SCIENTIFIC BASIS:

Type 1 Complex Regional Pain Syndrome (CRPS 1), formerly known as reflex sympathetic
dystrophy (RSD), is characterized by unpredictable progression and an unclear etiology,
often presenting with pain, swelling, and vasomotor dysfunction in an extremity. Trauma
or surgical procedures commonly precede its onset, though it can also arise from limb
immobility or occur without an identifiable trigger. Referred to as shoulder-hand
syndrome when linked to hemiplegic upper limb after a stroke, CRPS 1 often presents
with pain severity disproportionate to the initial injury or trauma, complicating its
management and requiring comprehensive care approaches.

General Objectives:

After 3 days of student nurse-patient interaction, the patient will verbalize

understanding of pain management strategies.

Specific Objectives:

After 4 hours of student nurse-patient interaction, the patient will be able to:

1. Report a reduction in pain intensity from 9/10 to 4/10 within 2 weeks.

2. Verbalize an increased sense of control and enhanced enjoyment of life.
3. Verbalize and demonstrate (nonverbal cues) relief and/or control of pain or
discomfort.

NURSING ACTIONS
1. Identify contributing factors.
a. This can help in developing targeted interventions, and with specifically
identifying the underlying factors or causes, thus nurses can further
tailor the care plans in addressing the specific needs and promote
effective outcomes. This can enable a comprehensive understanding of
the client’s health status.
2. Evaluate current and past analgesic, opioid, or other drug use.
 a. This is to understand the client’s pain management history and to
identify potential contributors that exacerbate their condition so that
we can learn what to avoid and what to include in the care plan. This
assessment guides nurses in identifying any needs for changes in the
medication regimen, minimizing risks of medication interactions or
tolerance development.

3. Evaluate pain behavior, noting past and current pain experience, using a pain
rating scale or diary.
a. enables nurses to gather objective data on the intensity and frequency
of the client's pain. This information informs treatment decisions,
facilitates monitoring of pain management effectiveness over time, and
guide adjustments to the pain management plan for optimal pain relief
and improved quality of life.
4. Ensure a comfortable and quiet environment to minimize stimuli that may exacerbate pain.
a. To support the patient's comfort and reduce sensory input and
minimize stimuli from intensifying pain or discomfort. This helps in
supporting the client’s ability to cope with the pain and enhance the
effectiveness of the interventions being given.
5. Acknowledge and assess pain matter-of-factly, avoid undue expressions of
concern.
a. To expound on the rationale, this provides a beneficial impact on a
client’s perception of health by fostering a therapeutic environment
where clients feel understood and supported without feeling
overwhelmed by emotions. This approach helps maintain professional
boundaries while effectively addressing the client's needs, promoting
trust and collaboration in pain management strategies.
6. Encourage participation in a multidisciplinary pain management plan.
a. This addresses complex issues of unresolved pain, and set goals for pain
relief and empowers clients to take an active role in their care and
access comprehensive treatment options. This collaborative approach
integrates medical, psychological, and rehabilitative interventions,
 optimizing pain relief and improving overall quality of life by addressing
the multifaceted nature of pain.
7. Review client pain management goals and expectations versus reality.
a. To ensure alignment between treatment plans and client needs and to
improve quality of life and ensure that clients can participate in daily life
activities.
8. Recommend or employ non pharmacological interventions, methods
of pain control (e.g., heat or cold applications, meditation, etc.)
a. To obtain comfort, improve healing, and decrease dependency on
analgesics
9. Encourage and assist family members to learn homecare interventions
a. To reduce pain level and offer a sense of comfort to client that he/she
has the support of SO. This enhances the family’s ability to provide
effective assistance and provides promotion of continuity and support
beyond healthcare settings.
10. Educate the patient and family about CRPS, including the nature of the
condition, potential triggers, and long-term management strategies.
a. To empower clients into actively participating in their management of
pain and care, make informed decisions, and adapt lifestyle practices to
manage CRPS effectively.