chap 9 Flashcards
pain is…
subjective
consequences of untreated pain
- unnecessary suffering
- physical/psychosocial dysfunction
- immunosuppression
- sleep disturbances
source of pain stimulates peripheral nerve endings
nociceptors
joint commission standards for pain management
require to improve pain assessment and management for all patients
transduction
injured tissue releases chemicals that affect nociceptors sending pain message up sensory neuron
transmission
pain impulse relays pain from spinal cord to brain
perception
pain perceived by brain
modulation
pain message is inhibited by brain stem neuron release of endogenous neurotransmitters
classification of pain
- nociceptive pain
- neuropathic pain
- inflammatory pain
nociceptive pain
normal response to noxious injury of tissues such as skin, muscles, visceral organs, joints, tendons, or bones
neuropathic pain
initiated/caused by primary lesion/disease in the somatosensory nervous system
inflammatory pain
result of activation and sensitization
types of pain
- acute
- chronic
- cancer
- intractable
- cutaneous
- visceral
- deep somatic
acute pain
- < 6 months
- associated w/ specific injury
- predictable beginning/ending
- self protective
chronic/persistent pain
- long term
- associated w/ specific cause of injury
- constant pain
- does not stop when injury heals
intractable pain
high resistance to pain relief
cutaneous pain
superficial pain
visceral pain
poorly localized, dull, or diffused pain
deep somatic pain
comes from sources such as blood vessels/joints/tendons/muscles/bone
7 dimensions of pain
- physical
- sensory
- behavioral
- sociocultural
- cognitive
- affective
- spiritual
QUESTT (pain in children)
- Q: question child
- U: use pain rating scales
- E: evaluate behavior/physiologic changes
- S: secure parents’ involvement
- T: take cause of pain into account
- T: take action and evaluate results
acute pain behaviors
- guarding
- grimacing
- moaning/agitation
- restlessness
- stillness
- diaphoresis
- change in VS
chronic pain behaviors
- bracing
- rubbing
- diminished activity
- sighing
- change in appetite
- sleep
when to reassess after pain medication
30 minutes
pain assessment tools
- visual analogue scale (VAS)
- numeric rating scale (NRS)
- numeric pain intensity scale (NPI)
- verbal descriptor scale
- simple descriptive pain intensity scale
- graphic rating scale
- verbal rating scale
- faces pain scales
3 most common pain assessment tools
- numeric rating scale (NRS)
- verbal descriptor scale
- faces pain scales
pain in neonates/infants
- N-PASS: neonates pain, agitation, & sedation scale
- Wong Baker FACES pain rating scale
- FLACC scale
FLACC scale
- face
- legs
- activity
- cry
- consolability
