Pain management

Pain Management Strategies

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Pain management
Pain management

Pain management is widely accepted principle in the healthcare management of people experiencing pain and discomfort because pain is already considered the fifth vital sign. Reducing pain to a tolerable level was once considered the goal of pain management, however even patients who have described pain relief as adequate often report disturbed sleep and marked distress because of pain.

In view of the harmful effects of pain and inadequate pain management , the goal of tolerable pain has been replaced by the goal of relieving pain symptoms and increased comfort as much as possible. Pain management strategies include both pharmacologic and non-pharmacologic approaches. These approaches are selected on the basis of the requirements and individualized goals of specific patients. Appropriate analgesic medications are used  as prescribed. They are not considered the last resort to be used only when other pain relief measures are no longer effective.

Pharmacologic interventions in pain management

Pharmacologic pain management is accomplished in collaboration with physicians, patients and often families. A physician or nurse practitioner prescribes specific medications for pain or may insert an IV line for administration of analgesic medications. Close collaboration and effective communication among healthcare providers is imperative for the effective management of pain.

In the home setting, the family often manages their patient’s pain and assesses the effectiveness of pharmacologic interventions along with the guidance of the family nurse who evaluates the adequacy of pain relief strategies and the ability of the family to manage the pain. Usually, patients who opted to be taken care in the home avail the services of a private duty nurse. The primary responsibility of the family nurse is to reinforce teaching and ensure proper communication among the patient, family care providers, physicians, pharmacists and other healthcare providers involved in the care of the patient.

Premedication assessment in pharmacologic pain management

Before administering any medication, the nurse should ask the patient regarding any known allergic responses to medications and the nature of any previous allergic responses. True allergic or anaphylactic response to opioids are very rare in general. However, it is not uncommon for patients to report minor allergic response to one class of opioid drugs. The nurse should properly obtain the patient’s medication history, including the patient’s current, usual or recent use of prescription and  over-the-counter medications as well as herbal agents. Because certain medications or conditions may affect analgesic medication’s effectiveness of its metabolism and the body’s  ability to safely excrete medications from the  body.

Gerontologic considerations in pain management

Physiologic changes in older adults strictly require that analgesic medications be administered with extreme caution. Adverse drug related interactions are more often likely to occur in older adults because of the higher incidence of chronic illness, their frail physical condition and advance age. Although the elderly population is a uniquely diverse group, differences in response to pain or medications by patients are more likely attributable to the chronic existing illness or other individual factors rather than the advance age of the elderly adult.

Opioid and non-opioid analgesic medications can be

administered to elderly patients but must be done with extreme caution because of the increased susceptibility to depression of both the nervous and the respiratory system. Finally, elderly patients possibly may obtain more pa more pain relief for a longer period of time than much younger patients as a result, one important consideration in pharmacologic pain management in the elderly adult require smaller and less frequent doses of analgesics.

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