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    Teknik Assesment Nyeri

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    srinining
    This document discusses various tools for assessing pain, including scales for measuring pain intensity and multi-dimensional scales. It describes the Leeds Assessment of Neuropathic Symptoms and Signs pain scale and ID Pain tool for distinguishing between nociceptive and neuropathic pain. Guidelines are provided for dosages of non-opioid and opioid analgesics. The importance of adequate pain management is discussed to avoid cardiovascular, pulmonary, gastrointestinal, renal, immune, and psychological issues. A multimodal approach including medication, physical therapy, and psychological approaches is recommended.

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    Teknik Assesment Nyeri

    Uploaded by

    srinining
    56 views20 pages
    This document discusses various tools for assessing pain, including scales for measuring pain intensity and multi-dimensional scales. It describes the Leeds Assessment of Neuropathic Symptoms and Signs pain scale and ID Pain tool for distinguishing between nociceptive and neuropathic pain. Guidelines are provided for dosages of non-opioid and opioid analgesics. The importance of adequate pain management is discussed to avoid cardiovascular, pulmonary, gastrointestinal, renal, immune, and psychological issues. A multimodal approach including medication, physical therapy, and psychological approaches is recommended.

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    belajar manajemen nyeri

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    This document discusses various tools for assessing pain, including scales for measuring pain intensity and multi-dimensional scales. It describes the Leeds Assessment of Neuropathic Symptoms and Signs pain scale and ID Pain tool for distinguishing between nociceptive and neuropathic pain. Guidelines are provided for dosages of non-opioid and opioid analgesics. The importance of adequate pain management is discussed to avoid cardiovascular, pulmonary, gastrointestinal, renal, immune, and psychological issues. A multimodal approach including medication, physical therapy, and psychological approaches is recommended.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    56 views20 pages

    Teknik Assesment Nyeri

    Uploaded by

    srinining
    This document discusses various tools for assessing pain, including scales for measuring pain intensity and multi-dimensional scales. It describes the Leeds Assessment of Neuropathic Symptoms and Signs pain scale and ID Pain tool for distinguishing between nociceptive and neuropathic pain. Guidelines are provided for dosages of non-opioid and opioid analgesics. The importance of adequate pain management is discussed to avoid cardiovascular, pulmonary, gastrointestinal, renal, immune, and psychological issues. A multimodal approach including medication, physical therapy, and psychological approaches is recommended.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 20

    TEKNIK

    ASSESMENT
    NYERI
    H.
    Asriadi.,S.Kep.,Ns.,M.Kep

    Untuk membedakan antara nyeri nosiseptif


    dan nyeri neuropatik dapat digunakan

    ID Pain
    LANNS (The Leeds Assessment ofNeuropathic Symptoms and
    Signs Pain Scale)

    Pain Assessment Scales


    Uni-Dimensional Scale
    Only measures pain intensity
    Appropriate for acute pain
    The most common scale used in
    outcome assessment (Analgesic
    efficacy)

    Verbal Rating Scale (VRS)


    Numeric Rating Scale (NRS)
    Visual Analog Scale (VAS)
    Wong Baker Pain Rating Scale

    Multi-Dimensional Scale
    Both intensity (severity)
    and unpleasantness
    (affective)
    Appropriate for chronic pain
    Research /pathophysiology
    Should be used in clinical
    outcome assessment

    McGill Pain Questionnaire (MPQ)


    The Brief Pain Inventory (BPI)
    The Memorial Pain Assessment Card
    Catatan harian nyeri (Pain diary)

    TOOL LAIN DALAM ASSESSMENT NYERI

    Neonatal Infant Pain Scale


    Nonverbal Pain Indicators (CNPI)
    Pain Assessment in Advanced Dementia
    Scale (PAINAD)
    FLACC singkatan dari Face, Legs, Activity, Cry, and
    Consolability
    Comfort Scale
    Opoid risk tool
    Behaviour Checklist Addiction
    Addiction Behaviors Checklist (ABC)

    Photographic/Numeric Pain Scale

    Modified
    McGill Pain
    Questionnaire
    15 Minutes

    Sensorik
    Afektif
    Evaluatif
    Macam2
    IRN
    INS
    71,4% Baik
    28,6% Lumayan
    dan sedang

    Treatment

    Relief

    General Activity
    Mood
    Walking ability

    Worst
    Least

    Normal work
    Relation with other people
    Sleep

    Average
    Enjoyment of life
    Right Now

    Quicker and easier


    Well established reliability
    in cancer, arthritis, and
    AIDs.
    Sensory, affective and
    functional status
    Useful for treatment
    response
    Takes up to 15 min
    Good choice for patients
    with progressive disease

    Patient Pain Diary


    Pain Scale

    10

    Dose
    Morning

    Dose
    Afternoon

    Evening

    Bedtime

    Location: Patient or nurse marks drawing

    Intensity: Patient rates the pain. Scale Used:

    Quality: Use patints words, e.g. prick, ache, burn, sharp, hot etc.
    Onset, duration, variations, rhythms (spontaneus or evoked):
    Manner of expressing pain: (Pain Behaviour)
    What relieves the pain?

    ultimodal Pain Management


    Coordinated use of medication & non medication
    to control the pain
    Consider the psycho-socio-cultural-spiritual aspects
    Acute pain interventions
    Treatment
    Methods

    Remove the
    cause
    of pain

    Surgery
    Splinting

    Drug therapy

    Non-opioid
    Aspirin & other

    NSAIDs
    Paracetamol
    Combinations

    Opioid

    Physical
    methods

    Regional
    analgesia

    High-tech

    Morphine Epidural infusion


    Local anaesthetic
    Others
    + opioid

    Low-tech
    Nerve bloks
    Local
    anesthetic
    + opioid

    Psychological
    approaches

    Physiotherapy Psychoprophylaxis
    Manipulation
    TENS
    Acupunture
    Ice

    Relaxation
    Hypnosis

    WHO Pain Ladder

    AKIBAT KELOLA NYERI YANG TIDAK


    ADEKUAT
    1.Kardivaskuler
    2.Paru

    3.Gastrointestinal
    4.Ginjal
    5.Koagulasi
    6.Imunologi
    7.Otot

    8.Psikis

    1.Takikardi, Hipertensi,
    Naiknya kerja jantung
    2.Spasme otot nafas,
    penurunan VC, atelektasis,
    arterial hypoxemia,
    naiknya risiko infeksi paru.
    3.Ileus pascaoperasi.
    4.Retensi urin, risiko oliguri.
    5.Risiko tromboemboli.
    6.Gangguan fungsi imunitas.
    7.Kelemahan otot, kelelahan,
    mobilitas terbatas, risiko
    tromboemboli.
    8.Ansietas, ketakutan,
    frustasi, rasa tidak
    nyaman.

    Adult dosing guidelines for non-opioid


    analgesics
    Drug
    Paraaminophenols
    Salicylates

    ROUTE
    Oral
    Oral

    Ibuprofen
    Ketoprofen
    Indomethacin
    Ketorolac

    Oral
    Oral
    Oral
    IV

    Diclofenac Potassium
    Meloxicam
    Piroxicam
    Elexoxib

    Oral
    Oral
    Oral
    Oral

    Dose

    500-1000 mg/4-6hr
    max dose adults
    4000 mg.
    500-1000 mg/4-6hr
    max dose adults
    4000 mg.
    400 mg/4-6hr.
    25-50 mg/6-8hr.
    25mg/8-12hr.
    30mg initial.1530mg/
    6-8hr not >5 days.
    50 mg/8hr.
    7.5-15 mg/24hr.
    20-40 mg/24hr.
    100-200 mg/12hr

    Opioids
    Analgesic
    1.Morphine iv dose 0.1 mg/kg with additional
    doses of 0.05 mg/kg.
    2.Meperidine iv dose 1 mg/kg with additional doses
    0.5 mg/kg.
    3.Fentanyl iv dose 2 3 mcg/kg with additional
    doses titrated by 0.5 mcg/kg until desired level of
    analgesia is reached.

    Paediatrics
    Morphine (i.d. 0.05 0.1 mg/kg iv, then
    titrate, maximum 10 mg/dose.
    or
    Fentanyl (i.d 1-2 g/kg, then titrate,
    maximum 100 g/dose)

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