Pathophysiology Master of Nursing Custom Essay
This is an assignment for peer 1 and 2.
Differentiate between acute and chronic pain. Which medication or therapies would be useful in treating these disorders? Also, describe the differences between somatic and visceral pain. Which organs or structures are typically affected to produce these two types of pain?
Please comment begin commenting on 2 of your peers’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress
Peer #1 Sheilla
Working on the medical/oncology floor, there are several patients who present with pain resulting from many different locations. We often hear a physician or nurse say the patient is just drug seeking. In treating pain, it is important for the care team to acknowledge their bias and treat the patient according to what he or she says the pain is.
When assessing a patient’s pain, the nurse should differentiate between an acute or chronic onset of pain. Acute pain is determined by pain that is precipitated from an injury, lasting for a short amount of time, and is no longer present after the underlying trigger has been treated. The purpose of the acute pain is to notify the person of the location and damage of the tissue involved. “The pain’s location, radiation, intensity, and duration, as well as those factors that aggravate or relieve it, provide essential diagnostic clues” (Porth & Matfin, 2009, p. 1241). Chronic pain is different from acute pain, in that it lasts for a longer period of time, usually six months or more. “Chronic pain is pain that persists longer than might be reasonably expected after an inciting event and is sustained by factors that are both pathologically and physically remote from the originating cause” (Porth & Matfin, 2009, p. 1241). Chronic pain can be debilitating in that the constant, and at times, intermittent pain affects a person’s psychological, physical, economic and familial aspect of life. A person living with chronic pain can become depressed or irritated that the pain cannot be managed, which in turn, has an effect on other areas of life.
There are several treatment options when managing a person’s pain. Analgesic pain medications are useful for treating acute pain as well as chronic pain. “Analgesic drugs do not cure the underlying cause of the pain, but their appropriate use may prevent acute pain from progressing to chronic pain” (Porth & Matfin, 2009, p. 1245). There are two types of analgesics to treat pain, non-narcotics (non-steroidal anti-inflammatory drugs [NSAIDs] and acetaminophen), and opioid analgesics. Other therapies used to treat pain include cognitive-behavioral interventions, such as relaxation, distraction, cognitive appraisal, imagery, meditation, and biofeedback. Physical agents, like heat and cold properties, have been used to treat pain. The choice for which to use depends on the type of pain experienced and the personal preference of the patient. Heat dilates blood vessels, and increases blood flow. It is helpful in stretching joints and muscles. Cold therapies function opposite from heat, in that is provides vasoconstriction of the blood vessel. Stimulus-induced analgesia is an older form used for pain relief, in that it’s been around for years. A transcutaneous electrical nerve stimulator (TENS), acupuncture, and neurostimulation are stimulus-induced ways to reduce pain.
Somatic pain takes place in deep body structures and is localized in nature, but can also radiate to other areas of the body from the original site. For example, muscles, tendons, joints, and blood vessels. This pain is described by the patient as a throbbing pain. Visceral pain is like somatic pain, being that the visceral pain is felt all over. Visceral pain originates from the organs, but can be referred to other areas of the body and include autonomic reflexes, such as nausea. The organs effected to produce this type of pain are thoracic, cervical, and abdominal viscera, and excludes the liver and lung parenchyma. Specifically, the thyroid gland, trachea, arteries, veins, lung, and heart are thoracic visceral organs. Abdominal visceral organs include, peritoneum, stomach, duodenum, intestine, colon, spleen, pancreas, kidney, adrenal gland, appendix, and gall bladder. The cervical viscera involve, pelvis, ovaries, testicles, uterus, bladder, and rectum.
Peer # 2 Bonnie
Pain is a normal part of life. It an uncomfortable or unpleasant sensation to the body that warns us we have been hurt or an indication something is wrong. It can appear suddenly or come about slowly. Pain is individualized and can range from mild and occasional to severe and constant. Pain can be classified as acute or chronic.
Acute pain starts suddenly, sharp in quality, but does not last long. Though it serves as a warning of disease or threat to the body, it can be caused by other circumstances such as surgery, broken bones, dental work, burns or cuts, and labor and childbirth. Acute pain may be mild and last only a moment, or severe and last for weeks or months, but never longer than 6 months. It disappears when the underlying cause is treated. Unrelieved acute pain can lead to chronic pain.
Chronic pain continues log after an injury has healed, remaining active in the nervous system for weeks months and even years. The pain itself becomes the disease. Chronic pain is usually associated with an underlying condition. Chronic pain is intense pain that lasts three months or longer and does not resolve in response to any treatment. It can be affected by physical (sitting, standing), environmental (weather changes), and psychological (stress) .Chronic pain cannot be treated or cured, it can only be managed. Therefore chronic pain may reduce quality of life, well-being and ability to function long term (Medicine Net, 2013).
Depending upon the severity of the pain it can be treated in a number of ways. Symptomatic options for treatment of pain include one or more of the following: NSAIDs such as Motrin or Aleeve; Tylenol; narcotics such as morphine or codeine; localized anesthetic; nerve blocks; acupuncture; electrical stimuli; physical therapy; surgery; relaxation techniques and behavior modifications.
Somatic pain is a type of nociceptive pain, generally described as musculoskeletal pain. It is easier to locate than visceral pain, but is more intense. The nerves that detect somatic pain are located in the skin and deep tissue. These specialized nerves, called nociceptors, pick up sensations related to temperature, vibration and swelling in the skin, joints and muscle (Porth, 1997).
Visceral pain is internal pain, coming from the organs or blood vessels. Nociceptors (pain detecting nerves) send an impulse from the painful site up the spinal cord into the brain. Visceral pain may feel dull and vague, harder to pinpoint. Examples of visceral pain are: irritable bowel syndrome; bladder pain; endometriosis pain; prostate pain. Other areas would be stomach and ureters (Porth,1997).
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