Post on 16-Jan-2015
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MYTH of OPIOID
Fact or Myth
People who take pain medication (opioids) generally become
addicted.
MYTH
Less then 1 percent of those who take opioids for
pain become addicted.
Fact or Myth
Elders tend to report more pain
as they age.
MYTH
Many elders tend to not report their pain
because they think it is a natural part of growing
older.
Fact or Myth
Opioids should not be considered when treating elders with severe pain.
MYTHOpioids are the first line of defense we have to combat severe pain. Opioids have no maximum daily dose. This allows us to adjust
dose to effective level, no matter how severe.
Fact or Myth
Effective pain control improves the ability to fight
disease.
FACT
One side effect of unrelieved pain is a compromised
immune system.
Fact or Myth
Constipation is a manageable side effect of
opioid use.
A bowel program must always be initiated with
opioid use.
FACT
True or False
Communication is a key component in good pain
management.
Communication must occur between all
persons/departments.
TRUE
Name three reasons why families or caregivers may not recognize or believe elders’ reports of pain.
• Fear of addiction• Culture• Fear of side effects• Don’t want loved
one to be “targeted or labeled”
• Knowledge deficit
Name three barriers to good pain management by health care providers.
• Personal biases• Inadequate pain
assessment skills• Lack of knowledge• Lack of time• Fear of patient addiction
Name three barriers to good pain
management by physicians.
• Fear of legal issues• Fear of regulatory
scrutiny• Unfamiliarity with
opioids• Fear of patient
addiction• Concern about
detrimental side effects
• Lack of communication by health care personnel and the patient/family
Give three reasons elders
may not report pain.
• Worry about cost• Fear of addiction• Fear of losing
independence• Don’t want to be a
bother• Culture• Fear of side effects• Cognitively Impaired• Depression• Low expectations for
pain relief
True or False
A person’s pain is whatever they say it is and exists whenever
they sayit does.
This is the definition advocated by Margo
McCaffery and is subscribed to by many
pain management programs.
TRUE
Give three signs of painthat might be exhibited by cognitively impaired elders.
Changes in emotion (tears)
Changes in movement (restlessness)
Verbal cues (whimpering, screaming)
Facial cues (grimacing) Changes in body
position (guarding)
What does WILDA stand for?
Words to describe painIntensity of the painLocation of the painDuration of painAggravating/Alleviating factors
What words might a person
use to describe Neuropathic pain?
• Shooting• Stabbing• Burning• Tingling• Numbness• Radiating
What words might a person use to describe
Somatic and/or Visceral pain?
Somatic – aching, throbbing, gnawing
Viceral – cramping, pressure, deep aching, referred
True or False
Pain medication can not be administered to a person
unless they ask for it.
Staff and family should recognize signs/symptoms of pain in individuals and
speak on their behalf.
FALSE
True or False
Nursing is the only discipline
that needs to be educated on pain.
All health care workers are part of the team responsible for providing effective pain
management.
FALSE
Name three different non- pharmacological
interventions.
MassageHeat/ColdRelaxation/
ImageryDistractionPastoral
Consult
ExerciseImmobilizationTENS
(transcutaneous electrical nerve stimulation)
AcupunctureHypnosis
How often should the nurse complete a
comprehensive pain assessment?
Admission/Readmission Change in pain status or
health status Each Minimum Data Set/
Outcome and Assessment Information Set (MDS/OASIS) Assessment
Name three things to educate the elder and
family about when implementing opioids or pain management.
Benefits of effective pain management
Options available Goal of treatment Side Effects and their
treatment (bowels!) Cost Negative effects of pain Pain symptoms – including
nonverbal
True or False
The elderly usually have at least three
different sites of pain.
And it is important to assess each pain site
separately and document according to
WILDA criteria.
TRUE
List at least three differences between
acute and chronic pain.
Acute vs. Chronic Pain
Acute Pain Short term Sudden onset Usually known
cause Usually goes
away Typically
doesn’t cause severe emotional stress
Chronic Pain Often unknown
cause/onset Causes
depression, sadness, anxiety, anger, loss of control
May continue throughout life and requires comprehensive treatment
What are some non-pharmacological
interventions that the departments other than
nursing can do?
Involve in activities 1:1 room visits Aromatherapy Touch – massage,
lotion Take on walks Read Support groups
What can administration do to support effective pain
management?
Effective policies Adequate supplies Training/education
programs
What does the WHO Ladder stand for and
how is it used?
World Health Organization▪ Systematic approach to
treat mild, moderate and severe pain
Jeopardy Game Template adapted from the work of Susan Collins and Eleanor Savko, District Resource Teachers for Hardin County Schools:
www.hardin.k12.ky.us/res_techn/sbjarea/math/MathJeopardy.htm
This material was prepared by the New Mexico Medical Review Association (NMMRA), the Medicare Quality Improvement
Organization for New Mexico, under contract with the Centers for Medicare & Medicaid
Services (CMS), an agency of the U.S. Department of Health and Human Services. It is based on material produced by the Kansas
Foundation for Medical Care. The contents presented do not necessarily reflect CMS policy.
9SOW-NM-PS-08-36
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Fact/Myth Barriers Assessment Education Interventions