N109: Foundations in Nursing Practice

N109: Foundations in Nursing Practice Study Guide • Myth #6: The clinician should control the administration of pain medication. Reality: Whenever possible, the patient, family, or caregivers should control their lives and the analgesic therapy. The patient is the only person who knows the amount of pain she is suffering. • Myth #7: People with chronic pain have hypochondriasis. Reality: Chronic pain is usually associated with a long-term illness. Chronic pain can be the result of damaged tissue, but very often is attributable to nerve damage. • Myth #8: Infants do not feel pain. Reality: Pain is experienced across the whole lifespan, including the infant stage. • Myth #9: Older patients constantly complain. Reality: Older patients are individuals, just like people in other age categories. In fact, the astute nurse should assess older individuals for pain, as some may not express pain for fear of losing an aspect of their freedom. • Myth #10: Lack of complaint means the patient is pain free. Reality: Individuals express pain in different ways. Often times cultural background effects how someone expresses pain. The nurse must not assume that a lack of complaint means the patient is pain free and should regularly assess the pain level. WHO analgesic ladder: Pain Rating (Scale of 1-10) Primary Medications Adjunct Medications Mild pain, or a rating of 0-3 Nonopioid, such as an NSAID or acetaminophen Antidepressant or anticonvulsant Moderate pain, or a rating of 4-6 Weak opioid, such as codeine or hydrocodone NSAID, acetaminophen, cyclooxygenase-2 inhibitors, antidepressant, or anticonvulsant Severe pain, or a rating of 7-10 Strong opioid, such as morphine, oxycodone, or fentanyl NSAID, acetaminophen, antidepressant, or anticonvulsant 2.5 Comfort Needs and Responses One of the primary tasks for a nurse is to provide comfort to individuals in distress. Comfort means to soothe or ease in a time of affliction or distress. Factors associated with comfort or discomfort may include: • Physical or emotional pain • Loss of familiar surroundings • Loss of routine • Fear of the unknown • Timing of procedures or treatment • Noise level (especially unfamiliar noises) • Loss of privacy

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