Nursing and Inter-professional management
- Nondrug Therapy
- Massage
- Exercise
- TENS or PENS
- Transcutaneous/ percutaneous electrical nerve stimulation (TENS/PENS) involves the delivery of an electric current through electrodes applied to the skin surface over the painful region, at trigger points, or over a peripheral nerve
- Acupuncture
- Traditional Chinese medicine
- Heat or cold therapy
- Cognitive therapies
- Hypnosis and Distraction
- Relaxation strategies
Nursing and Inter-professional management
- Patient’s report of pain is believed, is not perceived as “complaining”
- The nurse communicates concern and affirms her commitment to the patient
Tolerance
- Occurs with chronic exposure to a variety of drugs
- Very high opioid doses can result in opioid-induced hyperalgesia (OIH) rather than pain relief, thus increase in the dose can lead to higher pain levels.
- Need for increased dose to maintain same degree of pain control
- Rotate drug if tolerance develops, as increasing dose could result in opioid-induced hyperalgesia (OIH)
Physical dependence
- It is manifested by a withdrawal syndrome when the drug is abruptly decreased.
- To avoid withdrawal, drug should be tapered
Pseudo-addiction
- Inadequate treatment of pain where the patient exhibit behaviors commonly associated with addiction and commonly labelled as “drug seeking” resulting in mistrust between them and caregivers.
Addiction
- Neurobiological condition with drive to obtain and take substances for other than prescribed therapeutic value
- Tolerance and physical dependence are not indicators of addiction