The Fifth Vital

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Avoid the use of meperidine, codeine, and propoxyphene (available in combination with acetaminophen, as Darvocet). His life is full of lying, sneaking around, selling drugs, family problems, police problems, and a whole hell of a lot of danger. Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when pain is effectively treated. Patients may report pain in the absence of any observable or documented physiologic changes. To be patient-centered, respect the patient’s verbal and nonverbal expressions of pain without making judgments or inferences about the reality of the pain. If patients perceive that health care professionals doubt the existence of their pain, mistrust and other negative feelings can arise and interfere with a therapeutic nurse-patient relationship. Zhang H, Li N, Li Z, Li Y, Yu Y, Zhang L. Zhang H, et al. Front Pharmacol. 2022 May 3;13:898574. doi: 10.3389/fphar.2022.898574. eCollection 2022. Front Pharmacol. 2022. PMID: 35592413 Free PMC article. Review.

Character and quality of pain. What words does the patient use to describe the pain and its character, quality, or intensity? Pain is also a major economic problem and a leading cause of disability that hampers the lives of many people, especially older adults. Chronic pain is the most common cause of long-term disability, affecting millions of Americans and others throughout the world. Unable to escape the noose of addiction, he eventually lost the trust and support of everyone who had ever loved him. Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PAPurser L, Warfield K, Richardson C. Making Pain Visible: An Audit and Review of Documentation to Improve the Use of Pain Assessment by Implementing Pain as the Fifth Vital Sign. Pain Manag Nurs. 2014; 15( 1):137–42. doi: 10.1016/j.pmn.2012.07.007

I love this podcast and recommend it to so many of my supporters and readers looking for holistic reproductive health information. Lisa offers so many perspectives, angles within the field of sexual health, reproductive health and body literacy.Pain is complex and by trying to box it into a vital sign may unwittingly diminish the importance of a comprehensive pain assessment. While the 5th vital sign helps to recognize a patient is in pain this information is not complete. What is necessary is that clinicians possess the foundational knowledge critical for untangling the contributors to pain and the knowledge of management options based on these contributors. Lorenz KA, Sherbourne CD, Shugarman LR, Rubenstein LV, Wen L, Cohen A, Goebel JR, Hagenmeier E, Simon B, Lanto A, Asch SM. Lorenz KA, et al. J Am Board Fam Med. 2009 May-Jun;22(3):291-8. doi: 10.3122/jabfm.2009.03.080162. J Am Board Fam Med. 2009. PMID: 19429735 Clinical Trial.

Morphine-like substances called endorphins are released when the large-diameter nerve fibers are stimulated. These fibers close the gate and decrease pain transmission. This helps explain why many noninvasive pain management techniques work to relieve pain. Endorphins are thought to be a gene product, and producing them requires a stimulus to the brain. In your hospital, is there a regular evaluation of the quality of the pain records in the hospital charts? n (%) The attitudes of health care professionals toward pain influence the way they perceive and interact with patients in pain. Without adequate assessment skills or knowledge of pain and analgesic therapy, they may not be able to understand their patients’ pain.

Is there written orientations distributed through the departments on how to proceed with the patients’ pain recording? If yes, could you please send us a copy?