pain management


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Related to pain management: Chronic pain, Pain killers, Pain medication

Pain Management

 

Definition

Pain management encompasses pharmacological, nonpharmacological, and other approaches to prevent, reduce, or stop pain sensations.

Purpose

Pain serves as an alert to potential or actual damage to the body. The definition for damage is quite broad; pain can arise from injury as well as disease. After the message is received and interpreted, further pain can be counter-productive. Pain can have a negative impact on a person's quality of life and impede recovery from illness or injury. Unrelieved pain can become a syndrome in its own right and cause a downward spiral in a person's health and outlook. Managing pain properly facilitates recovery, prevents additional health complications, and improves an individual's quality of life.

Description

What is pain?

Before considering pain management, a review of pain definitions and mechanisms may be useful. Pain is the means by which the peripheral nervous system (PNS) warns the central nervous system (CNS) of injury or potential injury to the body. The CNS comprises the brain and spinal cord, and the PNS is composed of the nerves that stem from and lead into the CNS. The PNS includes all nerves throughout the body except the brain and spinal cord.
A pain message is transmitted to the CNS by special PNS nerve cells called nociceptors. Nociceptors are distributed throughout the body and respond to different stimuli depending on their location. For example, nociceptors that extend from the skin are stimulated by sensations such as pressure, temperature, and chemical changes.
When a nociceptor is stimulated, neurotransmitters are released within the cell. Neurotransmitters are chemicals found within the nervous system that facilitate nerve cell communication. The nociceptor transmits its signal to nerve cells within the spinal cord, which conveys the pain message to the thalamus, a specific region in the brain.
Once the brain has received and processed the pain message and coordinated an appropriate response, pain has served its purpose. The body uses natural pain killers, called endorphins, that are meant to derail further pain messages from the same source. However, these natural pain killers may not adequately dampen a continuing pain message. Also, depending on how the brain has processed the pain information, certain hormones, such as prostaglandins, may be released. These hormones enhance the pain message and play a role in immune system responses to injury, such as inflammation. Certain neurotransmitters, especially substance P and calcitonin gene-related peptide, actively enhance the pain message at the injury site and within the spinal cord.
Pain is generally divided into two categories: acute and chronic. Nociceptive pain, or the pain that is transmitted by nociceptors, is typically called acute pain. This kind of pain is associated with injury, headaches, disease, and many other conditions. It usually resolves once the condition that caused it is resolved.
Following some disorders, pain does not resolve. Even after healing or a cure has been achieved, the brain continues to perceive pain. In this situation, the pain may be considered chronic. The time limit used to define chronic pain typically ranges from three to six months, although some healthcare professionals prefer a more flexible definition, and consider chronic pain as pain that endures beyond a normal healing time. The pain associated with cancer, persistent and degenerative conditions, and neuropathy, or nerve damage, is included in the chronic category. Also, unremitting pain that lacks an identifiable physical cause, such as the majority of cases of low back pain, may be considered chronic. The underlying biochemistry of chronic pain appears to be different from regular nociceptive pain.
Some researchers have said that uninterrupted and unrelenting pain can induce changes in the spinal cord. In the past, intractable pain has been treated by severing a nerve's connection to the CNS. However, the lack of any sensory information being relayed by that nerve can cause pain transmission in the spinal cord to go into overdrive, as evidenced by the phantom limb pain experienced by amputees. Evidence is accumulating that unrelenting pain or the complete lack of nerve signals increases the number of pain receptors in the spinal cord. Nerve cells in the spinal cord may also begin secreting pain-amplifying neurotransmitters independent of actual pain signals from the body. Immune chemicals, primarily cytokines, may play a prominent role in such changes.
Scientists have long recognized a relationship between depression and chronic pain. In 2004, a survey of California adults diagnosed with major depressive disorder revealed that more than one-half of them also suffered from chronic pain.

Managing pain

Considering the different causes and types of pain, as well as its nature and intensity, management can require an interdisciplinary approach. The elements of this approach include treating the underlying cause of pain, pharmacological and nonpharmacological therapies, and some invasive (surgical) procedures.
Treating the cause of pain underpins the idea of managing it. Injuries are repaired, diseases are diagnosed, and certain encounters with pain can be anticipated and treated prophylactically (by prevention). However, there are no guarantees of immediate relief from pain. Recovery can be impeded by pain and quality of life can be damaged. Therefore, pharmacological and other therapies have developed over time to address these aspects of disease and injury.
PHARMACOLOGICAL OPTIONS. Pain-relieving drugs, otherwise called analgesics, include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, narcotics, antidepressants, anticonvulsants, and others. NSAIDs and acetaminophen are available as over-the-counter and prescription medications, and are frequently the initial pharmacological treatment for pain. These drugs can also be used as adjuncts to the other drug therapies, which might require a doctor's prescription.
NSAIDs include aspirin, ibuprofen (Motrin, Advil, Nuprin), naproxen sodium (Aleve), and ketoprofen (Orudis KT). These drugs are used to treat pain from inflammation and work by blocking production of pain-enhancing neurotransmitters, such as prostaglandins. Acetaminophen is also effective against pain, but its ability to reduce inflammation is limited.
NSAIDs and acetaminophen are effective for most forms of acute (sharp, but of a short course) pain, but moderate and severe pain may require stronger medication. Narcotics handle intense pain effectively, and are used for cancer pain and acute pain that does not respond to NSAIDs and acetaminophen. Narcotics are classified as either opiates or opioids, and are available only with a doctor's prescription. Opiates include morphine and codeine, which are derived from opium, a substance naturally found in some poppy species. Opioids are synthetic drugs based on the structure of opium. This drug class includes drugs such as oxycodon, methadone, and meperidine (Demerol). In August 2004, the Drug Enforcement Administration (DEA) issued new guidelines to help physicians prescribe narcotics appropriately without fear of being arrested for prescribing the drugs beyond the scope of their medical practice. DEA is trying to work with physicians to ensure that those who need to drugs receive them but to ensure opioids are not abused.
Narcotics may be ineffective against some forms of chronic pain, especially since changes in the spinal cord may alter the usual pain signaling pathways. In such situations, pain can be managed with the help of with antidepressants and anticonvulsants, which are also only available with a doctor's prescription.
Although antidepressant drugs were developed to treat depression, it has been discovered that they are also effective in combating some chronic headaches, cancer pain, and pain associated with nerve damage. Antidepressants that have been shown to have analgesic (pain reducing) properties include amitriptyline (Elavil), trazodone (Desyrel), and imipramine (Tofranil). Anticonvulsant drugs share a similar background with antidepressants. Developed to treat epilepsy, certain anticonvulsants were found to relieve pain as well. Drugs such as phenytoin (Dilantin) and carbamazepine (Tegretol) are prescribed to treat the pain associated with nerve damage.
Other prescription drugs are used to treat specific types of pain or specific pain syndromes. For example, corticosteroids are effective against pain caused by inflammation and swelling, and sumatriptan (Imitrex) was developed to treat migraine headaches.
Drug administration depends on the drug type and the required dose. Some drugs are not absorbed very well from the stomach and must be injected or administered intravenously. Injections and intravenous administration may also be used when high doses are needed or if an individual is nauseous. Following surgery and other medical procedures, patients may have the option of controlling the pain medication themselves. By pressing a button, they can release a set dose of medication into an intravenous solution. This procedure has also been employed in other situations requiring pain management. Another mode of administration involves implanted catheters that deliver pain medication directly to the spinal cord. Delivering drugs in this way can reduce side effects and increase the effectiveness of the drug.
NONPHARMACOLOGICAL OPTIONS. Pain treatment options that do not use drugs are often used as adjuncts to, rather than replacements for, drug therapy. One of the benefits of non-drug therapies is that an individual can take a more active stance against pain. Relaxation techniques, such as yoga and meditation, are used to decrease muscle tension and reduce stress. Tension and stress can also be reduced through biofeedback, in which an individual consciously attempts to modify skin temperature, muscle tension, blood pressure, and heart rate.
Participating in normal activities and exercising can also help control pain levels. Through physical therapy, an individual learns beneficial exercises for reducing stress, strengthening muscles, and staying fit. Regular exercise has been linked to production of endorphins, the body's natural pain killers.
Acupuncture involves the insertion of small needles into the skin at key points. Acupressure uses these same key points, but involves applying pressure rather than inserting needles. Both of these methods may work by prompting the body to release endorphins. Applying heat or being massaged are very relaxing and help reduce stress. Transcutaneous electrical nerve stimulation (TENS) applies a small electric current to certain parts of nerves, potentially interrupting pain signals and inducing release of endorphins. To be effective, use of TENS should be medically supervised.
INVASIVE PROCEDURES. There are three types of invasive procedures that may be used to manage or treat pain: anatomic, augmentative, and ablative. These procedures involve surgery, and certain guidelines should be followed before carrying out a procedure with permanent effects. First, the cause of the pain must be clearly identified. Next, surgery should be done only if noninvasive procedures are ineffective. Third, any psychological issues should be addressed. Finally, there should be a reasonable expectation of success.
Anatomic procedures involve correcting the injury or removing the cause of pain. Relatively common anatomic procedures are decompression surgeries, such as repairing a herniated disk in the lower back or relieving the nerve compression related to carpal tunnel syndrome. Another anatomic procedure is neurolysis, also called a nerve block, which involves destroying a portion of a peripheral nerve.
Augmentative procedures include electrical stimulation or direct application of drugs to the nerves that are transmitting the pain signals. Electrical stimulation works on the same principle as TENS. In this procedure, instead of applying the current across the skin, electrodes are implanted to stimulate peripheral nerves or nerves in the spinal cord. Augmentative procedures also include implanted drug-delivery systems. In these systems, catheters are implanted in the spine to allow direct delivery of drugs to the CNS.
Ablative procedures are characterized by severing a nerve and disconnecting it from the CNS. However, this method may not address potential alterations within the spinal cord. These changes perpetuate pain messages and do not cease even when the connection between the sensory nerve and the CNS is severed. With growing understanding of neuropathic pain and development of less invasive procedures, ablative procedures are used less frequently. However, they do have applications in select cases of peripheral neuropathy, cancer pain, and other disorders.

Preparation

Prior to beginning management, pain is thoroughly evaluated. Pain scales or questionnaires are used to attach an objective measure to a subjective experience. Objective measurements allow health care workers a better understanding of the pain being experienced by the patient. Evaluation also includes physical examinations and diagnostic tests to determine underlying causes. Some evaluations require assessments from several viewpoints, including neurology, psychiatry and psychology, and physical therapy. If pain is due to a medical procedure, management consists of anticipating the type and intensity of associated pain and managing it preemptively.

Risks

Owing to toxicity over the long term, some drugs can only be used for acute pain or as adjuncts in chronic pain management. NSAIDs have the well-known side effect of causing gastrointestinal bleeding, and long-term use of acetaminophen has been linked to kidney and liver damage. Other drugs, especially narcotics, have serious side effects, such as constipation, drowsiness, and nausea. Serious side effects can also accompany pharmacological therapies; mood swings, confusion, bone thinning, cataract formation, increased blood pressure, and other problems may discourage or prevent use of some analgesics.

Key terms

Acute — Referring to pain in response to injury or other stimulus that resolves when the injury heals or the stimulus is removed.
Chronic — Referring to pain that endures beyond the term of an injury or painful stimulus. Can also refer to cancer pain, pain from a chronic or degenerative disease, and pain from an unidentified cause.
CNS or central nervous system — The part of the nervous system that includes the brain and the spinal cord.
Iatrogenic — Resulting from the activity of the physician.
Neuropathy — Nerve damage.
Neurotransmitter — Chemicals within the nervous system that transmit information from or between nerve cells.
Nociceptor — A nerve cell that is capable of sensing pain and transmitting a pain signal.
Nonpharmacological — Referring to therapy that does not involve drugs.
Pharmacological — Referring to therapy that relies on drugs.
PNS or peripheral nervous system — Nerves that are outside of the brain and spinal cord.
Stimulus — A factor capable of eliciting a response in a nerve.
Nonpharmacological therapies carry little or no risk. However, it is advised that individuals recovering from serious illness or injury consult with their health care providers or physical therapists before making use of adjunct therapies. Invasive procedures carry risks similar to other surgical procedures, such as infection, reaction to anesthesia, iatrogenic (injury as a result of treatment) injury, and failure.
A traditional concern about narcotics use has been the risk of promoting addiction. As narcotic use continues over time, the body becomes accustomed to the drug and adjusts normal functions to accommodate to its presence. Therefore, to elicit the same level of action, it is necessary to increase dosage over time. As dosage increases, an individual may become physically dependent on narcotic drugs.
However, physical dependence is different from psychological addiction. Physical dependence is characterized by discomfort if drug administration suddenly stops, while psychological addiction is characterized by an overpowering craving for the drug for reasons other than pain relief. Psychological addiction is a very real and necessary concern in some instances, but it should not interfere with a genuine need for narcotic pain relief. However, caution must be taken with people with a history of addictive behavior.

Normal results

Effective application of pain management techniques reduces or eliminates acute or chronic pain. This treatment can improve an individual's quality of life and aid in recovery from injury and disease.

Resources

Periodicals

Finn, Robert. "More than Half of Patients With Major Depression Have Chronic Pain." Family Practice News October 15, 2004: 38.
"New Guidelines Set for Better Pain Treatment." Medical Letter on the CDC & FDA September 5, 2004: 95.

Organizations

American Chronic Pain Association. P.O. Box 850, Rocklin, CA 95677-0850. (916) 632-0922. 〈http://members.tripod.com/∼widdy/ACPA.html〉.
American Pain Society. 4700 West Lake Ave., Glenview, IL 60025. (847) 375-4715. http://www.ampainsoc.org.
National Chronic Pain Outreach Association, Inc. P.O. Box 274, Millboro, VA 24460-9606. (540) 997-5004.

management

 [man´ij-ment]
the process of controlling how something is done or used.
acid-base management in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from acid-base imbalance.
acid-base management: metabolic acidosis in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from serum bicarbonate levels lower than desired. See also metabolic acidosis.
acid-base management: metabolic alkalosis in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from serum bicarbonate levels higher than desired. See also metabolic alkalosis.
acid-base management: respiratory acidosis in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from serum pCO2 levels higher than desired. See also respiratory acidosis.
acid-base management: respiratory alkalosis in the nursing interventions classification, a nursing intervention defined as the promotion of acid-base balance and prevention of complications resulting from serum pCO2 levels lower than desired. See also respiratory alkalosis.
airway management in the nursing interventions classification, a nursing intervention defined as insertion or assisting with insertion and stabilization of an artificial airway. See also artificial airway management.
allergy management in the nursing interventions classification, a nursing intervention defined as the identification, treatment, and prevention of allergic responses to food, medications, insect bites, contrast material, blood or other substances.
anaphylaxis management in the nursing interventions classification, a nursing intervention defined as the promotion of adequate ventilation and tissue perfusion for a patient with severe allergic (antigen-antibody) reaction.
artificial airway management in the nursing interventions classification, a nursing intervention defined as the maintenance of endotracheal and tracheostomy tubes and preventing complications associated with their use. See also airway management.
behavior management in the nursing interventions classification, a nursing intervention defined as helping a patient to manage negative behavior.
behavior management: overactivity/inattention in the nursing interventions classification, a nursing intervention defined as the provision of a therapeutic milieu which safely accommodates the patient's attention deficit and/or overactivity while promoting optimal function.
behavior management: self-harm in the nursing interventions classification, a nursing intervention defined as assisting the patient to decrease or eliminate self-mutilating or self-abusive behavior.
behavior management: sexual in the nursing interventions classification, a nursing intervention defined as delineation and prevention of socially unacceptable sexual behaviors.
bowel management in the nursing interventions classification, a nursing intervention defined as establishment and maintenance of a regular pattern of bowel elimination.
case management
1. an approach to health care delivery that focuses on the complex needs of the patient and emphasizes the coordination and prioritization of all needed services. See also case manager.
2. in the nursing interventions classification, a nursing intervention defined as coordinating care and advocating for specified individuals and patient populations across settings to reduce cost, reduce resource use, improve quality of health care, and achieve desired outcomes.
case management (omaha) in the omaha system, an intervention on the first level of the intervention scheme, defined as nursing activities of coordination, advocacy, and referral that involve facilitating service delivery on behalf of the client, communicating with health and human services providers, promoting assertive client communication, and guiding the client toward use of appropriate community resources.
cerebral edema management in the nursing interventions classification, a nursing intervention defined as limitation of secondary cerebral injury resulting from swelling of brain tissue. See also cerebral edema.
chemotherapy management in the nursing interventions classification, a nursing intervention defined as assisting the patient and family to understand the action and minimize side effects of chemotherapy with antineoplastic agents.
code management in the nursing interventions classification, a nursing intervention defined as coordination of emergency measures to sustain life.
communicable disease management in the nursing interventions classification, a nursing intervention defined as working with a community to decrease and manage the incidence and prevalence of contagious diseases in a specific population.
constipation/impaction management in the nursing interventions classification, a nursing intervention defined as the prevention and alleviation of constipation and fecal impaction.
delirium management in the nursing interventions classification, a nursing intervention defined as provision of a safe and therapeutic environment for the patient who is experiencing an acute confusional state; see also delirium.
delusion management in the nursing interventions classification, a nursing intervention defined as promoting the comfort, safety, and reality orientation of a patient experiencing false, fixed beliefs that have little or no basis in reality. See also delusion.
dementia management in the nursing interventions classification, a nursing intervention defined as provision of a modified environment for the patient who is experiencing a chronic confusional state; see also dementia.
diarrhea management in the nursing interventions classification, a nursing intervention defined as the prevention and alleviation of diarrhea.
dysreflexia management in the nursing interventions classification, a nursing intervention defined as prevention and elimination of stimuli that cause hyperactive reflexes and inappropriate autonomic responses in a patient with a cervial or high thoracic cord lesion. See also dysreflexia.
dysrhythmia management in the nursing interventions classification, a nursing intervention defined as preventing, recognizing, and facilitating treatment of abnormal cardiac rhythms. See also dysrhythmia.
eating disorders management in the nursing interventions classification, a nursing intervention defined as prevention and treatment of severe diet restriction and overexercising or bingeing and purging of food and fluids. See also eating disorder.
electrolyte management in the nursing interventions classification, a nursing intervention defined as promotion of electrolyte balance and prevention of complications resulting from abnormal or undesired serum electrolyte levels.
electrolyte management: hypercalcemia in the nursing interventions classification, a nursing intervention defined as promotion of calcium balance and prevention of complications resulting from serum calcium levels higher than desirable. See also hypercalcemia.
electrolyte management: hyperkalemia in the nursing interventions classification, a nursing intervention defined as promotion of potassium balance and prevention of complications resulting from serum potassium levels higher than desirable. See also hyperkalemia.
electrolyte management: hypermagnesemia in the nursing interventions classification, a nursing intervention defined as promotion of magnesium balance and prevention of complications resulting from serum magnesium levels higher than desirable. See also hypermagnesemia.
electrolyte management: hypernatremia in the nursing interventions classification, a nursing intervention defined as promotion of sodium balance and prevention of complications resulting from serum sodium levels higher than desirable. See also hypernatremia.
electrolyte management: hyperphosphatemia in the nursing interventions classification, a nursing intervention defined as promotion of phosphate balance and prevention of complications resulting from serum phosphate levels higher than desirable. See also hyperphosphatemia.
electrolyte management: hypocalcemia in the nursing interventions classification, a nursing intervention defined as promotion of calcium balance and prevention of complications resulting from serum calcium levels lower than desirable. See also hypocalcemia.
electrolyte management: hypokalemia in the nursing interventions classification, a nursing intervention defined as promotion of potassium balance and prevention of complications resulting from serum potassium levels lower than desirable. See also hypokalemia.
electrolyte management: hypomagnesemia in the nursing interventions classification, a nursing intervention defined as promotion of magnesium balance and prevention of complications resulting from serum magnesium levels lower than desirable. See also hypomagnesemia.
electrolyte management: hyponatremia in the nursing interventions classification, a nursing intervention defined as promotion of sodium balance and prevention of complications resulting from serum sodium levels lower than desirable. See also hyponatremia.
electrolyte management: hypophosphatemia in the nursing interventions classification, a nursing intervention defined as promotion of phosphate balance and prevention of complications resulting from serum phosphate levels lower than desirable. See also hypophosphatemia.
energy management in the nursing interventions classification, a nursing intervention defined as regulating energy use to treat or prevent fatigue and optimize function.
environmental management in the nursing interventions classification, a nursing intervention defined as manipulation of the patient's surroundings for therapeutic benefit.
environmental management: attachment process in the nursing interventions classification, a nursing intervention defined as manipulation of the patient's surroundings to facilitate the development of the parent-infant relationship.
environmental management: comfort in the nursing interventions classification, a nursing intervention defined as manipulation of the patient's surroundings for promotion of optimal comfort.
environmental management: community in the nursing interventions classification, a nursing intervention defined as monitoring and influencing of the physical, social, cultural, economic, and political conditions that affect the health of groups and communities.
environmental management: home preparation in the nursing interventions classification, a nursing intervention defined as preparing the home for safe and effective delivery of care.
environmental management: safety in the nursing interventions classification, a nursing intervention defined as monitoring and manipulation of the physical environment to promote safety.
environmental management: violence prevention in the nursing interventions classification, a nursing intervention defined as monitoring and manipulation of the physical environment to decrease the potential for violent behavior directed toward self, others, or environment.
environmental management: worker safety in the nursing interventions classification, a nursing intervention defined as monitoring and manipulation of the worksite environment to promote safety and health of workers.
fiscal resource management in the nursing interventions classification, a nursing intervention defined as procuring and directing the use of financial resources to assure the development and continuation of programs and services.
fluid management in the nursing interventions classification, a nursing intervention defined as the promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels.
fluid/electrolyte management in the nursing interventions classification, a nursing intervention defined as the regulation and prevention of complications from altered fluid and/or electrolyte levels.
hallucination management in the nursing interventions classification, a nursing intervention defined as promoting the safety, comfort, and reality orientation of a patient experiencing hallucinations.
hyperglycemia management in the nursing interventions classification, a nursing intervention defined as preventing and treating above-normal glucose levels. See also hyperglycemia.
hypervolemia management in the nursing interventions classification, a nursing intervention defined as the reduction in extracellular and/or intracellular fluid volume and prevention of complications in a patient who is fluid overloaded. See also hypervolemia.
hypoglycemia management in the nursing interventions classification, a nursing intervention defined as preventing and treating low blood glucose levels. See also hypoglycemia.
hypovolemia management in the nursing interventions classification, a nursing intervention defined as the expansion of intravascular fluid volume in a patient whose volume is depleted. See also hypovolemia.
immunization/vaccination management in the nursing interventions classification, a nursing intervention defined as monitoring immunization status, facilitating access to immunizations, and provision of immunizations to prevent communicable disease.
ineffective community therapeutic regimen management a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a pattern of regulating and integrating into community processes of programs for treatment of illness and the sequelae of illness that are unsatisfactory for meeting health-related goals.
ineffective family therapeutic regimen management a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a pattern of regulating and integrating into family processes of a program for treatment of illness and its sequelae that is unsatisfactory for meeting specific health goals for a family member.
ineffective therapeutic regimen management a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a pattern of regulation and integration into daily living of a treatment program for illness and its sequelae that is unsatisfactory for meeting specific health goals.
medication management in the nursing interventions classification, a nursing intervention defined as facilitation of safe and effective use of prescription and over-the-counter drugs.
mood management in the nursing interventions classification, a nursing intervention defined as providing for safety and stabilization of a patient who is experiencing a dysfunctionally depressed mood or elevated mood.
nausea management in the nursing interventions classification, a nursing intervention defined as prevention and alleviation of nausea.
nutrition management in the nursing interventions classification, a nursing intervention defined as assisting with or providing a balanced dietary intake of foods and fluids.
pain management in the nursing interventions classification, a nursing intervention defined as alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient.
peripheral sensation management in the nursing interventions classification, a nursing intervention defined as prevention or minimization of injury or discomfort in the patient with altered sensation.
pessary management in the nursing interventions classification, a nursing intervention defined as placement and monitoring of a vaginal device for treating stress urinary incontinence, uterine retroversion, genital prolapse, or incompetent cervix. See also pessary.
pressure management in the nursing interventions classification, a nursing intervention defined as minimizing pressure to body parts.
program management a system of health care delivery in an institution or agency whereby staff are divided by broad patient categories rather than by professional groups.
pruritus management in the nursing interventions classification, a nursing intervention defined as preventing and treating itching.
radiation therapy management in the nursing interventions classification, a nursing intervention defined as assisting the patient to understand and minimize the side effects of radiation treatments. See also radiation therapy.
rectal prolapse management in the nursing interventions classification, a nursing intervention defined as the prevention and/or manual reduction of rectal prolapse.
reproductive technology management in the nursing interventions classification, a nursing intervention defined as assisting a patient through the steps of complex infertility treatment.
risk management the assessment and removal or control of hazard to patients, employees, or institutions.
seizure management in the nursing interventions classification, a nursing intervention defined as care of a patient during a seizure and the postictal state.
shock management in the nursing interventions classification, a nursing intervention defined as facilitation of the delivery of oxygen and nutrients to systemic tissue with removal of cellular waste products in a patient with severely altered tissue perfusion. See also shock.
shock management: cardiac in the nursing interventions classification, a nursing intervention defined as the promotion of adequate tissue perfusion for a patient with severely compromised pumping function of the heart.
shock management: vasogenic in the nursing interventions classification, a nursing intervention defined as the promotion of adequate tissue perfusion for a patient with severe loss of vascular tone.
shock management: volume in the nursing interventions classification, a nursing intervention defined as the promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume. See also hypovolemic shock.
specimen management in the nursing interventions classification, a nursing intervention defined as obtaining, preparing, and preserving a specimen for a laboratory test.
stress management in the omaha system, physical and emotional activities that immunize the body from known stressors.
supply management in the nursing interventions classification, a nursing intervention defined as ensuring acquisition and maintenance of appropriate items for providing care.
technology management in the nursing interventions classification, a nursing intervention defined as the use of technical equipment and devices to monitor patient condition or sustain life.
time management the effective planning and balancing of activities such as self-care, work, leisure, and rest in order to promote satisfaction and health.
unilateral neglect management in the nursing interventions classification, a nursing intervention defined as protecting and safely reintegrating the affected part of the body while helping the patient adapt to disturbed perceptual abilities. See also unilateral neglect.
urinary elimination management in the nursing interventions classification, a nursing intervention defined as the maintenance of an optimum urinary elimination pattern. See also urination.
vomiting management in the nursing interventions classification, a nursing intervention defined as prevention and alleviation of vomiting.
weight management in the nursing interventions classification, a nursing intervention defined as facilitating maintenance of optimal weight and percent body fat.

pain management

a nursing intervention from the Nursing Interventions Classification (NIC) defined as alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient. See also Nursing Interventions Classification.

pain man·age·ment

(pān manăj-mĕnt)
The treatment of pain, which includes medications, techniques such as biofeedback, and complementary and alternative medicine methods.

Patient discussion about pain management

Q. My life is hectic now with fibromyalgia,I need to know how you guys manage with this Muscular Pain? My life is hectic now with fibromyalgia, It started with the pain and turned to irritation and loss of confidence and I became helpless now in the sense like any one can come and pin me the way they want. I am not able to lead a healthy life which I have always dreamt of. I have tried all possible options that hit my mind….but the condition remains same and with medicines there are some other side effects too. ……. I need to know how you guys manage with this Muscular Pain….

A. Some good answers here and might i add I think for each of us it is taking suggestions and seeing what works for us. My doctor keeps reminding me the terrible thing about fibro is it affects everyone different so we have to do the trail and error "thing". I have osteoartritis, degenerative disc disease to so i have to factor those into the things I try. A lot of people soak in hot water...I can't I can't handle extreme temps, hot or cold...feels like needles shooting through me. I take tramadol everyday but have stronger meds for when it is the worse( I try to avoid those as much as possible) they have began muscle relaxers and they have made a difference...I still hurt and am stiff but at least I can manage to move. I rest when I need to...I don't push myself b/c if I do I have found it makes the next day even worse.Luckily I have great family support now, having support and someone to talk to for me has helped a lot.Try to do a little everyday...set small achaivable goals!

More discussions about pain management
References in periodicals archive ?
According to the report, the global pain management devices market will reach an estimated US$5.
supports the principles of the primacy of pain management over the fear of addiction when prescribing and/or administering controlled substances.
If a plaintiff/patient could convince a jury that a defendant/physician was liable for reckless pain management care which rose to the level of elder abuse, then the plaintiff/patient should more easily be able to convince that same jury that the defendant/physician also was liable for the lesser culpable standard of negligence.
Horizon trains all facility staff in pain management.
The significantly elevated Type A behavior score in CMP clients who completed rehabilitation suggests that an elevated level of work-oriented behavior may be helpful or even necessary to complete rehabilitation in a pain management program.
It's critical that we move from a one-size-fits-all approach to one that considers individual factors such as age, physical abilities and support systems to optimize pain management," Twillman said.
Who are the branded transdermal pain management product suppliers, their business models, and their capabilities?
Indeed, some doctors scoffed when she proposed studying pain management in children, because the conventional wisdom--since undercut--was that the brains of infants and toddlers were not developed enough to experience pain.
If you suspect you may have it, don't go to any old doctor, go to a pain management specialist for a diagnosis.
Mary's Nursing Center in Leonardtown, Maryland, came up with a novel approach to pressure-ulcer prevention: pain management.
Surveyors and civil courts are scrutinizing chronic pain management, and providers should, too.