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Nursing Care Adults with Chronic Issues > 6.1 Pain > Flashcards

6.1 Pain Flashcards

1
Q

Pain

A
  • Primary reason people seek healthcare
    Acute - Surgery, Trauma, Pain
    Chronic - Cancer, Back Pain
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2
Q

Endocrine (Chronic Pain)

A
  • Increases cortisol
  • Increased epinephrine
  • Increased diuretic hormone
  • Decreased insulin
  • Decreased testosterone
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3
Q

Metabolic (Chronic Pain)

A
  • Hyperglycemia

- Insulin Resistance

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4
Q

CVD (Chronic Pain)

A
  • Increased HR
  • Increased workload
  • Increased PVR (Pulmonary Vascular Resistance)
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5
Q

Respiratory (Chronic Pain)

A
  • Decreased Flow and Volume
  • Atelectasis
  • Decreased cough
  • Infection
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6
Q

Genitourinary (Chronic Pain)

A
  • Decreased Urinary Output (UOP)
  • Retention
  • Fluid Overload
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7
Q

GI (Chronic Pain)

A
  • Decreased gastric and bowel motility
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8
Q

Musculoskeletal (Chronic Pain)

A
  • Spasm
  • Fatigue
  • Immobility
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9
Q

Cognitive (Chronic Pain)

A
  • Mental Confusion
  • ## Reduction in Cognitive Function
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10
Q

Immune (Chronic Pain)

A
  • Depression of Immune Response
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11
Q

Developmental (Chronic Pain)

A
  • Increased behavioral and physiological responses of pain
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12
Q

Future Pain (Chronic Pain)

A
  • Affects the way you handle future pain

Chronic Pain Syndromes - Phantom Pain

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13
Q

Quality of Life (Chronic Pain)

A
  • Sleeplessness
  • Anxiety
  • Increased thoughts of suicide
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14
Q

Influences of Pain

A
  • Age, Sex, Gender, Race, Socioeconomic Status.

- Affects every body system

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15
Q

Cancer Chronic Pain vs Non-Cancer Chronic Pain

A
  • Breakthrough pain (Acute Exacerbations)
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16
Q

Nociceptive Pain

A
  • Tissue injury

- Normal Pain

17
Q

Neuropathic Pain

A
  • Abnormal pain

- Pathologic and results from damage to CNS or PNS

18
Q

Processes of Nociceptive Pain

A

Transduction - Stimuli activates afferent neuroreceptors
Transmission - Action potential transmitted across nerve
Perception - Activation of brain for awareness
Modulation - Response to the stimuli

19
Q

Neuropathic Pain

A
  • Mechanisms drive by damage to PNS or CNS
  • Abnormal processing of stimuli
  • May occur in absence of tissue damage and inflammation
  • Phantom pain, diabetic neuropathy, shingles pain
20
Q

Pain Assessment

A
  • Location
  • Intensity
  • Quality
  • Onset
  • Duration
  • Aggravating/Relieving Factors
  • Effects on quality of life
  • Comfort and function goals
21
Q

Pain Assessments

A
  • 1-10 scale
  • Wong-Baker FACES scale for children
  • Faces pain scale revised - Similar to Wong-Baker
  • Verbal Descriptor Scale - (pain, mild pain, severe pain. Describe pain as a phrase)
  • Visual Analog Scale (VAS) - (No pain to Worst Possible pain). Line with words across it.
  • Hierarchy of pain measures - Non-Verbal Patients
  • FLACC - Used for young children, look at facial expressions, leg movement, activity, crying
22
Q

Pain Assessments (cont)

A
  • Pain AD - For Advanced Dementia

- CPOT - Critical Care Patient Observation Tool for ICU patients who are intubated and cannot talk

23
Q

Pharmacological Pain Management

A
  • Opioids (inhibits nociceptive pain)
  • NSAID’s (inhibit prostaglandins)
  • Local Anesthetics (block nerve conduction at local level)
24
Q

Nonopioid Analgesic

A

Tylenol, Ibuprofen,

25
Q

Opioid Analgesics

A
  • Morphine, Fentanyl, Oxycodone
26
Q

Adjuvant Analgesic

A
  • Local anesthetics (lidocaine patch)
  • Anticonvulsants (Neurotin/gabapentin)
  • Antidepressants (Elavil/amitriptyline)
  • Ketamine (Dissociative Anesthetic)
27
Q

Physical Dependence

A
  • Physical Dependence
  • Do not abruptly stop. Taper off
  • Abrupt stop will show signs of withdrawal
28
Q

Tolerance

A
  • Needs higher dose to achieve same effect
29
Q

Addiction

A
  • Chronic relapsing treatable neurological disease
  • Genetic/psychosocial/environmental factors lead to addiction
  • Compulsive use and craving for effects other than pain relief.
30
Q

Pseudo-Addiction

A
  • Problem with patient not being treated correctly for pain relief
  • Often mistaked for drug seeking patients
  • Not accurately or adequately treated for pain relief
31
Q

Elderly and Medication

A
  • Start low go slow
  • NSAID’s can cause GI Issues especially in elderly
  • Sensitive to adjuvant analgesic’s such as anti-depressants and anti-convulsant for chronic pain
  • Opioids should be reduced by 25-50% dose (70+)
32
Q

Non-Pharmacological Pain Relief

A
  • Physical Therapy
  • Occupational Therapy
  • Hot/Cold
  • Proper Alignment
33
Q

Cognitive/Behavioral Pain Relief

A
  • Relaxation
  • Breathing
  • Music
  • Humor
  • Pet therapy
  • Herbs
  • Medicine
  • Yoga
34
Q

Steps of Pain

A
  • After injury, nerves send a signal to the spinal cord
  • Signal enters spinal cord via the dorsal root
  • Nociceptors release “Substance P”
  • Second order neuron receives information from substance P and sends information towards the brain
  • ## Travels to brain via spinothalamic tract (goes to thalamus)
35
Q

Alpha Delta Receptors

A
  • Myelinated and produce fast, well localized, sharp pain
36
Q

C-Fibers

A
  • Unmyelinated and produce slow poorly localized pain

- Burning and Throbbing pain

37
Q

Nociceptors

A
  • Afferent Fibers because they bring information into the brain

Nursing Care Adults with Chronic Issues (16 decks)

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