By
Sandra L. Siedlecki, RN, MSN, CEN
Pain is an uncomfortable feeling that tells you something maybe wrong in your body. Pain is your body’s way of sending a warning to your brain. Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure, and pain. When there’s an injury to the body these tiny cells send messages along nerves into the spinal cord and then up to the brain. Pain medicine blocks these messages or reduces their effect on the brain.
Pain can be managed effectively through relatively simple means in up to 90percent of the people. Failure to assess pain is a critical factor lading to undertreatment. People often think that pain is something they “just have to put up with.” But with current treatment, that’s no longer true. Many people also worry about getting “hooked” on pain medicines. Studies show that this is very rare – unless one already has a problem with drug abuse. Effective pain management is best achieved by a team approach involving patients, their families and health care providers. Both drug and non-drug treatments can be successful in helping to prevent and control pain.
In this excellent treatise on effective pain management, Ms. Siedlecki, with 25 years of experience in coronary care, surgical intensive care and emergency rooms, exposes the myths and facts about pain control, explains the neurophysiology of pain and discusses the etiology, assessment and treatment of various types of pain. She goes on to describe the pharmacological approach involving opioid and non-opioid medications for the treatment of both acute and chronic pain. And last but not least, she explores alternative, non-pharmacological pain treatment techniques. This book, replete with self-study exercises, takes a practical, clinical approach to pain management and it should be an essential guide for every practicing nurse.
| 1. | Identify common myths based on personal beliefs and experience. |
| 2. | Recognize misconceptions related to expression of pain and how these influence your nursing interventions. |
| 3. | Identify areas of pain management that need to be changed. |
| 4. | Identify myths related to addiction and pain relief. |
| 5. | Recognize your own strengths and weaknesses in the area of pain management. |
| 6. | Identify the various origins of pain sensations. |
| 7. | Describe the route of transmission of painful stimuli. |
| 8. | Identify various neurotransmitters and their role in the transmission of pain. |
| 9. | Explain how the reflex arc protects the body from excessive injury. |
| 10. | Identify the function of the limbic system, the thalamus, the cerebral cortex and the reticular formation. |
| 11. | Explain the gate-control theory of pain transmission. |
| 12. | Identify the components of the general adaptation syndrome (GAS), and how it relates to the body's response to pain. |
| 13. | Identify the characteristics related to acute pain. |
| 14. | Compare and contrast the etiology, assessment and treatment modalities of both acute and chronic pain. |
| 15. | Describe the myths associated with the management of acute and chronic pain and how they affect your nursing assessment and interventions. |
| 16. | Discuss the impact of personal bias and popular beliefs related to persons with chronic benign low back pain. |
| 17. | Identify the etiology of sickle cell pain and nursing interventions that are most effective in managing this type of chronic pain. |
| 18. | Describe the types of arthritis and the current treatment choices. |
| 19. | Identify the three major types of headache pain and the etiology associated with each. |
| 20. | Explain the etiology of cancer pain and how misconceptions regarding tolerance and reparatory depression affect pain management. |
| 21. | Describe initial assessment criteria for pain management. |
| 22. | Describe ongoing assessment of patients with pain. |
| 23. | Compare and contrast the assessment of patients with acute vs. chronic pain. |
| 24. | Select rating scales based upon individual differences and specific patient populations. |
| 25. | Explain the rationale for using specific assessment tools and rating scales for the assessment of pain. |
| 26. | Identify both the psychological and physical effects of pain. |
| 27. | Demonstrate the ability to select and develop instruments for the assessment of pain for specific patient populations. |
| 28. | Identify factors that affect individual behaviors and responses to pain. |
| 29. | Explain specific considerations for the assessment of respiratory depression and sedation. |
| 30. | Describe the correct documentation of pain management assessment. |
| 31. | Identify opioid and non-opioid medications used for the treatment of both acute and chronic pain. |
| 32. | Identify indications, contraindications, dosages, routes of administration, and side effects of common non-steroidal anti-inflammatory drugs (NSAIDs). |
| 33. | Discuss the indications for concomitant use of opioids and non-opioids, for the control of moderate to severe pain. |
| 34. | Explain the use of the analgesic equivalent charts. |
| 35. | Calculate correct dosages, changing routes of administration as well as drugs. |
| 36. | Identify the action and duration of both NSAIDs and opioid medications. |
| 37. | Identify indications, contraindications, dosages, routes of administration and side effects of common opioid medications used for pain management. |
| 38. | Explain the rationale and proper procedure for the administration of Narcan. |
| 39. | Identify medications and nursing interventions for the control of opioid side effects. |
| 40. | Explain the role of adjuvant medications for the control of pain. |
| 41. | Identify the advantages and disadvantages of alternative treatment modalities. |
| 42. | Explain the rationale for non-pharmacological treatment techniques. |
| 43. | Describe how to teach relaxation exercises. |
| 44. | Identify several methods of distraction. |
| 45. | Explain the principles of biofeedback. |
| 46. | Describe the use of transcutaneous stimulation. |
| 47. | Discuss the potential for the use of acupuncture and acupressure for the relief of pain. |
| 48. | Explain the nursing role in the use of non-pharmacologic pain management interventions. |
| 1. | Introduction |
| 2. | Myths and Facts About Pain and Pain Management |
| 3. | Neurophysiology |
| 4. | Types of Pain |
| 5. | Assessment of Pain and Pain Management |
| 6. | Pharmacology Part - I Non-Opiods |
| Pharmacology Part - II Opiods | |
| 8. | Alternative Management of Pain |
| 9. | Final Exam |
"I found material that was not covered in school. I learned a lot!" - D.M., RN, CA
"The course is very satisfactory especially since I work in a nursing home." - R.J.A., LVN, CA
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