Assessment and Multimodal Management of Pain

An Integrative Approach

1st Edition - December 26, 2016
Authors: Maureen Cooney, Ann Quinlan-Colwell
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 5 3 0 7 9 - 8
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 5 3 0 7 8 - 1

Learn best practices and evidence-based guidelines for assessing and managing pain! Assessment and Multimodal Management of Pain: An Integrative Approach describes how to provide e… Read more

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Learn best practices and evidence-based guidelines for assessing and managing pain! Assessment and Multimodal Management of Pain: An Integrative Approach describes how to provide effective management of pain through the use of multiple medications and techniques, including both pharmacologic and non-pharmacologic treatment regimens. A holistic approach provides an in-depth understanding of pain and includes practical assessment tools along with coverage of opioid and non-opioid analgesics, interventional and herbal approaches to pain, and much more. Written by experts Maureen F. Cooney and Ann Quinlan-Colwell, this reference is a complete, step-by-step guide to contemporary pain assessment and management.

Cover image
Title page
Table of Contents
Copyright
Dedication
Reviewers
Contributors
Clinical Scenario Contributors
Foreword
Acknowledgments
Chapter 1: The Evolution of Pain Assessment and Multimodal Analgesia as an Integrative Pain Management Approach
Incidence and Prevalence of Pain
Historical Perspective of Multimodal Pain Management
Pain Assessment as the Foundation of Multimodal Analgesia
Evolution of an Integrative Multimodal Approach for Pain Management (Multimodal Analgesia) (Multimodal Treatment)
Drivers for Integrative, Multimodal, Opioid-Sparing Approaches
Future Challenges and Opportunities for Multimodal Analgesia Within an Integrative Approach
Chapter 2: Importance of Multimodal Pain Management
Physiologic Complications of Unrelieved Pain
Psychosocial Implications of Unrelieved Pain
Role of Multimodal Analgesia in the Perioperative Setting
Role of Multimodal Analgesia in the Management of Chronic Pain
Ethical Considerations
Clinical Application
Key Points
Case Scenario
Chapter 3: Physiology of Pain
Theories of Pain
Other Models
Classifications of Pain
Pain Physiology and Pathophysiology
Special Conditions
Key Points
Case Scenario
Chapter 4: Barriers to Effective Pain Management
Patient Barriers
Clinical Application
Fear
Fear of Side Effects
Health Care Literacy
Family
Access Issues
Provider Barriers
System Barriers to Effective Pain Management
Opportunities
Key Points
Case Scenario
Chapter 5: Introduction to Pain Assessment
Importance of Pain Assessment
Classification of Pain
Roles of the Health Team in Pain Assessment
Timing and Frequency of Pain Assessment
Key Points
Case Scenario
Chapter 6: Pain Assessment in Cognitively Intact Adults
Accurate Pain Assessment
Pain Assessment
Components of a Comprehensive Pain Assessment
Conducting the Pain Assessment
Tools for Assessing Pain
Key Points
Case Scenario
Appendix 6-1
Appendix 6-2
Chapter 7: Pain Assessment of Patients Who Cannot Self-Report Pain
Pain Assessment of Patients Who Cannot Self-Report Pain
Pain Assessment in Critically Ill Adults Who Cannot Self-Report Pain
Patients With Delirium Who Cannot Self-Report Pain
Patients With Dementia Who Cannot Self-Report Pain
The Checklist of Nonverbal Pain Indicators (CNPI)
Patients With Intellectual Disabilities Who Cannot Self-Report Pain
Patients at the End of Life Who Cannot Self-Report Pain
Newer Trends in Pain Assessment for Patients Who Cannot Self-Report Pain
Cautions
Key Points
Case Scenario
Chapter 8: Assessment of Factors Affecting Pain and Affected by Pain
Sleep
Anxiety and Depression
Family Assessment
Financial Assessment
Key Points
Case Scenario
Chapter 9: Basic Concepts Involved with Administration of Analgesic Medications
Patient Considerations
Route Selection
Analgesic Dosing Considerations
Key Points
Case Scenario
Chapter 10: Nonopioid Analgesic Medications
Aspirin and Nonsteroidal Antiinflammatory Drugs
Multimodal Use of Nonopioid Analgesics
Key Points
Case Scenario
Chapter 11: Opioid Analgesics
Section 1
Opioid Receptors
Factors Affecting Drug Response
Opioid Classes
Key Points
Section 2
Key Points
Section 3
Tapering and Discontinuing Opioid Therapy
Key Points
Case Scenario
Chapter 12: Common Unintended Effects of Opioids
Constipation
Xerostomia (Dry Mouth)
Opioid-Induced Nausea and Vomiting
Pruritus
Urinary Retention
Hypogonadism
Sedation
Myoclonus
Opioid-Induced Hyperalgesia
Physical Dependence on Opioids
Opioid Tolerance
Immune Suppressing Effect of Opioids
Key Points
Case Scenario
Chapter 13: Preventing Opioid-Induced Advancing Sedation and Respiratory Depression
Acknowledgments
Opioids and Respiratory Function
Advancing Sedation and Opioid-Induced Respiratory Depression
Identification of the Risk Factors
Associated Pharmacologic Factors
Strategizing to Improve Safety for Patients at Risk
Assessing the Patient for Risk
Procedures for Intermittent Nursing Assessment for All Patients on Opioids: Level of Sedation
Procedures for Intermittent Nursing Assessment for All Patients on Opioids: Respiratory Status
Interventions After Assessment
Summary
Key Points
Case Scenario
Chapter 14: Opioid Use Disorder
Substance Use Disorder and Opioid Use Disorder
Caring for Patients With Pain and Opioid Use Disorder
Treatment of Opioid Use Disorder
Pain and Opioid Use Disorder: Acute Care Setting
Strategies to Reduce Risk
Key Points
Case Scenario
Chapter 15: Coanalgesic Medications
Medication Selection
Gabapentinoids
Antidepressants
Alpha-Adrenergic Receptor Agonists
Corticosteroids
N-Methyl-d-Aspartate Receptor Antagonists
Sodium Channel Blockers: Lidocaine and Mexiletine
Muscle Relaxants
Dronabinol, Nabilone, and Cannabidiol
Other Coanalgesic Medications
Key Points
Case Scenario
Chapter 16: Topical Analgesics for the Management of Acute and Chronic Pain
Benefits of Topical Analgesics
Types of Topical Analgesics
Compound Analgesics
Key Points
Case Scenario
Chapter 17: Patient-Controlled Analgesia
General Concepts
Optimize Safety Within the Patient-Controlled Analgesia Process
Prescription Components
Routes of Administration
Patient Assessment and Monitoring to Optimize Safety
Evaluating Equipment to Optimize Patient Safety
Authorized Agent–Controlled Analgesia
Key Points
Case Scenario
Chapter 18: Regional Analgesia, Local Infiltration, and Pain Management
Neuraxial Analgesia
Regional Analgesia
Regional Analgesia Infusion Systems
Local Infiltration Analgesia
Additional Analgesic Procedures Involving Use of Local Anesthetics
Key Points
Case Scenario
Chapter 19: Interventional Approaches
Acknowledgement
Anatomy of the Central Nervous System
Spinal Pain
Diagnostic Imaging
Spinal Injections
Implantable Therapies
Key Points
Case Scenario
Chapter 20: Exercise and Movement
Fear of Pain With Movement
Exercise-Induced Hypoalgesia
Movement
Dance Movement Therapy
Exercise
Tai Chi
Yoga
Physical Therapy
Patient Education for All Exercise and Movement
Key Points
Case Scenario
Chapter 21: Distraction and Relaxation
Distraction
Relaxation
Progressive Muscle Relaxation
Music Therapy
Animal-Assisted Therapy
Guided Imagery
Autogenic Training
Key Points
Case Scenario
Chapter 22: Cognitive-Behavioral and Psychotherapeutic Interventions as Components of Multimodal Analgesic Pain Management
Integrative, Interdisciplinary, and Multimodal Pain Treatment
Interdisciplinary Pain Rehabilitation or Functional Restoration Programs
Cognitive-Behavioral Therapy
Evidence Supporting Cognitive-Behavioral Therapy for Pain Management
The Activating Event Belief Consequence Model
Acceptance and Commitment Therapy
Biofeedback (Applied Psychophysiology)
Mindfulness-Based Stress Management and Mindfulness-Based Cognitive Therapy
Psychoeducation
Key Points
Case Scenario
Chapter 23: Energy Healing Therapies or Biofield Therapies as Components of Multimodal Analgesic Pain Management
Reiki
Therapeutic Touch
Healing Touch
Acupuncture
Auricular Acupuncture
Acupressure
Key Points
Case Scenario
Chapter 24: Manual Therapies for Pain Management
Manual Therapy
Osteopathy, Osteopathy Manual Medicine, or Osteopathic Manipulative Therapy
Craniosacral Therapy
Massage Therapy
Reflexology
Chiropractic Practice
Myofascial Trigger Point Therapy
Muscle Energy Technique
Fascial Distortion Model
Key Points
Case Scenario
Acknowledgments
Chapter 25: Spirituality as a Component of Multimodal Pain Management
Spirituality
Prayer
Meditation
General Cautions and Precautions Regarding Meditation
Key Points
Case Scenario
Chapter 26: Natural Products: Supplements, Botanicals, Vitamins, and Minerals as a Component of Multimodal Pain Management
Dietary Supplements
Botanicals and Herbs
Pharmaconutrients: Nutritional Modulators of Pain
Supplements
Vitamins
Key Points
Case Scenario
Chapter 27: Additional Nonpharmacologic Interventions as Components of Multimodal Pain Management
Aromatherapy
Caring, Empathy, and Compassion by Caregivers
Crossing Hands and/or Arms Over the Midline
Dietary Choices
Environmental Modifications
Hypnosis
Mirror Therapy or Mirror Visual Feedback Therapy
Obesity and Weight Management
Static Magnet Therapy
Temperature Modalities
Alternating or Contrasting Temperature Therapy
Valsalva Maneuver
Key Points
Case Scenario
Chapter 28: Improving Institutional Commitment for Effective Multimodal Pain Management
Organizational Commitment to Quality and Pain Management
Organizational Initiatives to Support Quality of Safe and Effective Multimodal Pain Management
Quality Improvement
Clinical Nursing Efforts to Support Organizational Initiatives
Education of Clinicians
Future Opportunities for Improvement
Key Points
Case Scenario
Appendix: Terminology
Index