'd) • Characteristics of pain (cont'd) – Relief measures – Contributing symptoms – Behavioral effects on the client – Influences on ADLs • Client expectations Mosby items and derived items © 2005 by Mosby, Inc.
![Nursing Diagnoses • • Anxiety Ineffective coping Fatigue Acute pain Chronic pain Ineffective role Nursing Diagnoses • • Anxiety Ineffective coping Fatigue Acute pain Chronic pain Ineffective role](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-15.jpg)
Nursing Diagnoses • • Anxiety Ineffective coping Fatigue Acute pain Chronic pain Ineffective role performance Disturbed sleep pattern Mosby items and derived items © 2005 by Mosby, Inc.
![Planning • Goals and outcomes – Client is using pain relief measures safely • Planning • Goals and outcomes – Client is using pain relief measures safely •](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-16.jpg)
Planning • Goals and outcomes – Client is using pain relief measures safely • Setting priorities • Continuity of care Mosby items and derived items © 2005 by Mosby, Inc.
![Implementation: Health Promotion • Client education • Holistic care Mosby items and derived items Implementation: Health Promotion • Client education • Holistic care Mosby items and derived items](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-17.jpg)
Implementation: Health Promotion • Client education • Holistic care Mosby items and derived items © 2005 by Mosby, Inc.
![Nonpharmacological Pain Relief • • Relaxation and guided imagery Distraction Biofeedback Cutaneous stimulation—massage, application Nonpharmacological Pain Relief • • Relaxation and guided imagery Distraction Biofeedback Cutaneous stimulation—massage, application](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-18.jpg)
Nonpharmacological Pain Relief • • Relaxation and guided imagery Distraction Biofeedback Cutaneous stimulation—massage, application of hot/cold, TENS • Herbals • Reducing painful stimuli and perception Mosby items and derived items © 2005 by Mosby, Inc.
![Controlling Painful Stimuli • Managing the client’s environment— bed, linens, temperature • Positioning • Controlling Painful Stimuli • Managing the client’s environment— bed, linens, temperature • Positioning •](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-19.jpg)
Controlling Painful Stimuli • Managing the client’s environment— bed, linens, temperature • Positioning • Changing wet clothes and dressings • Monitoring equipment, bandages, hot and cold applications • Preventing urinary retention and constipation Mosby items and derived items © 2005 by Mosby, Inc.
![Implementation of Comfort Measures • Pharmacological pain relief – Analgesics: NSAIDs and nonopioids, adjuvants Implementation of Comfort Measures • Pharmacological pain relief – Analgesics: NSAIDs and nonopioids, adjuvants](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-20.jpg)
Implementation of Comfort Measures • Pharmacological pain relief – Analgesics: NSAIDs and nonopioids, adjuvants – Patient-controlled analgesia (PCA) – Local analgesic infusion pump – Topical analgesics and anesthetics – Local and regional anesthetics Mosby items and derived items © 2005 by Mosby, Inc.
![Implementation of Comfort Measures (cont'd) • Surgical interventions • Procedural pain management • Chronic Implementation of Comfort Measures (cont'd) • Surgical interventions • Procedural pain management • Chronic](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-21.jpg)
Implementation of Comfort Measures (cont'd) • Surgical interventions • Procedural pain management • Chronic and cancer pain management Mosby items and derived items © 2005 by Mosby, Inc.
![Implementation of Comfort Measures (cont'd) • Barriers to effective pain management • Nursing implications Implementation of Comfort Measures (cont'd) • Barriers to effective pain management • Nursing implications](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-22.jpg)
Implementation of Comfort Measures (cont'd) • Barriers to effective pain management • Nursing implications for safe and effective implementation of comfort measures Mosby items and derived items © 2005 by Mosby, Inc.
![Implementation: Restorative Care • Pain clinics • Palliative care • Hospices Mosby items and Implementation: Restorative Care • Pain clinics • Palliative care • Hospices Mosby items and](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-23.jpg)
Implementation: Restorative Care • Pain clinics • Palliative care • Hospices Mosby items and derived items © 2005 by Mosby, Inc.
![Evaluation • Client care • Client expectations Mosby items and derived items © 2005 Evaluation • Client care • Client expectations Mosby items and derived items © 2005](http://slidetodoc.com/presentation_image_h2/852d8c5453a1472ffc7260487ea992b2/image-24.jpg)
Evaluation • Client care • Client expectations Mosby items and derived items © 2005 by Mosby, Inc.
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