CONCEPT OF PAIN

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.

Gate Control Theory

IV.

Responses to Pain

V.

Factors affecting Pain Experience

b. Ethical and cultural values
c. Developmental stage
Infant
Toddler and preschooler
School age child
Adolescent
Adult
elderly
d. Environment and support people
e. Past pain experiences

CONCEPT OF PAIN
f.

Meaning of pain

g. Anxiety and stress

VI.

Assessment of Pain
a. Pain History
Patient Interview Guide for Pain
Mnemonics for Pain assessment
o

OLDCART

PQRST

b. Pain Intensity or Rating Scales

Wong Baker FACES Rating Scale

10 point pain intensity scale

c. Pain Quality
d. Patterns of Pain
e. Precipitating Factors to Pain
f.

Associated Symptoms

g. Effect on Activities of Daily living (ADL)

h. Coping Resources
i.

Affective Responses

j.

Observation of Behavioral and Physiologic Responses

k. Daily Pain Diary

VII.

Nursing Diagnoses for Pain

VIII.

Nursing Management for Pain

1. Barriers to Pain Management
2. Pharmacologic Pain Management
a. Opiod analgesics
Types and Examples
Full agonist
Mixed agonist antagonists

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

Patient Controlled Epiduaral Analgesia (PCEA)

Continous Local Anesthetics

Patient controlled Analgesia

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.

Nonpharmacologic Invasive Procedures

Updates/Latest Trends in Pain Management

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

Course Code: Nursing Management 104

Course Title: Concept of Surgery
Time: 1:00-5:00 pm. MT
Course Objectives:
After studying the concept, the students should be able to:
1. Differentiate among the various types and purposes of surgery
2. Identify personal factors that increase the clients risk for complications and
immediately following surgery
3. Use effective communication when teaching clients and family members
about what to expect during the surgical experience
4. Assume the role of client advocate
5. Perform an accurate preoperative assessment of the clients physical and
psychosocial status
6. Identify laboratory value changes that may affect the client response to
drugs, anesthesia, and surgery
7. Describe the legal implications and proper procedures for obtaining informed
consent
8. Explain the purposes and techniques commonly used for client preoperative
preparation
9. Prioritize teaching needs for the client preparing for surgery
10.Recognize client conditions or issues that need to be communicated to the
surgical and postoperative teams
Course Outline:
I. Overview of Perioperative Nursing
a. Phases of Perioperative Nursing
b. Conditions Requiring Surgery
c. Classifications of Surgery

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

IV. The Patient in Postoperative Period

a. Hemostasis and Wound closure
b. Wound Healing
c. Classification of Surgical Wounds
d. Postoperative Complications

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.

AGE associated Problems

III.

Shock and Burns

a. Shock
1. Pathophysiology
2. Signs and symptoms
3. Treatment and nursing management
b. Burns
1. Pathophysiology
2. Signs and symptoms

CONCEPT OF PAIN
3. Treatment and management

IV.

Peripheral and Pulmonary Edema

a. Pathophysiology
b. Signs and symptoms
c. Treatment and management

V.

IV therapy and Tube Feedings

a. Purpose of IV therapy
b. IV solutions
c. IV procedure
d. Total parenteral nutrition (TPN)
e. Tube Feedings

CONCEPT OF PAIN

Concept: Cellular Aberrations