Chapter 36 Pain Management in Children Flashcards
What is Transduction
Nociceptors (specialized nerve cell endings) are activated when exposed to noxious stimuli
What is Transmission?
Stimuli is converted to electrical impulses and relayed to spinal cord and brain by afferent nerve fibers and unmyelinated small C fibers. Neurotransmitters facilitate transmission process to the brain
What is Preception
Nerve fibers divide in the dorsal horn of the spinal cord, cross to the opposite side, and rise upward to the thalamus
A-delta fibers
Sharp, stabbing, local pain
C-fibers
Lead to diffuse, dull, burning, or aching pain
Pain threshold
Point where a person feels the lowest intensity of pain stimulus
What is Modulation
Neuromodulators modulate the pain sensation
Acute pain
Pain associated with a rapid onset of varying intensity. It indicates tissue damage that resolves with healing of the injury
Chronic Pain
Pain that persists past expected point of healing, provides no protective function, may be contionious or intermittent, can interfere with activities of daily living and sleep, may have periods of exacerbation and remission
Consequences of unrelieved pain respiratory
- Rapid shallow breathing- can lead to alkalosis
- Inadequate expansion of lungs- bronchoiectasis, atelectasis
- Inadequate cough- retention of secretions
Consequences of unrelieved pain Cardiovascular
Increased heart rate, tissue ischemia
Consequences of unrelieved pain Mobility
- will not spontaneously move in bed
- will not ambulate
Consequences of unrelieved pain Fluid & electrolyte
- rapid respipration and perspiration
- increased metabolic rate
Consequences of unrelieved pain Psychological consequences
Nightmares, anxiety, poor coping
Factors influencing pain
Age
gender
cognitive level
temperament
previous pain experiences
family and cultural background
situation factors
