Chapter 7 Pain

Question 1

what is the definition of pain

Answer 1

pain is the way your brain interprets information about unpleasant stimuli

Question 2

what are afferent pathways

Answer 2

nerves that carry messages to the brain for interpretion

Question 3

what are efferent (or descending) pathways

Answer 3

carry messages away from the brain via spinal cord

Question 4

what are nociceptors

Answer 4

• receptors that activate the afferent pathway
• found in body tissue (soma) and organs (viscera)

Question 5

what are pain receptors sensitive to?

Answer 5

• chemical changes
• temperature
• mechanical stimuli
• tissue damage

Question 6

when pain receptors are stimulated impulses are transmitted to what ?

Answer 6

the spinal cord

Question 7

what are some nervous system responses to pain?

Answer 7

increased hr, rr, and bp

Question 8

what is pain threshold vs tolerance?

Answer 8

pain threshold: the point at which pain is received
pain tolerance: length of time/intensity of pain a person can endure before outwardly responding to it

Question 9

what is the Gate Control Theory? (GCT)

Answer 9

• when the gate is open, pain sensation is allowed through
• what gate is closed pain sensation is blocked

Question 10

what are some nursing applications of gate control theory?

Answer 10

-activity in the small-diameter nerve fibers seems to open the gate
-activity in the large-diameter nerve fibers seems to close it

Question 11

what do endorphins do

Answer 11

attach to pain receptors and block pain sensation

Question 12

what is nociceptive pain

Answer 12

pain stimuli from body tissue (somatic) or visceral (organs) structures

Question 13

what is neuropathic pain?

Answer 13

associated with dysfunction of the nervous system involving an abnormality in processing sensations (associated with medical conditions rather than tissue damage)

Question 14

what are the four phases of nociceptive pain in order?

Answer 14

1. Transduction
2. Transmission
3. Perception
4. Modulation

Question 15

what happens during the transduction phase

Answer 15

when tissue damage causes the release of substances that stimulate nociceptors and initiates the sensation of pain

Question 16

what happens during the transmission phase

Answer 16

involves movement of pain sensation to spinal cord

Question 17

what happens during the perception phase

Answer 17

occurs when impulses reach the brain and pain is recognized

Question 18

what happens during the modulation phase

Answer 18

occurs when neurons in the brain send signals back down the spinal cord by release of neurotransmitters

Question 19

what are some physical factors that affect pain?

Answer 19

• pain threshold/pain tolerance
• age
• physical activity
• integrity of nervous system

Question 20

what are some psychological factors that affect pain?

Answer 20

• culture
• ethnicity
• religious beliefs
• past experiences
• anxiety
  -situational factors

Question 21

acute pain vs chronic pain

Answer 21

acute: has a known cause, surgical procedure, minor burn, sprained ankle lasts hours to days
chronic pain: may have a known cause lasts months to years

Question 22

what are some nonpharmacologic approaches to pain relief?

Answer 22

• sleep, relaxation, meditation
• meditation, music, massage
• hypnosis, biofeedback
• acupuncture, acupressure, TENS

Question 23

what are adjuvants? examples?

Answer 23

medications that assist with other issues and therefore also decrease pain ( but they are not pain meds)
- antidepressants, anticonvulsants, muscle relaxants, and marjuana

Question 24

what are some examples of opiods and nonopiods

Answer 24

opioids: morphine, oxycodone, hydrocodone
nonopioids: acetaminophen and NSAIDs

Question 25

special consideration/interactions in pain management ?

Answer 25

• aspirin and anticoagulant effects
• acetaminophen and liver toxicity

Question 26

what are some nursing considerations to be on the lookout for when relieving pain with medication?

Answer 26

constipation- fluid and fiber
drowsiness and euphoria
itching and hives
respiratory depression
addiction to narcotics

Question 27

what are some elder care points

Answer 27

• pain perception does not diminish with age, it may increase as tolerance to pain decreases
• most common causes are joint pain, low back pain, pain from fracture sites

Question 28

special considerations for older adults?

Answer 28

• start low and slow, half the recommended dose
• older adults may feel pain as much as younger adults
• greater risk for under-treated pain
• evaluate response, drug effectiveness, side effects

Question 29

what are some invasive treatment of pain?

Answer 29

• sympathectomies
• rhizotomies
• cordotomies