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Volume 16, Number 2, pages 12 - 17
Pain assessment and management for a dialysis patient with diabetic peripheral neuropathy
By Jennifer Innis, RN, MA, ACNP
Abstract
More than 50% of all patients with end stage renal disease (ESRD) have pain, and this pain is often due to diabetic peripheral neuropathy. Using a case study of a dialysis patient who has neuropathic pain, this article examines the assessment and management of this pain. Assessment is the essential first step. Patients’ self-report of pain is the most reliable and valid indicator of pain intensity. Pain may be managed through the use of non-opioids, opioids and adjuvants. However, for patients with ESRD on dialysis, certain considerations concerning drugs used to manage pain need to be taken into account. Complementary therapies have also been used in pain management in patients with ESRD, and there is a need for greater research in this area.
Learning objectives
After reading the article, the reader will be able to:
- Define diabetic peripheral neuropathy
- Identify symptoms associated with diabetic peripheral neuropathy
- Describe use of non-opioids, opioids and adjuvants in pain management
- Identify side effects of opioids
- Identify complementary therapies for pain in patients with ESRD
Author Affiliation(s): Jennifer Innis, RN, MA, ACNP, is a Nurse Practitioner, Pain Service, St. Michael's Hospital, Toronto, Ontario.