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Course Title: NCM 102- Curative and Preventive Nursing Care Management
Placement: Second Semester, BSN III
Units: 16 units (8 units lecture, 8 units RLE)
Concept: Pain
Objectives:
1. Identify types and categories of pain according to location, etiology, and
duration
2. Differentiate pain threshold from pain tolerance
3. Describe the four processes involved in nociception and how pain
interventions can work during each process
4. Identify the subjective and objective data to collect and analyze when
assessing pain
5. Identify examples of nursing diagnoses for clients with pain
6. Identify barriers to effective pain management
7. Describe pharmacologic interventions for pain
8. Describe non- pharmacologic interventions for pain
Concept Content:
I.
Nature of Pain
a. Types of pain
1. Duration
Acute pain
Chronic pain
2. Origin
Cutaneous pain
Deep somatic pain
Visceral pain
3. Location Experienced in the Body
Radiating pain
Referred pain
CONCEPT OF PAIN
Intractable pain
Neuropathic pain
Phantom pain
b. Concepts associated with pain
1. Pain threshold
2. Hyperalgesia
3. Pain sensation
4. Pain reaction
5. Pain tolerance
II.
Physiology of Pain
a. Nociception
1. Transduction
2. Transmission
3. Perception
4. modulation
III.
IV.
Responses to Pain
V.
CONCEPT OF PAIN
f.
Meaning of pain
Assessment of Pain
a. Pain History
Patient Interview Guide for Pain
Mnemonics for Pain assessment
o
OLDCART
PQRST
Associated Symptoms
Affective Responses
j.
VIII.
CONCEPT OF PAIN
Partial agonist
Side effects of opiods
Nursing Considerations
Routes for Opiod Delivery
Oral
Nasal
Rectal
Subcutaneous
Intramuscular
Intraspinal
o
Bolus
Continous Infusion
b. Equianalgesic drugs
c. Adjuvant analgesics
d. Nonopiod Analgesics/ NSAIDS
Examples of NSAIDS
Side Effects of NSAIDS
Nursing Consideration
3. WHO Three Step Ladder Approach
4. Nonpharmacologic Pain Management
a. Physical interventions
b. Cutaneous stimulations
c. Immobilization
d. Transcutaneous Electrical Nerve Stimulation (TENS)
e. Distraction
CONCEPT OF PAIN
f.
IX.
TEACHING STRATEGY:
Reporting
Class discussion
Problem Method
Drill Method
COURSE REQUIREMENTS:
a. Examination
b. Research Paper
c. Graded Computations
Grading:
25%- Participation
25%- Short and long Quizzes
25%- Prelim, Midterm, Final Exams
10%- Projects/ Reaction Papers
10%- Attendance
5%- Attitude
REFERENCES:
Brunner and Suddarth, Medical Surgical Nursing, ( Lippincott Williams and
Wilkins: New York), vol 1 & 2 , 10th ed.
Lewis et al., Medical Surgical Nursing: Assessment and Management of
Clinical Problems, (Mosby Publishing Company: New York), vols., 1 and 2, 7 th Ed.
Kozier et al., Fundamentals of Nursing, 4th Ed.,
Udan, Josie., Medical Surgical Nursing: Review Textbook, 2 nd edition.
Luckmann and Sorensen Medical Surgical Nursing
Sandra Smith NCLEX-RN Medical Surgical Nursing Textbook/
CONCEPT OF PAIN
CONCEPT OF PAIN
a.1 according to degree of risk
a.2 according to urgency
a.3 according to reasons of surgery
a.4 according to extent of surgery
a.5 according to type
d. Factors Affecting Surgery
e. Special Considerations in Surgery
e.1 ambulatory surgery patient
e.2 elderly patients
e.3 obese patients
e.4 patients with disabilities
e.5 patients undergoing emergency surgery
II. The Patient in Preoperative Period
a. Preoperative Assessment of Factors that Affect Patients
b. Physical Preparation
c. Preoperative teaching
d. Pain Management
e. Informed Consent
f. Preoperative Psychosocial Preparations
III. The Patient in Intraoperative Period
a. The Perioperative/ Surgical Patient Care team
a.1 members of the surgical team
a.2 functions and responsibilities of perioperative nurse
a.3 roles of intraoperative nurse
b. The Surgical Environment
b.1 physical facilities
b.2 zones
c. Surgical Asepsis and Sterile Technique
c.1 microbiologic considerations
c.2 principles of asepsis and sterile technique
c.3 attire, surgical scrub, gowning and gloving
c.4 skin preparation, positioning, therapeutic positions
c.5 draping
c.6 decontamination and disinfection
c.7 sterilization
d. The Surgical Experience
e. Pharmacology and Anesthesia
e.1 Surgical Pharmacology
e.2 Anesthesia: Techniques and Agents
1. ASA Physical Status Classification System
2. Stages of Anesthesia
Beginning anesthesia
Excitement
Surgical anesthesia
Medullary depression
3. Types of Anesthesia and Sedation
General anesthesia
Regional anesthesia
Epidural
CONCEPT OF PAIN
f.
Spinal
Local conduction blocks
4. Spinal Set Preparation Guide
e.3 Sutures
Assessment of suture line
Methods of suturing
Suture sizes
Types of suture material:
1. Absorbable
Surgical gut: plain and chromic
Collagen sutures
Synthetic absorbable polymers
Polydioxanone suture
Poliglecaprone 25
Polyglyconate
Polyglactin 910
Polyglycolic acid
copolymer
2. Nonabsorbalbe
Surgical silk
Surgical cotton
Surgical stainless steel
Surgical nylon
Polyester fiber
Polybutester
Polyethylene (dermalene suture)
Polypropylene
Tissue Adhesives
1. Biologic Adhesives
2. Synthetic Adhesives
3. Antimicrobial suture
Removal of Sutures
Potential Intraoperative Complications
d.1 nausea and vomiting
d.2 hypoxia and other respiratory complications
d.3 hypothermia
d.4 malignant hyperthermia
d.5 disseminated intravascular coagulopathy
CONCEPT OF PAIN
Prepared by:
CONCEPCION BINAMIRA CLEMENA, RM, RN
Bicol College
COLLEGE OF NURSING
Daraga, Albay
Concept: Fluids and Electrolytes
I.
Body Fluids and Electrolytes Compartments, Distribution and Functions
A. Body Fluids
d. Movement of fluids between compartments
e. Body water and its functions
B. Electrolytes
a. Functions of ectrolytes
b. Normal lab values
CONCEPT OF PAIN
c. Internal Regulation of Body Fluids and Electrolytes
d. Fluid imbalances
1. Hyperosmolar imbalances
2. Hypoosmolar imbalances
3. Isotonic imbalaces
e. Electrolyte Imbalances (Excess and Deficits)
1. Sodium
2. Potassium
3. Calcium
4. Magnesium
5. Phosphorus
C. Acid Base Imbalances
a. Regulation of acid base balance
b. Respiratory acidosis
c. Respiratory alkalosis
d. Metabolic acidosis
e. Metabolic alkalosis
II.
III.
CONCEPT OF PAIN
3. Treatment and management
IV.
V.
CONCEPT OF PAIN