According to different studies, pain is the second cause of consultation in Primary Care, and more than 50% are related to chronic pain. Therefore, applying various tools by health professionals is essential to prevent, treat and control it.
Being sharp pain a symptom, chronic pain may become an actual sickness, becoming a serious public health problem and the most frequent cause of suffering, personal, social or work impairment. Therefore, it is essential the application of different tools by sanitary professionals to prevent, treat and control it.
Pain is an unpleasant, subjective sensation and can be a vital sign that something is altered, that is, that there is some type of damage to the tissues from a minor to a greater degree.
The pain threshold is the amount of painful stimulus necessary to experience pain, and it can be altered due to a person’s degree of consciousness.
Pain tolerance is the maximum amount and duration a person is willing to endure. This varies considerably from one person to another and is conditioned by sociocultural and psychological factors.
Pain receptors called nociceptors are stimulated due to direct injury to the receptor cell or by releasing chemicals such as bradykinin. However, pain does not necessarily appear as a consequence of stimulation of nociceptors. Pain occurs when the pain message is removed along the spinal cord to the brain, where the stimulus is interpreted.
Three natural mechanisms in the body intervene in the transmission and perception of pain: Enkephalins (capable of inhibiting the release of P substances), Endorphins (which have been shown to have greater potency than encephalins) and Dynorphins (have an excellent analgesic effect).
Nursing treatment for pain control consists of independent and collaborative interventions. We find non-invasive measures such as massage, progressive relaxation and directed imagination within the first. In collaboration interventions, we see the administration of analgesics requiring a doctor’s prescription.
The ideal way to treat pain is the combination of different methods to achieve adequate relief.
The identification of pain by nursing is critical. For this, it is essential to convey the feeling that you believe the pain expressed by the patient. To do this, you must listen carefully to what the client says about his pain, attend to his demands quickly and never underestimate his opinion.
On the other hand, nurses can help provide accurate information about pain and facilitate them to talk about their different emotional reactions, among which are fear, frustration, helplessness and inability to perform their tasks properly.
It should be explained that pain is an individual experience and discussed why it increases or decreases in different circumstances so that the patient knows how to identify and better manage the situation.
A critical factor is an emotional component that often accompanies pain, such as fear and anxiety. Anxiety increases pain intensity, and in turn, an increase in pain generates more significant pressure, which is why it is as important to treat pain as anxiety. Therefore, it is appropriate to encourage clients to share their fears and concerns about their reactions to pain.
Distraction methods involve diverting a person’s attention and reducing pain perception. For example, another stimulus can inhibit the receptors in the spinal cord that receive the peripheral pain stimulus from other peripheral nerve fibres carrying a different stimulus.
Slow, rhythmic breathing: Encourage the patient to focus on the sensation of breathing slowly and rhythmically, evoking a calm image.
Massage: Teach the patient to breathe rhythmically while applying a massage to a painful area with circular movements or gently rubbing.
Music: Encourage the patient to listen and focus on their favourite music, following the rhythm and lyrics.
Guided Imagery: Ask the patient to close their eyes and imagine and describe some pleasant event, encouraging them to tell the details.
Cutaneous stimulation of the skin is capable of reducing the intensity of pain, but that tactile stimulation helps distract from the painful experience.
Analgesic oils containing menthol relieve pain, especially muscle and joint pain, providing an immediate sensation of warmth that lasts for several hours.
Application of cold or heat: Ice packs reduce the speed of conduction of pain impulses to the brain and motor impulses to the muscles. Heat stimulates the synthesis of serotonin, which helps a person feel safe and secure. It can be applied in the form of clothes or hot compresses.
Contralateral stimulation is achieved by stimulating the skin opposite the painful area. This system is effective when the painful area is hypersensitive, untouchable, or inaccessible by casts, bandages, or other devices.
Administration of analgesics: They modify the perception and interpretation of pain through the depression of the central nervous system. They are effective as long as they are given before the client experiences pain. Therefore, it is essential to administer it at regular intervals. Therefore, the nurse should review the side effects, collateral effects and allergies before distributing them.
Patient Controlled Analgesia (PCA): It is a method of pain management that allows the patient to take an active part in treating their pain. The type and dose of analgesia needed for pain control vary from patient to patient.
It consists of administering a previously established dose of a narcotic agent through an electronic infusion pump. This allows for much more consistent pain relief than traditional systems. In addition, these systems incorporate security mechanisms to prevent the client from suffering from overdosing and abusive use. For example, most PCA pumps allow for a constant infusion of narcotics and self-administered boluses. For this system to be successful, it is essential to educate the patient.
Acute pain (unpleasant sensory and emotional experience caused by actual or potential tissue injury or described in such terms) R/C your disease process.
NIC: Pain management .
- Perform a comprehensive pain assessment that includes location, characteristics, duration, frequency, intensity, and triggers.
- Watch for nonverbal cues, especially those who cannot communicate effectively.
- Make sure that the patient receives the corresponding analgesic care.
- Provide information about pain, causes, how long it will last, and expected discomfort.
- Control environmental factors.
- Encourage the patient to monitor their pain.
- Use pain control measures before the pain becomes severe.
- Anxiety (Feeling of apprehension caused by the anticipation of danger. It is a warning signal that warns of imminent danger and allows the individual to take measures to deal with it) R/C ignorance of the disease process.
NIC: Relaxation techniques
- Maintain eye contact with the patient
- Reduce or eliminate stimuli that create fear or anxiety
- Reaffirm the patient in his security
- Stay with the patient.