Self Directed Learning Package - University of Queensland

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82 • The Palliative Approach ToolkitIncident Pain• pain results from a specific event e.g. wound dressing,movement• requires analgesia PRIOR to the event that causes the pain.Key PointRemember to allow time for analgesia to workbefore undertaking the intervention.Breakthrough Pain• pain occurs between regular scheduled doses of analgesia• common in cancer pain• response should be to give an additional prescribedbreakthrough dose of analgesia• review/ reassess pain and treatment regime if doses areneeded repeatedly.PathophysiologyPain can also be classified according to its physiological causes.• Nociceptive pain occurs because of stimulation of nerves inthe skin and deep tissues called ‘nociceptors’.• Neuropathic pain is caused by the damage to the actualnerves themselves.Classification of pain 2,18Type Characteristics Descriptors ExamplesNociceptive - Somatic Well localised Gnawing, aching,throbbing, sharpSuperficial: pressuresoresDeep: bone fractureNociceptive - VisceralPoorly localised,sometimes referredDeep, squeezing,penetrating, pressureIntestinal or biliary colicNeuropathicCan follow dermatome/nerve distributionBurning, shooting,radiating, tingling,numbness, pins andneedles, deep achingPost herpetic neuralgia(shingles), spinal cordcompression
83 • Self Directed Learning Package - Advanced Registered & Enrolled NurseFactors affecting pain thresholdA person’s pain perception and experience are influenced bytheir mood, past pain experiences, social and physical situationand the meaning they give to both their illness and their pain.Factors that affect pain thresholdThreshold lowered• insomnia• fatigue• anxiety• fear• anger• depression• mental isolation.Threshold raised• relief of other symptoms• sleep• sympathy• understanding• relaxation• reduction in anxiety• analgesics.Thinking PointThink about the differences between these two lists.Can you recall a time where you noticed differencesin a resident’s mood after you encouraged them toparticipate in group activities, or someone sat andtalked to them about their fears?ActivityIdentify a resident who is experiencing pain.List two non-pharmacological strategies you can trial inthe next fortnight to assist with their pain:1.2.
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Self Directed Learning Package - University of Queensland

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