Chapters 1, 2, 3, 4, 8, 9, 10, 11, 12, 13 Flashcards
Annular Lesions
Description: circular, begins in center & spreads to periphery
Ex. Ringworm
Confluent Lesions
Description: lesions run together
Ex. Urticaria (hives)
Discrete Lesions
Description: distinct, individual lesions that remain separate
Ex. Skin tags, acne
Gyrate Lesions
Description: twisted, coiled, spiral, snakelike
Linear Lesions
Description: a scratch, a streak, line or stripe
Zosteriform Lesions
Description: linear arrangement along unilateral nerve route
Ex. Herpes Zoster
Grouped Lesions
Description: clusters of lesions
Ex/ Vesicles of contact dermatitis
Target Lesions
Description: resembles iris of eye, concentric rings of color in lesions
Ex. Erythema Multiforme
Polycyclic Lesions
Description: annular lesions grow together
Ex. psoriasis, lichen planus
Macule Lesion
Description: soley a color change, flat & circumscribed of less that 1 cm.
Ex. Freckles, petechiae, measles, scarlet fever
Papule Lesion
Description: solid elevated, circumscribed less than 1 cm.
Ex. Mole or Wart
Patch Lesion
Description: Macules that are larger than 1 cm.
Ex. mongolian spot, cafe au lait spots, measles rash
Nodule Lesions
Description: solid elevated, hard or soft, larger than 1 cm.
Ex. xanthoma, fibroma
Wheal Lesion
Description: superficial raised, transient & erythematous, slightly irregular shape from edema
Ex. Mosquito bite, allergic reaction
Urticaria Lesion (Hives)
Description: wheals coalesce to form extensive reaction, intensely pruritic
Vesicle Lesion
Description: elevated cavity containing free fluid, up to 1 cm. “blister”
Ex. Herpes simplex, early varcellia, herpes zoster
Bulla Lesion
Description: Larger than 1 cm. usually single chambered superficial to epidermis; thin walled & ruptures easily
Ex. Friction blister, burns
Cyst Lesion
Description: Encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevated
Ex. sebaceous cyst, wen
Pustule Lesion
Description: turbid fluid (pus) in the cavity. Circumscribed and elevated
Ex. Impentigo, acne
Crust Lesion
Description: The thickened, dried out exudate left when pustules burst or dry up
Ex. Impetigo (dry-honey color), scab
Scale Lesion
Description: Compact desiccated flakes of skin dryor greasy, silvery or white from shedding of dead excess keratin cells
Ex. Eczema, psoriasis, ichthyosis, seborrheic dermatitis
Fissure Lesion
Description: linear crack with abrupt edges, extends into dermis
Ex. Cheilosis (corners of mouth), athlete’s foot
Erosion Lesion
Description: Scooped out but shallow depression. Superficial; epidermis lost; no bleeding (b/c does not extend to dermis)
Ulcer Lesion
Description: Deeper depression extending into dermis, irregular shape; may bleed
Ex. Stasis ulcer, pressure injury
Excoriation Lesion
Description: self-inflicted abrasion; superficial; scratches from intense itching
Ex. insect bite, scabies, dermatitis
Scar Lesion
Description: After a skin lesion is repaired normal tissue is lost and replaced with connective tissue (collagen)
Ex. healed area of surgery, injury, or acne
Atrophic Scar Lesion
Description: Skin level is depressed with loss of tissue, thinning of epidermis
Ex. Striae
Keloid Lesion
Description: A benign excess of scar tissue beyond sites of original injury. May occur months-years after original trauma. Most common in ages 10-30 Africans, Hispanics, Asians.
Primary Skin Lesions
Macule Papule Patch Plaque Nodule Wheal Tumor Urticaria Vesicle Bulla Cyst Pustule
Secondary Skin Lesions
Crust Scale Fissure Erosion Ulcer Excoriation Scar Lichenification Keloid Atrophic Scar
Lichenification Lesion
Description: Prolonged intense scratching eventually thickens skin and produces tightly packed sets of papules
Lanugo
The fine downy hair of the newborn infant
Vitiligo
The complete absences of meanin pigment in patchy areas.
When assessing Skin Lesions what do the ABCDE’s stand for?
A- Asymmetry B- Border C- Color variation D- Diamete E- Elevation
What color occurs on the skin with anemia, shock, arterial insufficiency?
Gray - Dark Skinned
Pallor - Light Skinned
When red-pink tones from oxygenated hemoglobin are lost the skin take on color of ___ tissue
Connective
Cyanosis
A blush-ish color from decreased profusion
Diaphoresis
Profuse perspiration
Diaphoresis accompanies (4 things)
Thyrotoxicosis
Heart Attach
Anxiety
Pain
What does the skin feel like during Hyperthyroidism?
Smooth, soft, like velvet
What does the skin feel like during Hypothyroidism?
Rough, dry, and flaky
Anasarca
Bilateral edema, generalized over whole body (consider central problem. Ex. Heart or Kidney failure)
Cherry (Senile) Angiomas
Small, slightly raised red dots that commonly appear on the trunk
What integumentary defect occurs when congenital cyanotic heart disease, lung cancer or pulmonary diseases occur?
Clubbing of the nails
Mongolain Spot
Hyperpigmenttion in African American, Asian, American Indian, And Latino newborns. Occurs usually around sacrum, or butt, sometimes on abdomen or arms
Cafe Au Lait Spots
Large round or oval patch of light brown pigmentation. Usually present at birth
What do you consider if you observe 6 or more Cafe Au Lait Spots on a newborn?
Neurofibromatosis
Erythema Toxicum
Common rash that appears first 3-4 days of life “Flea-bite rash”
Acrocyanosis
Temporary blue-ish color around lips, hands and fingernails in newborn
What could persistent Acrocyanosis be a sign of?
CyanoticCongenital Heart Disease
Cutis Marmorata
a transient mottling in trunk or extremities
What could persistent Cutis Marmorata occur with?
Down Syndrome or Prematurity
What are indicators of fetal distress?
Green-brown discoloration of skin, nails, and cord with passing of meconium in utero
Milia
tiny white papules on the forehead and eyelids caused by sebum that occludes the opening of the follicles
Physiologic Jaundice
Normal in 50% of newborns
Develops after the 3-4 day of life because of increased number of RBCs
What does Jaundice in a 1 day old baby indicate?
Hemolytic Disease
What does Jaundice in a 2 week old baby indicate?
Biliary Tract Obstruction
What does excessive sweating in children indicate?
Hypoglycemia, Heart Disease, Hyperthyroidism
Nevus Simplex or Stork Bite
Flat irregularly shaped red/pink patch on forehead or back of neck in newborns
Open Comedones
Blackheads
Closed Comedones
Whiteheads
Striae
“Stretch marks”
Linea Nigra
Brown-ish-Blackline down the midline if abdomen in pregnant women
Chloasma
Irregular brown patch of hyperpigmentation on the face of pregnant women
Why are Vascular Spider common in pregnant women?
Increase estrogen
5 or more spider angioma possibly indicate what in pregnant women?
Liver Disease
Senile Lentigines
Common variations of hyperpigmentation in older adults “Liver spots”
Keratoses
Raised thickened areas of pigmentation
Crusty, scaly or warty
Seborreic Keratoses
Dark, greasy, and” Stuck on”
Not cancerous
Actinic Keratoses
red-tan scaly plaques that increase in numbers and become raised and rough
Are premalignant
What is a healthy capillary refill time?
1.5-2 seconds; 4 seconds MAX
Sebaceous Hyperplasia
Raised yellow papule with a central depression
Occur in older adults
Subjective Data
What the person SAYS about him/herself
Objective Data
What you OBSERVE about the patient during assessment
What 6 Phases are included in the Nursing Process?
Assessment Diagnosis Outcome Identification Planning Implementation Evaluation
First Level Priority Problems
Life threatening - Emergent
Ex. ABC’s
Second Level Priority Problems
Require intervention before further deterioration
Ex. Mental status, acute pain, abnormal labs, risk of infections
Third Level Priority Problems
Require attention but can be attended to after more emergent problems
What is focus-centered database?
For limited/short-term problems
“Mini database”
What is a follow-up database?
Evaluated at regular intervals after initial visit
Used in both acute and chronic problems
What is a complete database?
Includes complete health history and full physical exam, both present and past health problems
What is an Emergency Database
Urgent rapid collection of crucial info and often compiled concurrently with lifesaving measures
Holistic Health
consideration of the whole person
Biomedical Theory
Theory of illness causation assumes that all events in life have a cause and effect.
“Germ Theory”
Naturalistic Theory
Believe that the forces of nature must be kept in natural balance or harmony
The Naturalistic Theory is most common in what 2 cultural groups?
American Indians
Asians
Magicoreligious Perspective
The world depends of supernatural forces for good and evil
Ex. Voodoo & Witchcraft
What does FICA mean?
Faith, Importance/Influence, Community, Address/Action
When do you use FICA?
To obtain a spiritual history
What does RCOPE questions have in common?
the word “God”
When do you use RCOPE?
To understand how a person is coping with loss or illness
As the interviewer what 4 internal factors should you be aware of?
Liking Others
Empathy
Ability to Listen
Self-Awareness
As the interviewer what 1 external factor should you be aware of?
The physical setting
As the interviewer how much space should be between you and the patient?
4-5 feet
Equal-Status Seating
Both you and the client should be comfortably seated at eye level with nothing in front of you. Chairs at 90 degrees
When do you use an open-ended question?
Begin interview
Introduce new sections of questions
Whenever the patient introduces a topic
When do you use closed/direct questions?
To elicit specific information
To fill in any details the patient may have left out
For what ages of a child would you focus more of the caregiver?
1-6
What could cause the child to feel threatened?
The interviewer standing above the child
Maintaining eye contact
What kind of words/sentences do you use when speaking to a child?
Short/simple words and sentences
Piaget’s Stage: Sensorimoter
Birth-2 years
Vocabulary: >200 words (mostly nonverbal communication)
Manipulation of Objects
Piaget’s Stage: Preoperational
2-6 years
Vocabulary: >10,000 words (grammar and language to communicate)
Symbolic Thinking
Piaget’s Stage: Concrete Operations
7-11 years
Vocabulary: Passive tense mastery; complex grammar
Logical Thinking; numbers
Piaget’s Stage: Formal Operations
12+ years
Vocabulary: Near adult-like
Abstract Thinking; futuristic; broad
Icebreakers for School-Aged-Childern
Friends, activities, sports, school
Adolescence stage begins with ___
Puberty
____ is the most important thing you can communicate to an adolescent
Respect
True/False: Ask adolescents questions about him/herself before health concern questions.
True. The adolescent wants to talk about him/herself first. Ask open ended questions about friends, schools, activities.
What kind of questions do you ask adolescents?
Short and simple
True/False: For an adolescent more emotionally charged questions should be asked later in the interview.
True. You have now developed a trust after the first parts of the interview. They are more willing to be truthful with you. Opportunity to discuss interventions. Praise good behaviors
Always address an older adult by his/her ____
Surname
What kind of questions do you ask older adults?
NOT short or simple; could be perceived as “baby talk”
Is it okay to touch the adolescent when beginning interviewing?
No, not before the physical exam
Is it okay to touch the older adult before beginning the interview?
Yes, nonverbal communication is important to older adults.
When a hearing-impaired patient who prefers lip-reading is being interviewed, What kind of person is best for this task?
A healthcare provider without a beard or mustache and no foreign accent.
What are the don’t to interviewing a patient who lip reads?
Exaggerating lip movement, shouting
What are the do’s to interviewing a patient who lip reads?
Slow speech with hand gestures
These drugs are CNS depressants
Alcohol, Benzodiazepines, Opioids (Heroin, methadone, Morphine, Oxycodone)
What do CNS depressants do?
Slow brain activity, and impair judgement, memory, intellectual performance and motor skills.
These drugs are simulates of the CNS
Cocaine and Amphetamine
What do CNS stimulates do?
Cause intense high, agitation, and paranoid behavior
These drugs are hallucinogens
LSD, Ketamine, PCP
What do hallucinogens do?
Cause bizarre, inappropriate, sometimes violent behavior. Superhuman strength and insensitivity to pain
What kind of question do you ask a patient under the influence of drugs?
Nonthreatening questions and manners
What do you avoid while interviewing someone under the influence?
Confrontation & turning your back to them
What is the top priority when interviewing someone under the influence?
Find out the time the patient took their last drug, how much it was, and what exactly it was
What do you do first when interviewing someone who is already angry?
Deal with the angry feelings first before starting the interview.
What is the Health History Sequence?
Biographic Data Reason for seeking care Present health Past history Medication reconciliation Family history Review of systems Functional Assessment or ADLs
What does ADL mean?
Activities of Daily Living
Symptom
A SUBJECTIVE sensation that the person feels from the disorder
Sign
An OBJECTIVE abnormality that you as the examiner could detect on physical examination or through diagnostic testing
Present Health includes:
Location Character/Quality Quantity/Severity Timing Setting Relieving Factors Associated Factors Patient's Perception
Past Health includes:
Childhood Illnesses Accidents/Injuries Serious/Chronic Illnesses Hospitalizations Operations Obstetric History Immunizations Last Exam Date Allergies Current Medications
Medication Reconciliation
A comparison list of current medications with a previous list. The purpose is to reduce errors and promote patient safety
Medications include:
Over the counter medication (Especially aspirin) Vitamins Birth control Antacids Cold Remedies Herbal Medications
What are the three purposes fro review of systems?
- ) To evaluate the past and present health state of each body system
- ) To double-check in case any significant data was omitted in Present Illness Section
- ) To evaluate health promotion practices
What is the order of system review examination?
Head-to-Toe
What is important to mention when reviewing the Musculoskeletal System?
History of arthritis or gout
How do you ask about Intimate Partner Violence?
With open-ended questions first. If they feel unsafe, follow up with closed/direct questions
How do you ask about Prenatal Status?
Start with open-ended questions. “Tell me about your pregnancy.”
What are common pediatric allergies?
Cow’s milk, eggs, peanuts, tree nuts, soybean, and fish
What is the difference between a true allergy and a food intolerance?
True Allergy: Can be life threatening
Food Intolerance: Causes distress, and illness, non life threatening
What motor skills should a school-aged-child posess?
Run, jump, climbs, rides bike, coordinated skills: tie shoe, uses scissors, language skills: tell time, vocabulary
What should be recorded when taking a nutritional history of an infant?
If the child is breastfed or bottle fed Nursing frequency, duration Any supplements Method of weaning Formula type Any problems Introduction to solid foods
What should be recorded when taking a nutritional history of a preschool and school-aged-child
Appetite 24-hour recall Vitamins Junk food Parent's perception of child's nutrition
What does HEEADSSS stand for?
H -Home Environment E- Education E- Eating A- Activities D- Drugs S- Sexuality S- Suicide/Depression S- Safety
How many hours of sleep does a teen need?
9 hours per night
When do you use HEEADSSS?
When interviewing an adolescent
Palpation
Applies sense of touch while examining a patient
What can fingertips feel best when palpating?
Fine tactile discrimination: texture, swelling, pulsation, and lumps
What can grasping with finger and thumb feel best when palpating?
Position, shape, and consistency of organ or mass
What can the dorsa of the hands and fingers feel best when palpating?
Temperature
What can the base of fingers feel best when palpating?
Vibration
Percussion
Tapping the person’s skin with short, sharp strokes to assess underlying structures
Inspection
Concentrated watching
What sound would come from normal lung tissue?
Medium/loud, low pitched clear/hollow sound
What sound would come from a child’s lung or an adult with emphysema?
Louder low pitched booming sound
What sound would come from a stomach or intestine?
Loud high pitched musical sound
What sound would come from a dense organ?
Soft high pitched muffled sound
What sound would come from a location where no air is present? (Muscle/Bone)
Very soft high pitched sound with a dead stop/dullness
What 4 characteristics are assessed when performing percussion?
Amplitude
Pitch
Quality
Duration
What sounds are heard best by the diaphragm?
Breath, bowel, and normal heart sounds
What sounds are heard best by the bell?
Extra heart sounds or murmurs
What lighting is best for an examination room?
Tangenital Lighting
True/False: The Otoscope can be use to inspect the ear and nose
True.
Opthalmascope
illuminates the internal eye structures
Which microorganisms are antibiotic resistant and difficult to treat?
MRSA, VRE, and tuberculosis
Which microorganism are most effectively rid by alcohol?
Mycobacterium tuberculosis, Hepatitis B & C, and HIV
When examining a patient what should you start with? (So they don’t feel a threat?
Vital Signs (Make small talk), then examine hands (skin)
What is the major task of the infant?
Establishing trust
When should an examination occur for an infant?
1-2 hour AFTER feeding
True/False: It is okay to examine a baby while it is sleeping
True.
What should you do when the infant is fussy?
Offer brightly colored toys
Should you keep eye contact with an infant while examining?
Yes.
What should you use when performing invasive steps on an infant?
A pacifier
What do you perform at the end of the examination with an infant?
The Moro “Startle” reflex
What is the major task of a toddler?
Developing Autonomy
Where should the toddler be sitting when the examination is performed?
The caregiver’s lap
Who should undress the toddler for examination?
The caregiver
What is the major task for a preschool child?
Developing initiative
What age will a child feel comfortable of the exam table?
4 or 5 years old
How can you reduce the fears of a preschool child?
Let him/her play with equipment first
What should you provide when examining a preschool & adolescent child?
Reassurance and Praise
What should you examine first when examining a preschool child?
Thorax, abdomen, extremities, and genitals
What should you examine first when examining an adolescent?
Head-to-toe assessment - Genital last
What is the major task of an adolescent?
Developing self-identity
What is the major task of a school-aged-child
Developing industry
When can a child decide whether a caregiver can stay in the examination room?
Age 11 or 12
What is the major task of an older adult?
Developing the meaning of life and one’s own existence
Should the adolescent be examined with a caregiver in the room?
No
When a patient is exhibiting a Tripod position it can be an indicator of ____
Chronic Pulmonary Disease
A toddler usually exhibits ___ regarding posture
“Toddler Lordosis”
Gait
Feet approximately shoulder width apart; foot placement is accurate (Normal)
When a patient is sitting straight up and resist laying down this can be an indicator of ____
Heart Failure
When a patient is curled up in the fetal position this can be an indicator of ____
Acute Abdominal Pain
Propulsion
difficulty stoping after ambulation (Abnormal)
ROM
Range of Motion
How can you help people how appear anxious?
Smile
Velcro fasteners instead of buttons on clothing may be an indicator of ____
Motor Disfunction
Short-term illnesses associated with unexplained weight loss
Fever
Infection
Disease of the mouth or throat
Long-term illnesses associated with unexplained weight loss
Endocrine diseases Malignancy Depression Anorexia Nervosa Bulimia
Unexplained weight gain is associated with what?
Heart Failure
BMI can be calculated by:
lb./in. X 703 OR kg./meter2 (squared)
What one thing can cause a false BMI?
Gain or loss of muscle mass
What is the normal BMI range?
18.5-24.9
A patient with a 17.9 BMI is classified as what?
Underweight
A patient with 25.1 BMI is classified as what?
Overweight
A patient with 34.5 BMI is classified as what?
Class 1 Obesity
A patient with 37.2 BMI is classified as what?
Class 2 Obesity
A patient with 41.1 BMI is classified as what?
Extreme Obesity (Class 3)
What biological marker would you use to place a measuring tape when measuring waist circumference?
The top of the iliac crest (hip bone)
Normal waist circumference in women:
Less than or equal to 35 in.
Normal waist circumference in men:
Less than or equal to 40 in.
A larger waist circumference in either men or women could put them at a higher risk for __ ___ ___ ___
Type 2 Diabetes
Dyslipisemia
Hypertension
Cardiac Vascular Disease (CVD)
Signs of child abuse are:
Child avoids eye contact
Exhibits no separation anxiety
Parent is disgusted by child’s odor, sounds, drooling, or stools
What do you weigh an infant on?
Platform-type Scale (weigh to the nearest 1/2 oz.)
When do you use am upright scale to take a child’s weight?
2-3 years
When would you stop measuring a child’s height in a supine position?
At 2 years of age
What biological marker do you use to measure head circumference?
The eyebrows
If the head is irregularly large for child’s age it can be an indicator of ____
Intracranial Pressure
What biological marker do you use to measure chest circumference?
The Nipple Line
Kyphosis
Humpback appearance common in the very old and those with osteoporosis
What is different about older adult’s gait?
It is usually wider base to compensate for diminished balance
What 3 things contribute to older adult’s height shrinkage?
Thinning of vertebral disks
Postural changes (Kyphosis)
Slight flexion of knees and hips
Hypopituitary Dwarfism is a deficiency of what hormone at what stage of life?
Growth Hormone in childhood
Gigantism is excessive secretion of which hormone and at which stage of life?
Growth Hormone in childhood
Where is growth hormone secreted from?
Anterior Pituitary Gland
What are signs of gigantism?
Increased height and weight and delayed sexual development
Acromegaly is also called ____
Hyperpituitarism
Acromegaly is excessive OR deficiency of growth hormone secretion in what stage of life?
Excessive secretion in the adult years
What are signs of Acromegaly?
Overgrowth of bones in face, hands, and feet (Not height)
What complication can be a cause from Acromegaly?
Enlarged internal organs (Cardiomegaly) Metabolic Disorders (Diabetes Mellitus)
Achondroplastic Dwarfism is what kind of disorder?
Genetic
Achondroplastic Dwarfism signs
Normal trunk size Short arms & legs Short Stature Large head with frontal bossing Midface hypoplasia Thoracic Kyphosis Lumbar Lordosis Abdominal Protrusion
Anorexia Nervosa is what kind of disorder?
Mental
Cushing Syndrome is an excessive production of which hormone?
Adrenocorticotropin (ACTH)
ACTH stimulate the adrenal cortex to produce ____
Cortisol
Cushing Syndrome signs
Weight gain Edema Obesity Buffalo Hump Muscle wasting Weakness Reduced height Bruising Acne
You can get Marfan’s Syndrome by ____
Heredity
Marfan’s Syndrome signs
Tall; thin stature Arachnodactyly (Long thin fingers) Hyperextenible joints Arm span greater than height Pectus Excavatum (Sternal deformity) High arched narrow palate Narrow Face Pes Planus (Flat feet)
What can occur in a patient with Marfan’s Syndrome
Cardiovascular complications
Leading to early mortality rates
What is the normal oral temp range?
96.4-99.1
What is the temperature regulator of the body?
Hypothalamus
Do older adult have normal deep temperature readings?
No. Older adult’s temperature are usually lower (97.2)
What temp is considered to be Hypothermia?
Below 96.8 degrees
What temp is considered to be Hyperthermia?
Greater than 100.4
Normal heart rates are higher in infants OR adults?
Infants- resting heart rate range is 100-180 (adults resting heart rate range is 55-90)
Bradycardia is common in patients experiencing ___
Heart Disease
What is a common symptom of fever, sepsis, pneumonia, myocardial infarction, and pancreatitis?
Tachycardia
What does weak thready pulse reflect?
Decrease Stroke volume
A patient with a 0 pulse force recording has what kind of pulse?
None
A patient with a 1+ pulse force has what kind of pulse?
Weak and thready
A patient with a 3+ pulse force has what kind of pulse?
Full and bounding
Normal Respiratory rate for 0-1 year old
24-38
Normal Respiratory rate for 1-3 year old
22-30
Normal Respiratory rate for 4-6 year old
20-24
Normal Respiratory rate for 7-9 year old
18-24
Normal Respiratory rate for 10-14 year old
16-22
Normal Respiratory rate for 15-18
14-20
Normal Respiratory rate for adult
10-20
What mean arterial pressure (MAP) is needed to maintain adequate tissue and organ profusion?
Greater than 60 mmHg
The level of BP is determine by which 5 factors?
Cardiac Output Vascular Resistance Volume Viscosity Elesticity of Arteriole Walls
What does the BP do if cardiac out increases?
BP increases
What does BP do if blood viscosity increases?
BP increases
What is the auscultatory gap?
a period when Korotkoff sounds disappear during auscultation
What is the interval between Orthostatic Vital Signs positions?
3 minutes
In a patient with coarctation of the aorta where do you take BP?
Thigh
Why do you take BP in the thigh of a patient with coarctation of the aorta?
The blood supply to the thigh is not effected by the constriction. The arm is therefore the BP will be falsely high
Nociceptors
Detect painful sensations from the periphery and transmit them to the CNS
What two primary sensory fibers are part of Nociceptors
AS & C fibers
AS fibers
Myelinated; large in diameter; transmit more rapid
C fibers
Unmyelinated; smaller; transmit more slowly
Associated with sensations of diffused, aching and long lasting
Nociceptive 4 Phases
- ) Transduction
- ) Transmission
- ) Perception
- ) Modulation
What happened on a molecular lever during transduction?
Injured tissues release a variety of chemicals, including substance P, histamine, prostaglandins, serotonin, and bradykinin
Where does the pain impulse move from and to during Transmission?
From the spinal cord to the brain (Thalamus to higher cortical areas)
What is perception?
Signifies the conscious awareness of a painful sensation
What part of the brain usually interprets is perception of pain?
Limbic System
What does modulation do?
Inhibit pain signals (stop/slow down)
Neurotransmitters that produce an analgesic effect:
Serotonin, Norepinephrine, Neurotensin, GABA, Endorphines, Enkephalins, Dynorphins
Examples of Nociceptive pain:
Skinned knee, menstrual cramps, kidney stones, venipuncture, joint pain
True/False Nociceptive pain can turn into Neuropathic pain over time.
True. B/c constant irritation and inflammation can alter nerve cells
Neuropathic pain
Abnormal processing of pain message
Conditions that cause Neuropathic pain:
Diabetes mellitus
Herpes Zoster
HIV/AIDS
Chemotherapy
What device can you use to identify pain?
fMRI - Functional MRI
Visceral Pain
Originates from larger internal organs
What is visceral pain described as?
Dull, deep, squeezing, cramping
Somatic Pain
Originated from musculoskeletal tissues or body surface
Deep Somatic Pain
Comes from sources such as the blood vessels, joints, tendons, muscles, and bone
Cutaneous Pain
Derived from skin surface and subcutaneous tissues
What is deep somatic pain described as?
Aching or Throbbing
What is cutaneous pain described as?
Superficial, sharp, or burning
What is somatic pain described as?
Sharp or dull
What symptoms can accompany somatic pain?
Nausea, sweating, vomiting, tachycardia, hypertension (Like Visceral Pain)
Acute Pain
Short-term
Dissipates after injury heals
Chronic Pain
When pain continues for 6 months or longer
What chronic nonmalignant pain associated with?
Musculoskeletal conditions (Arthritis, Low back pain, Fibromyalgia)
Breakthrough Pain
A transient spike in pain level in an otherwise controlled pain syndrome. (End-of-dose medication failure)
Referred Pain
Pain felt at a particular sire but originates from another location
When should pain rating scales be introduced?
4 or 5 years old
What are some acute pain behaviors?
Guarding, Grimacing, vocalization (moaning), agitation, restlessness, stillness, diaphoresis, change in vital signs
What are some chronic pain behaviors?
Bracing, rubbing, diminished activity, and change in appetite
What does the CRIES pain tool measure?
Physiologic and behavior indicators of neonates on a 3 point scale
What is FLACC?
A nonverbal assessment tool for infants and young children under 3 years old
What 5 things does FLACC assess?
Facial expression, Leg movement, Activity level, Cry, and Consolability
Hoe do people with dementia communicate pain?
Agitation, pacing, repetitive yelling
