chronic exam 1-pain

Question 1

type A delta fibers

Answer 1

carry rapid, sharp, pricking sensation
quick transmission
found in skin, muscles
may be localized

Question 2

C fibers

Answer 2

carry dull, burning, aching sensation
slow transmission
found in muscle, periosteum, viscera (organs)
more continuous and constant pain

Question 3

pain threshold

Answer 3

Amount of a pain stimulus required to perceive as pain

Question 4

Pain tolerance

Answer 4

amount of pain a person is willing to endure

Question 5

Intractable

Answer 5

pain not responsive to conventional treatment

Question 6

psychogenic

Answer 6

Pain for which no pathologic condition can be found

Question 7

Radiating pain

Answer 7

Diffuse pain around the site of origin, not well localized

Question 8

Localized pain

Answer 8

Confined to the site of origin

Question 9

Projected pain

Answer 9

Pain along the specific nerve or nerves

Question 10

Acute pain

Answer 10

Short duration of less than six months
Identifiable onset
Often has useful function
Accompanied by sympathetic responses

Question 11

Chronic pain

Answer 11

Longer duration of more than six months
Persistent, recurrent
No foreseeable end
Observable pain expression often absent

Question 12

Characteristics of acute pain

Answer 12

Physiologic changes in vital signs
Limited lifestyle impact
Treatment usually has high success

Question 13

Characteristics of chronic pain

Answer 13

Low or no physiologic changes
Impacts behavior, cognitive, social roles and lifestyle
Treatment is more difficult

Question 14

nocioceptive pain

Answer 14

Normal processing of stimuli that damages normal tissue or has the potential to do so

Question 15

Neuropathic pain

Answer 15

Abnormal processing of sensory input by peripheral or central nervous system

Question 16

nocioceptive pain arises from three major types of structures

Answer 16

Cutaneous (somatic)
Deep somatic (bones, muscles, skin joints, connective tissue)
Visceral (organs)

Question 17

cutaneous pain

Answer 17

Superficial structures of skin and subcutaneous tissue

Well defined, localized

Question 18

Deep somatic pain

Answer 18

Originates in bone, blood vessels, nerves, muscles, and other tissues
Dull, poorly localized

Question 19

Visceral pain

Answer 19

Arises from body organs

Known for referred pain

Question 20

Referred pain

Answer 20

Felt in an area distant from the site of origin

Question 21

Centrally generated pain

Answer 21

Injury to either peripheral or central nervous system or dysregulation of the autonomic nervous system

Question 22

Peripherally generated pain

Answer 22

Pain along one or more peripheral nerves

Question 23

Nonmalignant chronic pain

Answer 23

Rheumatoid arthritis rightists (non-cancerous)

Question 24

Intermittent chronic pain

Answer 24

Occurs at specific intervals (migraines)

Question 25

Malignant chronic pain

Answer 25

May have elements of both acute and chronic (tumor)

Question 26

Pain behaviors as assessment tool

Answer 26

``` Facial expression Vocal behavior Aggressive behavior Increase in body movements Changes in ADLs Irritability, confusion, withdrawn, agitated ```

Question 27

Clinical signs of pain

Answer 27

``` Increased pulse, blood pressure, respiratory rate-often not present with chronic pain Dilated pupils Increased perspiration Guarding Muscle rigidity ```

Question 28

Assessment of factors which influence the pain experience

Answer 28

``` Situation Race culture ethnicity Age Gender Anxiety Past experiences with pain ```

Question 29

Nonnarcotic analgesics

Answer 29

``` Aspirin (ASA) Acetaminophen (Tylenol) Cox two inhibitors (Celebrex, Bextra) NSAIDs (Ibuprofen, Indocin) nonsteroidal anti-inflammatory drugs Utram ```

Question 30

Narcotic analgesics

Answer 30

``` Opioid agonists (morphine sulfate, Dilaudid, codeine, oxycodone, hydrocodone) Methadone Propoxyphene Fentanyl Meperidine ```

Question 31

Action of opioid analgesics

Answer 31

Bind with opiate receptors in the CNS to alter the perception of pain

Question 32

Adverse affects of opioid analgesics

Answer 32

Constipation, nausea and vomiting, respiratory depression, urinary retention

Question 33

Opioid antagonist

Answer 33

Blocks opiate receptors, used to treat overdoses | Narcan (naloxone)

Question 34

Action of non-opioid analgesics

Answer 34

Inhibit prostaglandin synthesis

Question 35

Adverse affects of non-opioid analgesics

Answer 35

G.I. upset G.I. bleeding Tinnitus-tingling in ears Liver or kidney toxicity

Question 36

Routes of administration for opioid analgesics

Answer 36

``` Oral/rectal IM and subQ IV Transdermal and transmucosal Intraspinal Nerve blocks Epidural ```

Question 37

Patient controlled analgesia

Answer 37

Patient controls frequency of pain medication | Dr. order includes: drug, amount, block out time interval and route is IV

Question 38

Capnography monitoring

Answer 38

To monitor CO2 levels which will rise with hypoventilation | Use Narcan to treat respiratory depression

Question 39

Epidural catheters

Answer 39

Local anesthetic or narcotic medication into the epidural space Medication is Duramorph Often used in labor and delivery, also orthopedics Side effects similar to morphine sulfate Complication of possible infection

Question 40

Tens unit

Answer 40

Transcutaneous electrical nerve stimulation | It's electric current to skin and tissue, adjustable voltage; portable

Question 41

Guided imagery

Answer 41

Envision something pleasant; can include music and aromatherapy

Question 42

Oral morphine

Answer 42

Three times the IV dose

Question 43

Antidepressants

Answer 43

Alter serotonin levels and block receptors and spinalthalamic tract that transmit pain parentheses neuropathic pain

Question 44

Anticonvulsants

Answer 44

Use for neuropathic pain

Question 45

Anxiolytics

Answer 45

Xanax Valium thorazine Ativan