Pain Management - Cheat Sheet
Your last-minute revision companion for Pain Management in Perioperative & Pain Nursing. This rapid-fire reference covers pain physiology, assessment tools, pharmacologic and non-pharmacologic management, critical safety rules, and high-yield NLE facts.
Pain Physiology & Definition
Important facts
- Transduction: noxious stimulus activates nociceptors → nerve impulse generated.
- Transmission: impulse travels peripheral nerve → spinal cord → brain.
- Perception: brain becomes conscious of pain.
- Modulation: body dampens or amplifies signal via endogenous opioids (endorphins) and descending pathways.
- Gate Control Theory: non-painful stimuli (rubbing, heat, massage) 'close the gate' in spinal cord and reduce pain transmission—rationale for non-drug measures.
- Pain is subjective; objective signs may be absent in chronic pain.
Key definitions
Pain (Gold Standard Definition)
Example
A patient reports 7/10 pain even if no objective signs are visible; this IS pain and must be treated.
Whatever the patient says it is, existing whenever the patient says it does—the patient's self-report is the MOST RELIABLE indicator.
Acute Pain
Example
Post-operative pain, acute fracture, appendicitis.
Recent onset, protective warning of tissue injury, resolves as healing occurs (under 3–6 months); accompanied by sympathetic responses (tachycardia, hypertension, diaphoresis).
Chronic (Persistent) Pain
Example
Diabetic neuropathy, chronic back pain, cancer pain.
Lasts beyond expected healing (longer than 3–6 months); may lack outward physiologic signs; associated with fatigue, depression, functional limitation.
Nociceptive Pain
Example
Post-surgical pain (somatic), post-MI pain (visceral).
From actual tissue damage; includes somatic (well localized, aching/throbbing) and visceral (deep, cramping, poorly localized, may be referred).
Neuropathic Pain
Example
Diabetic neuropathy, phantom limb pain, shingles.
From nerve damage or dysfunction; described as burning, shooting, tingling, electric-like.
Diagrams to know
- The four processes of nociceptive pain transmission (transduction → transmission → perception → modulation).
- Gate Control Theory mechanism in the spinal cord.
Pain Assessment Tools & PQRST
Common values
Value
30–60 minutes
Symbol
N/A
Quantity
Reassessment timing after oral analgesia
Value
15–30 minutes
Symbol
N/A
Quantity
Reassessment timing after IV analgesia
Value
0–10
Symbol
N/A
Quantity
FLACC total score range
Important facts
- Always REASSESS pain after intervention: 30–60 minutes post oral analgesia, 15–30 minutes post IV.
- Assessment includes effect on function, sleep, mood, and cultural factors.
- Patient's self-report is ALWAYS the gold standard—do not rely on objective signs alone.
- Use age-appropriate and condition-appropriate tools (nonverbal, pediatric, elderly).
- Document baseline pain, location, quality, severity, and response to treatment.
Key definitions
PQRST Mnemonic
Example
Patient states sharp pain in right lower quadrant, worse with movement, better with rest, began acutely 2 hours ago—classic appendicitis presentation.
Systematic pain assessment framework: Provocation/Palliation (what makes it better/worse), Quality (sharp/dull/burning/cramping), Region/Radiation, Severity (intensity on scale), Timing (onset/duration/pattern).
Numeric Rating Scale (NRS)
Example
Patient reports 7/10 pain.
0–10 scale where 0 = no pain, 10 = worst imaginable pain; standard for adults and older children.
Wong-Baker FACES Scale
Example
Child points to crying face = moderate to severe pain.
Cartoon faces from smiling to crying; useful for young children (~3 years+) and patients with communication barriers.
FLACC Scale
Example
Tight face (2) + rigid legs (2) + no activity (2) + high cry (2) + difficult to console (2) = 10/10.
Behavioral tool for infants and nonverbal patients: scoring Face, Legs, Activity, Cry, Consolability (each 0–2, total 0–10) by observation.
Diagrams to know
- PQRST framework for systematic pain history.
- Pain rating scales in visual format (0–10, faces, FLACC scoring).
WHO Analgesic Ladder & Non-Opioid Analgesics
Common values
Value
~4 g/day (less with liver disease)
Symbol
N/A
Quantity
Acetaminophen max daily dose
Value
5 days
Symbol
N/A
Quantity
Ketorolac max duration
Important facts
- WHO Ladder: use NON-OPIOIDS first (Step 1) before escalating.
- Dose analgesics AROUND THE CLOCK for continuous pain, not only 'as needed'.
- Acetaminophen MAX ~4 g/day (less with liver disease or alcohol use); hepatotoxicity is silent and dangerous.
- NSAIDs: give WITH FOOD, watch for black tarry stools (GI bleeding), monitor renal function, use caution in older adults and those with peptic ulcer disease.
- Adjuvant drugs (antidepressants, anticonvulsants like gabapentin/pregabalin, corticosteroids) especially useful for neuropathic pain.
- Ketorolac (Toradol) is short-acting ONLY (max 5 days)—high risk of GI and renal toxicity.
- Oral route preferred when patient can tolerate.
Key definitions
WHO Analgesic Ladder
Example
Start acetaminophen for post-operative pain; if inadequate, add codeine; if still inadequate, switch to morphine.
Three-step approach for pain management, especially cancer and chronic pain: Step 1 (mild) non-opioids → Step 2 (mild–moderate) weak opioids added → Step 3 (moderate–severe) strong opioids added; adjuvants at any step.
Acetaminophen (Paracetamol)
Example
Max dose ~4 g/day in adults; overdose antidote is acetylcysteine.
Non-opioid analgesic and antipyretic with MINIMAL anti-inflammatory effect; DANGER IS HEPATOTOXICITY.
NSAIDs (Ibuprofen, Naproxen, Ketorolac)
Example
Give with food to reduce GI upset; ketorolac for short-term only (risk of GI/renal damage).
Non-opioid analgesics that reduce pain, fever, inflammation by inhibiting prostaglandins; WATCH FOR GI BLEEDING, RENAL IMPAIRMENT, INCREASED BLEEDING.
Diagrams to know
- WHO Analgesic Ladder step-by-step progression.
- Acetaminophen vs NSAID comparison and adverse effects.
Opioid Analgesics - CRITICAL SAFETY
Common values
Value
< 12 breaths/min (institutional policy may vary)
Symbol
RR
Quantity
Respiratory rate threshold for holding opioid
Value
2–10 mg every 3–4 hours
Symbol
N/A
Quantity
Morphine typical IV dose
Value
10–30 mg every 3–4 hours
Symbol
N/A
Quantity
Morphine typical oral dose
Important facts
- RESPIRATORY DEPRESSION IS THE #1 OPIOID DANGER—assess RR BEFORE giving opioid.
- HOLD OPIOID DOSE AND NOTIFY PROVIDER IF RR < 12 (or per institutional policy); watch for increasing sedation which precedes respiratory depression.
- Monitor level of consciousness, oxygen saturation, and blood pressure.
- NALOXONE is the opioid antidote—short-acting; repeat dosing or infusion may be needed; can precipitate acute withdrawal and pain return.
- CONSTIPATION DOES NOT RESOLVE WITH TOLERANCE—treat proactively with stimulant laxative, fluids, fiber, activity.
- Adverse effects: respiratory depression, sedation, constipation, nausea/vomiting, urinary retention, hypotension, pruritus, miosis (pinpoint pupils).
- Use caution in older adults (more sensitive, slower clearance), respiratory disease, hepatic/renal impairment, opioid-naive patients.
- Patients with substance use disorder still deserve adequate pain relief; treat pain with clear monitoring plan.
- Tolerance, physical dependence, and addiction are DISTINCT—do NOT undertreat pain due to unfounded addiction fears.
- In cancer and palliative care, opioids are given generously; NO arbitrary ceiling on titration for severe pain.
Key definitions
Opioid Analgesics (Morphine, Fentanyl, Hydromorphone, Oxycodone, Codeine, Tramadol)
Example
Morphine: typical dose 2–10 mg IV or 10–30 mg orally every 3–4 hours, titrated to effect and per order.
Bind opioid receptors to relieve moderate to severe pain; MOST DANGEROUS RISK IS RESPIRATORY DEPRESSION.
Naloxone (Antidote/Reversal Agent)
Example
Give naloxone if RR < 8 or severe sedation; monitor for return of pain and acute withdrawal.
OPIOID ANTAGONIST that reverses respiratory depression and sedation in opioid overdose; short-acting (repeat dosing or infusion may be needed).
Tolerance
Example
Patient on long-term morphine may need dose escalation over time.
Need for increasing doses to achieve same analgesic effect; NOT the same as addiction.
Physical Dependence
Example
Sweating, anxiety, muscle aches if opioid is suddenly stopped.
Body's physiologic adaptation to opioid; withdrawal occurs on abrupt cessation; NOT the same as addiction.
Addiction
Example
Patient seeks opioids for euphoria, not pain relief; lies about doses.
Compulsive use despite harm, loss of control, continued use despite negative consequences; TRUE psychological disorder.
Diagrams to know
- Opioid safety checklist: RR assessment → dose decision → monitoring parameters → naloxone availability.
- Tolerance vs Physical Dependence vs Addiction comparison.
Patient-Controlled Analgesia (PCA)
Common values
Value
5–10 minutes
Symbol
N/A
Quantity
Typical PCA lockout interval
Important facts
- ONLY THE PATIENT should press the PCA button—NO family members, NO PCA by proxy.
- Teach patient to press button WHEN PAIN BEGINS, not waiting until pain is severe.
- Verify drug, concentration, dose, lockout interval, and limits with SECOND NURSE before use.
- Monitor respiratory rate, sedation level, oxygen saturation, pain relief; document amounts delivered and attempted.
- Ensure NALOXONE and resuscitation equipment are IMMEDIATELY AVAILABLE.
- Most common opioid for PCA: morphine.
- PCA works best for acute post-operative pain and acute exacerbations of chronic pain.
- If patient is sedated or respiratory depression develops, hold further dosing, check RR, consider naloxone.
Key definitions
PCA (Patient-Controlled Analgesia)
Example
Post-operative patient presses PCA button when pain begins; gets small IV morphine dose immediately.
Allows patient to self-administer preset IV opioid dose by pressing button; provides steady pain control and patient autonomy.
Lockout Interval
Example
Common lockout = 5–10 minutes; patient cannot receive another dose within this window even if button is pressed repeatedly.
Time period after each dose during which the PCA will not deliver another dose; prevents overdose.
PCA by Proxy
Example
Family member presses button to help patient → patient receives opioid doses patient didn't request → respiratory depression risk.
UNSAFE PRACTICE where family member or staff member presses the button for the patient; HIGH OVERDOSE RISK.
Diagrams to know
- PCA setup and operation flowchart.
- Lockout interval timeline.
Non-Pharmacologic Pain Management
Important facts
- Non-pharmacologic measures COMPLEMENT medications—not replace them.
- Especially valuable for CHRONIC PAIN and to REDUCE OPIOID REQUIREMENTS.
- Cutaneous stimulation: heat (muscle tension, arthritis), cold (acute injury, inflammation), massage, TENS unit.
- Cognitive-behavioral: relaxation and breathing techniques, guided imagery, distraction (music, TV, conversation), biofeedback.
- Positioning, rest, and immobilization of painful part reduce pain.
- Acupuncture and acupressure supported by some evidence.
- Support functional goals: improved sleep, activity, quality of life (especially chronic pain).
- Multimodal approach (combining pharmacologic and non-pharmacologic) is most effective.
Key definitions
Gate Control Theory Application
Example
Rubbing a child's bumped knee → non-painful sensory input closes gate → child feels less pain.
Non-painful stimuli (rubbing, heat, massage) 'close the gate' in spinal cord and reduce pain transmission; rationale for non-drug measures.
Cutaneous Stimulation
Example
Warm compress for muscle tension, ice pack for acute injury, TENS unit for chronic neuropathic pain.
Physical therapies: heat, cold, massage, TENS (transcutaneous electrical nerve stimulation).
Cognitive-Behavioral Strategies
Example
Guided visualization of peaceful place, listening to music, deep breathing exercises.
Mental techniques: relaxation, guided imagery, distraction, music, biofeedback.
Diagrams to know
- Gate Control Theory mechanism.
- Non-pharmacologic interventions categorized by type (cutaneous, cognitive-behavioral, positional).
Routes of Administration & Special Populations
Common values
Value
5–10 minutes
Symbol
N/A
Quantity
IV opioid onset time
Important facts
- ORAL ROUTE PREFERRED when patient can tolerate (cost-effective, patient preference).
- IV: fastest onset (~5–10 min), ideal for acute severe pain (post-operative, trauma).
- Transdermal (fentanyl patch): for STABLE chronic pain ONLY—NOT for acute or opioid-naive patients (risk of overdose).
- OLDER ADULTS: more sensitive to opioids/sedation, slower drug clearance, prone to NSAID-related GI and renal harm. START LOW AND GO SLOW; reassess frequently.
- OPIOID-NAIVE patients: EXTRA MONITORING for respiratory depression required.
- PEDIATRIC: dose by weight, use age-appropriate assessment tools (FLACC for infants/toddlers, Wong-Baker for young children, NRS 0–10 for older children).
- SUBSTANCE USE DISORDER history: still deserve adequate pain relief; establish CLEAR TREATMENT PLAN and CLOSE MONITORING.
- Use equianalgesic dosing charts when switching routes/drugs.
Key definitions
Equianalgesic Dosing
Example
Using equianalgesic chart when switching from oral morphine to fentanyl patch.
Converting between different opioid routes or drugs while maintaining same analgesic effect; prevents under- or over-dosing.
Routes of Analgesic Administration
Example
Oral for chronic pain, IV for post-operative acute pain, transdermal fentanyl patch for stable cancer pain.
Oral (preferred when tolerated), IV (fastest onset for acute severe pain), transdermal (stable chronic pain), subcutaneous, rectal, epidural, intrathecal.
Diagrams to know
- Routes of analgesic administration and onset times.
- Equianalgesic dosing principles.
Chronic Pain Management & Interdisciplinary Approach
Common values
Value
3–6 months
Symbol
N/A
Quantity
Chronic pain duration threshold
Important facts
- Chronic pain (>3–6 months) requires MULTIMODAL, INTERDISCIPLINARY approach—no single treatment is adequate.
- Set FUNCTIONAL GOALS, not pain elimination (often unrealistic).
- Address depression, anxiety, social isolation that accompany chronic pain.
- BELIEVE THE PATIENT'S REPORT—do NOT undertreat pain due to addiction fears.
- Adjuvant drugs crucial: antidepressants (amitriptyline, duloxetine), anticonvulsants (gabapentin, pregabalin), corticosteroids for neuropathic pain.
- Around-the-clock long-acting opioids + short-acting breakthrough doses in cancer pain.
- Monitor for tolerance (need more for same effect), physical dependence (withdrawal on abrupt stop), and addiction (distinct from tolerance/dependence).
- In cancer and palliative care: opioids given generously to relieve suffering—NO arbitrary ceiling on titration for severe pain.
- Coordination between specialists: pain management physician, nurse, physical therapist, psychologist, social worker.
Key definitions
Chronic Pain Management
Example
Chronic back pain patient: long-acting morphine + short-acting breakthrough dose + gabapentin + physical therapy + cognitive-behavioral therapy.
Multimodal, interdisciplinary approach combining analgesics (often around-the-clock long-acting with breakthrough doses), adjuvants, physical therapy, and psychological support.
Functional Goals
Example
Goal: patient can sleep 6 hours without interruption, walk 30 minutes daily, return to work part-time.
Patient-centered outcomes in chronic pain: improved sleep, activity, work, social participation, and QUALITY OF LIFE—NOT total pain elimination.
Diagrams to know
- Chronic pain management multidisciplinary team and approach.
- Tolerance vs Physical Dependence vs Addiction clarification.
Nursing Diagnoses & NLE High-Yield Content
Important facts
- Pain assessment is FOUNDATION of all pain management nursing diagnoses.
- ALWAYS ask patient about pain—do not assume absence of complaints means no pain.
- Document pain using PQRST; rate severity on standardized scale; reassess after intervention.
- Nursing interventions span pharmacologic (administer analgesics per order, monitor response, watch for adverse effects) and non-pharmacologic (positioning, comfort measures, distraction, relaxation).
- Patient education: how to use PCA, realistic pain goals, importance of around-the-clock dosing for chronic pain.
- Advocacy: ensure patient receives adequate pain relief; challenge myths about opioids and addiction.
- Cultural sensitivity: pain expression varies by culture; respect patient's pain management preferences.
- Coordinate with interdisciplinary team: physician, pharmacist, physical therapist, psychologist for optimal pain management.
Key definitions
NANDA-I Nursing Diagnosis: Acute Pain
Example
Acute Pain r/t post-operative incision AEB 8/10 on pain scale, tachycardia, guarding behavior.
Unpleasant sensory and emotional experience arising from actual or potential tissue damage, lasting less than 3 months; related to post-operative trauma, injury, inflammation.
NANDA-I Nursing Diagnosis: Chronic Pain
Example
Chronic Pain r/t diabetic neuropathy AEB report of burning sensation in feet, depression, sleep disruption, fatigue.
Pain lasting more than 3 months, may not have visible objective signs; related to chronic disease, cancer, neuropathy; impacts function and mood.
Diagrams to know
- Nursing process applied to pain management (assessment → diagnosis → planning → intervention → evaluation).
- Maslow hierarchy and pain (physiologic need; safety need for absence of suffering).
Must remember
- Pain is WHATEVER THE PATIENT SAYS IT IS, existing whenever the patient says it does—ALWAYS believe patient's self-report; objective signs may be absent, especially in chronic pain.
- ASSESS RESPIRATORY RATE BEFORE GIVING OPIOID; HOLD DOSE AND NOTIFY PROVIDER IF RR < 12 (or per institutional policy)—respiratory depression is the #1 opioid danger.
- NALOXONE (opioid antidote) is SHORT-ACTING; repeat dosing or IV infusion may be needed because naloxone wears off before the opioid does; have resuscitation equipment ready.
- CONSTIPATION DOES NOT RESOLVE WITH TOLERANCE—proactively prescribe stimulant laxative, fluids, fiber, and activity with all opioid regimens.
- ACETAMINOPHEN HEPATOTOXICITY is the #1 danger—max dose ~4 g/day in adults (less with liver disease/alcohol); antidote is acetylcysteine.
- NSAIDs CAUSE GI BLEEDING and RENAL IMPAIRMENT—give WITH FOOD; watch for black tarry stools; ketorolac short-term ONLY (max 5 days).
- ONLY THE PATIENT presses the PCA button—NO family members, NO 'PCA by proxy' (extreme overdose risk); verify drug/dose/lockout interval with second nurse.
- WHO LADDER (mild → moderate → severe) uses AROUND-THE-CLOCK DOSING for continuous pain, NOT as-needed; add adjuvants for neuropathic pain.
- TOLERANCE, PHYSICAL DEPENDENCE, and ADDICTION are DISTINCT—tolerance and dependence do NOT indicate addiction; do NOT undertreat pain due to addiction fears.
- REASSESS PAIN after intervention: 30–60 minutes after oral analgesia, 15–30 minutes after IV—document baseline pain, intervention, and response using PQRST and standardized scale.
Last minute tips
- If NLE question mentions 'patient says pain is 7/10 but has no vital sign changes'—THAT IS VALID PAIN. Believe the patient. Objective signs may be absent in chronic pain.
- For opioid questions: ALWAYS think 'respiratory depression first.' If respiratory rate is borderline (RR 12–14), reassess sedation level and consider holding dose pending provider evaluation.
- PCA by Proxy = WRONG AND DANGEROUS. Only patient presses button. Lockout interval prevents overdose. If patient is too sedated to press button, PCA is not appropriate.
- Acetaminophen toxicity is cumulative and SILENT (patient may have liver damage without symptoms). Remember ~4 g/day max and watch for products containing acetaminophen (many OTC combos).
- On chronic pain questions, remember the interdisciplinary team (MD, RN, PT, psychologist) and FUNCTIONAL GOALS (sleep, activity, QOL)—not total pain elimination. Address depression and anxiety.
Comparison tables
Pain Assessment Tools Comparison
| Tool | Population | Method | Scale Range | Key Advantage |
|---|---|---|---|---|
| Numeric Rating Scale (NRS) | Adults, older children | Self-report | 0–10 | Standard, quick, universally understood |
| Wong-Baker FACES | Young children (~3 yrs+), communication barriers | Point to cartoon faces | 0–10 (faces) | Visual, non-verbal, culturally universal |
| FLACC Scale | Infants, nonverbal, cognitively impaired | Behavioral observation (Face, Legs, Activity, Cry, Consolability) | 0–10 (each item 0–2) | Objective, no patient communication required |
Acetaminophen vs NSAIDs vs Opioids
| Analgesic Type | Onset | Peak Effect | Max Daily Dose | Key Adverse Effects | When to Avoid/Use Caution |
|---|---|---|---|---|---|
| Acetaminophen | 30–60 min (oral) | 1–2 hours | ~4 g/day (less with liver disease) | Hepatotoxicity (silent, dangerous) | Liver disease, chronic alcohol use, concurrent acetaminophen-containing products |
| NSAIDs (ibuprofen, naproxen, ketorolac) | 30 min (oral), 10 min (IV ketorolac) | 1–3 hours | Per drug; ketorolac max 5 days | GI bleeding/ulceration, renal impairment, increased bleeding | Peptic ulcer disease, renal disease, older adults, anticoagulant use; ketorolac short-term only |
| Opioids (morphine, fentanyl, hydromorphone, oxycodone) | IV 5–10 min, oral 30–60 min | IV 15–30 min, oral 1–2 hours | No ceiling (titrate to effect) | Respiratory depression (MOST DANGEROUS), constipation, sedation, nausea, urinary retention, hypotension, miosis | RR < 12, severe respiratory disease, opioid allergy; start low in older adults/opioid-naive; naloxone must be available |
WHO Analgesic Ladder by Pain Severity
| Step | Pain Severity | First-Line Drugs | Adjuvants | When to Escalate |
|---|---|---|---|---|
| Step 1 | Mild | Acetaminophen, NSAIDs | Adjuvants for neuropathic pain | If pain remains uncontrolled after adequate trial |
| Step 2 | Mild to Moderate | Weak opioids (codeine, tramadol) + non-opioids | Adjuvants for neuropathic pain | If pain remains uncontrolled after adequate trial |
| Step 3 | Moderate to Severe | Strong opioids (morphine, fentanyl, hydromorphone) + non-opioids | Adjuvants for neuropathic pain | Titrate opioid dose up; palliative care no ceiling on opioid |
Opioid-Related Concepts: Tolerance vs Physical Dependence vs Addiction
| Concept | Definition | Timeline | Reversible? | Indicates Addiction? |
|---|---|---|---|---|
| Tolerance | Need for higher doses to achieve same analgesic effect | Develops over days to weeks with regular use | Yes, by increasing dose | NO—tolerance does not indicate addiction |
| Physical Dependence | Body's physiologic adaptation; withdrawal (sweating, anxiety, muscle aches) occurs on abrupt cessation | Develops within days of regular opioid use | Yes, by gradual dose tapering | NO—physical dependence does not indicate addiction |
| Addiction (Opioid Use Disorder) | Compulsive use despite harm, loss of control, continued use despite negative consequences—TRUE psychological disorder | Varies; may develop over weeks to months | Requires treatment (behavioral therapy, medication-assisted treatment) | YES—addiction is the concern; requires different treatment approach |
Acute Pain vs Chronic Pain
| Feature | Acute Pain | Chronic Pain |
|---|---|---|
| Duration | < 3–6 months | > 3–6 months |
| Onset | Recent, sudden | Gradual or from previous acute injury |
| Cause | Warning of tissue injury | May not have clear ongoing tissue damage |
| Visible Signs | Sympathetic responses: tachycardia, hypertension, diaphoresis, facial grimace, guarding | May be ABSENT; no outward signs |
| Associated Symptoms | Anxiety, fear | Depression, fatigue, sleep disruption, functional limitation, social isolation |
| Management Approach | Pain relief as pain resolves with healing | Multimodal, interdisciplinary; focus on FUNCTIONAL GOALS and quality of life |
Nociceptive vs Neuropathic Pain
| Feature | Nociceptive Pain | Neuropathic Pain |
|---|---|---|
| Cause | Actual tissue damage or inflammation | Nerve damage or dysfunction |
| Types | Somatic (skin, muscle, bone—well localized, aching/throbbing) and Visceral (organs—deep, cramping, poorly localized, referred) | Burning, shooting, tingling, electric-like sensations |
| Examples | Post-surgical pain, fracture, appendicitis, myocardial infarction | Diabetic neuropathy, phantom limb pain, shingles, spinal cord injury |
| Response to NSAIDs/Opioids | Usually responds well to standard analgesics | Often POORLY responsive to opioids alone; requires adjuvants (gabapentin, pregabalin, antidepressants) |
Diagrams
Pain Management Complete Overview
Comprehensive mind map showing all major topics in pain management: physiology, types, assessment tools, pharmacologic and non-pharmacologic strategies, administration routes, special populations, and chronic pain considerations.
Opioid Safety Decision Tree - CRITICAL FOR RN PRACTICE
Critical decision tree for RN safety in opioid administration. Emphasizes respiratory rate assessment before dosing, sedation monitoring, and appropriate timing of reassessment based on route.
WHO Analgesic Ladder - Pain Management Escalation
Step-by-step escalation through WHO Analgesic Ladder from mild pain (Step 1: non-opioids) to severe pain (Step 3: strong opioids). Shows decision points for inadequate pain control and emphasis on around-the-clock dosing and adjuvant use.
Pain Assessment and Reassessment Timeline in Clinical Practice
Timeline showing critical reassessment intervals for different routes of pain medication: 15–30 minutes after IV analgesia, 30–60 minutes after oral analgesia, and ongoing monitoring for signs of adequacy and adverse effects.
Acute vs Chronic Pain: Clinical State Differentiation
State diagram showing the clinical progression and differentiation between acute pain (recent onset, visible signs, resolves with healing) and chronic pain (persists >3–6 months, may lack visible signs, requires interdisciplinary approach and focus on functional goals).
Components of Comprehensive Pain Management Approach
Pie chart illustrating the relative importance and integration of different components in comprehensive pain management: pharmacologic treatment, non-drug interventions, patient education, team coordination, and functional outcomes.