NURS 1730 Lecture Notes - Lecture 11: Biofeedback, Health Literacy, Acupressure
11-63-173
Week Eleven: March 26 - 30, 2018
Introduction to Nursing II
Health Promotion and Protection: Movement Disorders
Learning Goals:
-Understand the physiology, characteristics and factors that influence pain
-Explore the nursing process as it relates to pain and management
-Describe evidence-based interventions to manage pain
-Understand the nurse’s role in assessing and managing end-of-life care needs
The Nature of Pain
- Involves sensory, emotional and cognitive components
- Shaped by past experience, culture, and situational
- Physical and/or psychological stimulus
- Pain is what the person says it is!
-The fear of pain is said to rank second only to the fear of death.
Gate-Control Theory of Pain
- Gating mechanisms along the central nervous system.
- Pain-relief interventions need
to close the gate.
- Proposed by Ronald Melzack and Patrick Wall in 1965,
- Spinal cord contains a neurological "gate" that either blocks pain signals or allows them
to continue to the brain. The "gate" in the spinal cord operates by differentiating
between the types of fibers carrying pain signals. Pain signals traveling via small
nerve fibers are allowed to pass through, while signals sent by large nerve fibers
are blocked. Gate control theory is often used to explain phantom or chronic pain.
Physiology of Pain: Nociception
1. Transduction: C and A-delta fibers recognize the pain.
2. Transmission: Pain is transmitted from nociceptors fibers. Dorsal horn, to brainstem, to
thalamus and cortex.
3. Perception: You realize you’re in pain.
4. Modulation: DMPPS increase or decrease modulation of pain; how it’s transmitted.
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11-63-173
Week Eleven: March 26 - 30, 2018
Client Responses
- Psychological responses
- Behavioural responses
Types of Pain
Acute Pain:
Identifiable cause, predictable ending, short
duration
Chronic Pain:
Not always predictable, may not have
identifiable cause, not time-limited, persistent
at varying levels of intensity.
Cancer/Malignant:
Can be acute or chronic
Inferred Physiological:
Nociceptive (visceral, somatic) or neuropathic
Anticipatory:
If you’ve had pain before, you know what it
will be like (ie. labour)
Others:
Acute on chronic psychological, spiritual total
Communication of Pain/Discomfort
- How pain is expressed is highly influenced by the unique history of the individual and the
meaning ascribed to the pain.
- Spiritual and psychological pain may be expressed as “not feeling well.”
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11-63-173
Week Eleven: March 26 - 30, 2018
- Response to pain reflects an individual’s cultural expectations and understanding of
acceptable behaviour.
Knowledge, Attitudes, and Beliefs
- Subjective nature of pain
- Nurse’s response to patient’s report of pain
- Prejudices and misconceptions (ie. addictions)
Factors Influencing Pain
- Physiological factors
- Social factors
- Spiritual factors
- Psychological factors
- Cultural factors
Poorly Managed Pain → This is what happens when pain is not managed
Denial of the Soul
- Poorly managed pain is denial of the nursing practice.
Nursing Process and Pain
- Pain management should be systematic.
- Think critically!
- Pain management should include the patient’s quality of life.
- Clinical guidelines are available to manage pain.
Assessment
- Characteristics
- P, Q, R, S, T, U, V
- Onset and duration
- Location
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Document Summary
Understand the physiology, characteristics and factors that influence pain. Explore the nursing process as it relates to pain and management. Understand the nurse"s role in assessing and managing end-of-life care needs. Shaped by past experience, culture, and situational. Pain is what the person says it is! The fear of pain is said to rank second only to the fear of death. Gating mechanisms along the central nervous system. to close the gate. Proposed by ronald melzack and patrick wall in 1965, Spinal cord contains a neurological gate that either blocks pain signals or allows them to continue to the brain. The gate in the spinal cord operates by differentiating between the types of fibers carrying pain signals. Pain signals traveling via small nerve fibers are allowed to pass through, while signals sent by large nerve fibers are blocked. Gate control theory is often used to explain phantom or chronic pain.
