Pain management


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Pain management

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Figure 73.1 The stages of pain management

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Figure 73.2 The three P’s of pain management

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Figure 73.3 Interventions

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Figure 73.4 The WHO two-step approach to pain management


Table 73.1 Consequences of unrelieved pain









Physical effects


  • Rapid, shallow, splinted breathing, which can lead to hypoxaemia and alkalosis
  • Inadequate expansion of lungs and poor cough, which can lead to secretion retention and atelectasis
  • Increased heart rate, blood pressure and myocardial oxygen requirements, which can lead to cardiac morbidity and ischaemia
  • Increased stress hormones which in turn increase the metabolic rate, impede healing and decrease immune function
  • Slowing or stasis of gut and urinary systems, which leads to nausea, vomiting, ileus and urinary retention
  • Muscle tension, spasm and fatigue, which leads to reluctance to move spontaneously and refusal to ambulate, further delaying recovery
Psychological effects


  • Anxiety, fear, distress, feelings of helplessness or hopelessness
  • Avoidance of activity, avoidance of future medical procedures
  • Sleep disturbances
  • Loss of appetite
Other effects


  • Prolonged hospital stays
  • Increased rates of readmission to hospital
  • Increased outpatient visits

Why managing pain in children is important

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Jun 7, 2018 | Posted by in NURSING | Comments Off on Pain management
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