Question

When teaching a patient about transcutaneous electrical nerve stimulation (TENS), which of the following represent an accurate description of the nonpharmacological therapy? (Select all that apply.) A. Turn TENS on before patient feels discomfort. B. TENS works peripherally and centrally on nerve receptors. C. TENS does not require a health care provider order. D. Remove any skin preparations before attaching TENS electrodes. E. Placing electrodes directly over or near the pain site works best.

Short answer

The accurate descriptions of TENS are B (TENS works peripherally and centrally on nerve receptors), D (Remove any skin preparations before attaching TENS electrodes), and E (Placing electrodes directly over or near the pain site works best).

Step-by-step solution

Understanding TENS

Transcutaneous Electrical Nerve Stimulation (TENS) is a nonpharmacological method that uses low-voltage electrical currents to relieve pain. The therapy involves the use of a battery-powered device that delivers electrical impulses through electrodes attached to the skin.

Assessing Each Statement

Evaluate each statement against the known principles and applications of TENS therapy to determine if it is accurate.

Evaluating Statement A

Turn the TENS on before the patient feels discomfort is not a standard recommendation. TENS is generally used as needed for pain relief and therefore does not need to be turned on before discomfort begins.

Evaluating Statement B

TENS works both peripherally by stimulating nerves at or near the site of pain, and centrally by modulating pain perception in the central nervous system. Therefore, this statement is accurate.

Evaluating Statement C

TENS typically requires a prescription or a healthcare provider's order, particularly when used for the first time, as it needs to be tailored to the specific needs of the patient. So, this statement is inaccurate.

Evaluating Statement D

Skin should be free of lotions, oils, or other skin preparations before attaching TENS electrodes to ensure good adhesion and electrical contact. Therefore, this statement is accurate.

Evaluating Statement E

For the best effectiveness, electrodes should be placed directly over or near the pain site, following a pain management provider's instructions. Thus, this statement is accurate.

Key concepts

Nonpharmacological Pain Relief

Nonpharmacological pain relief refers to methods of managing pain without the use of drugs. One such method is Transcutaneous Electrical Nerve Stimulation (TENS), which is widely recognized as an effective tool for pain control. TENS therapy administers mild electrical currents to the skin, stimulating nerves to alleviate pain.

The primary goal of TENS is to interrupt the pain signal pathways to the brain, thereby decreasing an individual's perception of pain. It is particularly beneficial for individuals seeking an alternative to medications, which can have side effects or potential for dependency. With increasing interest in holistic and integrative health approaches, nonpharmacological options like TENS are valuable components of a comprehensive pain management plan.

Nonpharmacological approaches can also include a variety of other methods such as physical therapy, cold and heat application, acupuncture, massage, relaxation techniques, and cognitive-behavioral therapy. Combining TENS with these modalities may further enhance pain relief and provide holistic benefits to the patient.

TENS Therapy Application

The application of TENS therapy is a straightforward process but requires some basic knowledge and preparation. To begin a TENS session, the areas of pain must be identified to strategically place the electrodes. The TENS unit is a small, portable device with adjustable settings, allowing the intensity and pulse of the electrical current to be tailored to an individual's comfort and therapeutic needs.

During the application, the electrical impulses transmitted through the electrodes can feel like a tingling or buzzing sensation, which should not be painful. The duration and frequency of TENS therapy can vary based on the intensity of pain and response to the treatment. It is typically recommended to start with shorter sessions and gradually increase based on the patient's comfort level and therapeutic outcomes.

Key Points for TENS Therapy Application:

• Identify and prepare the pain area.
• Adjust the TENS unit settings for comfort and therapeutic needs.
• Start with shorter sessions and increase as needed.
• Track patient’s response to adjust therapy accordingly.

Proper guidance from a healthcare provider is essential for optimizing the effectiveness of TENS therapy and ensuring patient safety.

TENS Electrodes Placement

The placement of TENS electrodes is crucial for the effectiveness of the therapy. It is generally advised to position the electrodes either directly over the area of pain or along the nerve pathways that are associated with the pain. For optimal results, the electrodes should be placed at a proper distance from each other, as outlined by the device's manual or a healthcare professional's recommendation.

Incorrect placement can reduce the efficacy of TENS therapy and may lead to discomfort. Prior to attaching the electrodes, ensure the skin is clean and free from any lotions or oils to provide good adhesion and conductivity. Adhesive pads attached to the electrodes should be applied firmly to the skin to maintain consistent contact throughout the therapy session.

Best Practices for Electrode Placement:

• Clean and dry the application area thoroughly.
• Place electrodes directly over or near the pain area, avoiding broken or irritated skin.
• Follow device instructions for ideal distance between electrodes.
• Reposition electrodes if tingling sensation is not felt or pain persists.

Correct electrode placement is a delicate balance between following general guidelines and customizing the approach to each individual's needs, emphasizing the importance of professional input for successful pain management with TENS.