Medical-surgical Nursing Demystified

(^536) Medical-Surgical Nursing Demystified

Pain

Pain is sensed through nerve endings, which are generously spread throughout the

internal tissues and the skin. The brain is the only structure without pain receptors.

When pain receptors are stimulated, discomfort or pain results, prompting that

action be taken to remove the cause of the pain. The pain impulse travels along

sensory fibers of the spinal nerves to the spinal cord and then to the brain, which

interprets the degree and source of the pain. The brain can then signal nerve fibers

to release chemicals to inhibit pain signals. Some of the chemicals—enkephalins,

serotonin, and endorphins—are able to suppress pain signals and provide endoge-

nous pain control. Visceral pain is pain from an organ secondary to surgery, cramp-

ing, ischemia, stretching, or spasms. Referred pain is the sensation of pain coming

from another part of the body than where it actually originates. It is common for

heart pain to be felt in the arm, jaw, or back. The pain impulses from the heart

travel the same circuit as the receptors in these areas, confusing the interpretation

in the brain.

Key Terms

Adjuvant modalities

Biofeedback

Electomyography

Endorphins

Enkephalins

Likert scale

Neuroleptics

Serotonin

Serum levels

Acute pain

Chronic pain

Peripheral neuropathy

Phantom limb pain

Substance use disorders

Drug addiction

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Learning Objectives