Category:

Management of Cancer Pain

Course Outline

  • Cancers: lung, breast, colon, prostate, gynecological
  • Hodgkins disease
  • Non-hodgkins lymphoma
  • Leukemia’s
  • Children with cancer
  • Diagnostic testing
  • Chemotherapy
  • Radiation therapy
  • Alternative methods of treatment
  • Pain control
  • Maintaining nutritional status
  • Oncological emergencies
  • Psychological support
  • Legal and ethical issues
  • Care maps and the case manager

Learning Objectives

  1. Define the scope of cancer pain management.
  2. List 4 causes of pain in cancer patients.
  3. Discuss the probability of successful management of cancer pain.
  4. List 2 important reasons for controlling cancer pain.
  5. Discuss the relationship between cancer pain and quality of life.
  6. Define pain.
  7. List 3 barriers to cancer pain management.
  8. Discuss the relationship between cost and reimbursement for pain management.
  9. List 4 components of the initial pain assessment.
  10. State the primary source for pain assessment data.
  11. State 3 characteristics of a good pain assessment tool.
  12. State 3 times when pain should be assessed and documented.
  13. Discuss 3 potential causes for discrepancies between behaviors and a patient’s self- report of pain.
  14. List 8 common cancer pain syndromes.
  15. List the 3 major classes of drugs used in cancer pain management.
  16. State 3 recommendations for pharmacologic management of cancer pain.
  17. Discuss the importance of around-the-clock administration of pain medication.
  18. List 3 major side effects of NSAIDs.
  19. Define the following and give an example of each type of opioid:
    • Full agonist
    • Partial agonist
    • Agonist-antagonist
  20. State why meperidine should not be used in long-term management of cancer pain.
  21. Define opioid tolerance and discuss its clinical implications.
  22. Define opioid physical dependence and state the clinical application of this concept.
  23. List 4 routes of analgesic administration and discuss the pros and cons of each.
  24. List 5 side effects of opioids and discuss the nursing management of each.
  25. Define adjuvant drug and give 3 examples.
  26. Discuss the role of placebos in management of cancer pain.
  27. Discuss 3 principles to include in discharge planning of the patient being treated for cancer pain.
  28. List 3 physical modalities of pain management and state one precaution to follow with each.
  29. Discuss the role of exercise in cancer pain management.
  30. List 3 effect of prolonged immobilization.
  31. Discuss the role of psychological interventions in cancer pain management.
  32. List 3 advantages of relaxation techniques and imagery as part of a pain management approach.
  33. Define the following terms in relation to pain management:
    • Distraction
    • Reframing
  34. Discuss the role of patient education in cancer pain management.
  35. Discuss the role of pastoral care in cancer pain management.
  36. State the panel consensus regarding invasive palliative approaches to pain management.
  37. List 3 indications for palliative radiation therapy.
  38. State 3 precautions to be followed when administering radiation therapy.
  39. Define and give an example of each of the following:
    • Acute radiation effects
    • Late radiation effects
  40. Discuss the role of anesthetic techniques in management of cancer pain.
  41. Discuss nursing implications for neuroablation therapies.
  42. List 4 principles relevant to surgical management of pain due to primary or metastatic tumor.
  43. Discuss potential for chronic pain syndromes after surgery.
  44. List 4 factors to consider when managing procedure-related pain.
  45. Discuss 4 types of drugs used for management of procedural pain.
  46. State 2 important considerations when using conscious sedation for procedural pain.
  47. Discuss the panel consensus regarding managing pain in special populations.
  48. State the primary assessment method for young children and cognitively impaired adults.
  49. State a precaution to follow when administering opioids to infants.
  50. State the relationship between aging and opioid administration.
  51. Discuss the relationship between uncontrolled pain and new psychiatric symptoms, including depression.
  52. Discuss 4 factors to consider when managing cancer pain in patients diagnosed as substance abusers.
  53. Discuss the occurrence of pain in HIV infection.
  54. Discuss 2 considerations when evaluating cancer pain management.
  55. List 9 recommendations to be implemented in a cancer pain management practice setting.

Course Contents

Executive Summary

  1. Overview
  2. Assessment of Pain in the Patient With Cancer
  3. Pharmacologic Management
  4. Nonpharmacologic Management: Physical and Psychological Modalities
  5. Nonpharmacologic Interventions: Invasive Therapies
  6. Procedure Related Pain in Adults and Children
  7. Pain in Special Populations
  8. Monitoring the Quality of Pain Management

References

Attachment B: Pain assessment and management instruments

Attachment C: Sample relaxation exercises