Chapter 4 Assessment and Care of Patients with Pain Concepts • The priority concept in this chapter is comfort • The interrelated concepts in this chapter are cognition sensory Perception Pain The Scope of the Problem • Pain is a major economic problem and a leading cause of disability that changes the lives of many people, especially older adults. • Chronic non-cancer pain such as osteoarthritis, rheumatoid arthritis, and diabetic neuropathy is the most common cause of long-term disability, affecting millions of Americans and others throughout the world. • Universal, complex personal experience • Is an impairment in comfort; major economic concern; leading cause of disability • Failure to manage pain is a worldwide health problem • Inter-professional pain initiatives help patients receive best treatment Definitions of Pain • Unpleasant sensory and emotional experience associated with actual or potential tissue damage • Whatever person experiencing it says it is; exists whenever person says it does • Self-report always most reliable indication of pain Categorization of Pain by Duration • Acute pain - Short-lived - Results from sudden, accidental trauma; surgery; ischemia; acute inflammation • Chronic (persistent) pain - Can last a person‘s lifetime - Chronic cancer pain - Chronic non-cancer pain • Pain is treated inadequately in almost all health care settings. • Populations at the highest risk in medical-surgical nursing are older adults, patients with substance use disorder, and those whose primary language differs from that of the health care professional. • Older adults in nursing homes are at especially high risk because many residents are unable to report their pain. In addition, there often is a lack of staff members who have been educated to manage pain in the older-adult population. Acute Pain • Acts as warning sign • Activation of sympathetic nervous system • ―Fight-or-flight‖ reactions - Increased vital signs - Sweating - Dilated pupils - Restlessness - Apprehension - Distress of varying degrees