Comfort Flashcards
pain can be
psychological and emotional stressors
decreased sleep =
increased perception of pain
if we manage pain we have
decrease suffering
decrease hospital readmission for pain
prevent acute from turning into chronic pain syndromes
pain is
unpleasant sensory and emotional experience associated with actual or potential tissue damage
pain is what the
person says it is, existing whenever they say it does
if past experience of pain is bad/untreated
increased anxiety
people respond to pain based on
ability to tolerate pain and past experiences with pain
what affect pain
gender and culture
pain is accompanied by
suffering
inadequate pain refief hastens
death
how does inadequate pain relief hasten death
increase psychologic stress
decrease mobility
- pnumonia
- thromboemboli
- increase work of breathing
- increase oxygen demand of myocardium
HCAPs survery
answer call light
treat pain
sickle cell crisis
fluid
oxygen
pain meds
as nurses we need to removed what surrounding pain
biases and judgements
when are opiods good
post op
- allows to get up and move
- reverse anestheitcs
- reflexes return
- bowels move
- lung expansion
- eat and drink
- healing
- decrease PONV
- decreases pain
who thinks they will get additvcted
older adults
why do we not want to wait to use an opiod until it is really needed
it will take longer to get pain controlled if it is a 10/10 rather than a 3/10
when do we treat pain
as soon as patient says they are in pain
what should we educate patients about unpleasant side efefcts
we have meds to treat that
what is one opioid that isn’t a shot
fentynal
patch
with the opioid crisis what is happening
prescribed less
decrease treatment of pain
transduction
activation od pain receptors
what is converted to electrical impulse in transduction
stimulus
what are peripheral pain receptors
nocieptors
transmission
impulse traveling up spinal cord to higher center
perception
awareness of the characteristics of pain
pain threshold
lowest intensity of a stimulus that causes you to recognize pain
is threshold same or different in people
same
pain tolerance
greatest level of pain that a subject is ale to endure
is tolerance the same or different
different
modulation
inhibition or modification of pain
gate control theory explains why
different people interpret similar painful stimuli differently
gate open
allow sensations to be felt
gate closed
less transmission up to brain
gating mechanisms determines the impulse
that reaches the brain
what are some things that close the gate
music
back rub
warm compress
duration of pain
acute
chronic
acute pain
sudden onset
result of clearly defined cause
heals when underlying cause heals
chronic
any pain that lasts beyond normal healing peroid
patients with chronic pain have difficultly
describing pain because it is poorly localized
3 responses to pain
physiologic
behavioral
affective
physiologic
increase in pulse, BP, RR
who might not have a physiologic response
chronic pain because they have adapted to pain
is physiologic response always present
no
behavioral is voluntary or involuntary
voluntary
examples of behavioral responses
protecting, grimacing, moaning
affective response
pain causes fear, anger, depression
anxiety does what to pain
aggravate pain
is pain a part of aging
no
do babies feel pain
yes
if past experience with pain is poor (untreated) how will the person feel now
increase anxiety
pain assessment is
asking and believing the patient
non verbal pain indicators is what response
behavioral
voluntary
examples of nonverbal pain indicators
moaning
crying
grimacing
guarded position
reduced social interactions
difficulty concentration
changes in eating
when should pain be assessed
regular intervals
new report of pain
after pharm and non pharm intervention
what do we assess with pain
sedation
why do we assess after pharm and non pharm
if it worked
evaluation
why is it important to asses sedation
because it helps us decide best intervention because if the patient is sedated we do not want to give a opioid because they are depressors
steps of pain assessment
intesnity
location
quality
aggravating and alleviating factors
goals
FLACC
faces, legs, arms, cry, consoability
1-10
numerical used in patient who can talk
PAINAD
advanced dementia
baker wong faces
peds
somatic means
body
somatic descriptors
aching, deep, dull, gnawing, throbbing, sharp, stabbing
examples of somatic
muscle, tendon, bone
visceral means
organ
visceral discriptors
cramping, squeezing, pressure, referred
visceral examples
gallstones, kidney stones, pancreatitis
referred pain
perceived at another location other than site of painful stimulis
neuropathic descriptor
burning, numbness, radiating, shooting, tingling, touch, sensitive
neuropathic examples
herpes zoster, peripheral neuropathy
cutaneous
superficial, skin, subq, sharp with a burning sensation
phantom limb pain
perception of sensations that occur following partial or complete amputation
atractable pain
severe constant, relentless, debilitating pain, uncurable
atractable pain leads to
boedbound/house bound
early death
how does phantom limb pain resolve
with time
aggravating/alleviating factors
what makes it worse
better
affected by movement or postion
does nonpharm help
do we rely on vital sign change
no
we need to educate patient to tell us
when pain starts
non pharm relief
complementary alternative therapies
can nonpharm be used with pharm
yes or alone
are non pharm orders
no they are independent nursing interventions
what are some examples of nonpharm
distractors
humor
music
imagery
relaxation
cutaenous
acupuncture
hypnosis
biofeedback
touch
animal
acetaminophen over max does affects
renal
NSAIDS do not work on
GI irritation/stomach bleeding
common opiods
morphine, codeine, fentynal
what is adjuvant
used for other reasons but enhances the affect of opoids
level one of pyramid
nonopoid and adjuvant
level 2 of pyramid
opioid
nonopioid
adjuvant
level 3 of pyramid
increased does or frequency of opoiod, nonopoid, adjuvant
goal of pyrimid
freedom of pain
morphine
gold standard
common side affect with morphine
nausea and vomiting, morphien itch
codeine can have what issues
stomach
hydromophone
deluded
methadone
dolaphine
fentnyal takes how long
12 hours
- give meds until reaches 12 hours
how much stronger is fentynal than morphine
8-10
how long does fentynal last
3 days
adjuvant drugs
anticonvulsants, tricyclic antidepressants, steroids, anti anxiety
PCA
patient controlled anesthesia
what does the pateint have to be for PCA
alert and oriented
what does PCA inhibit
overdose
PCA can be incombination with
continuous infusion
what is the common drugs for PCA
morphine, fentynal, hydromorphone
PCA has what settings
lock out
break through pain
flare up of moderate to severe pain that occurs even when the patient is taking around the clock meds
what should we have ordered for break through pain
PRN
physical dependence
the body physiologically adapts to the presence of an opioid and suffers withdrawal symptoms if the opioid is suddenly stops
is physical dependence addiction
no
psychological dependence
pattern of compulsive drug use characterized by continued craving for an opioid and the need to sue the opioid for effects other than pain relief
is psychological dependence addiction
yes
tolerance
common physiological result of chronic opioid use, a larger dose of opioid is required to maintain the same level of analgesia
placebo
harmless pill prescribed for for the psychological benefit of the patient than the physiological
is placebo ethical
no
is pain a process of aging
no
pain is often unreported in elderly which leads to
higher risk for patient experiencing pain
are adverse effects of pain meds more dramatic in elderly
yes
why do elderly have more dramatic affects to pain meds
decreased liver and renal
elderly have more
prolonged effect and we need to watch for cumulative affect
metabolized
liver
excreted
kidney
