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Nursing fundamentals > Comfort > Flashcards

Comfort Flashcards

1
Q

what is the only intervention a pt with pain usually wants?

A

pain relief

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2
Q

How is pain classified?

A

According to the duration, source, mode of transmission, and its etiology

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3
Q

What is acute vs chronic pain?

What is remission vs exacerbation?

What classification of pain is this?

A

Acute pain is rapid onset, variable intensity pain that is the bodies way of telling you there is tissue damage or disease. After the underlying problem is solved acute pain disappears.

Chronic pain lasts beyond normal healing period often greater than 6 months and interferes with functioning and often causes depression

People with chronic pain experience remission where there is no symptoms and exacerbation where there is symptoms

duration

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4
Q

What type of pain is caused by uncontrolled cancer?

A

chronic malignant pain

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5
Q

what type of pain is very resistant to treatment ?

A

chronic non malignant

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6
Q

what are some problems in treating chronic pain?

A

pts have a hard time describing it because of poor localization

its often perceived as meaningless, causing withdrawal, depression, anger, frustration, and dependency

Care giver bias

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7
Q

What is cutaneous, somatic, and visceral pain?

What classification is this?

A

Cutaneous is superficial usually involving the skin

Somatic pain is diffuse or scattered and originates in tendons, ligaments, bones, blood vessels, and nerves.

Visceral pain is poorly localized and originates in body organs in thorax, cranium, and abdomen

source of pain

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8
Q

What is guarding?

A

its a reflex contraction or spasm of the abdominal wall that tries to prevent additional trauma to underlying tissues

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9
Q

What is nociceptive pain?

How is it treated?

A

somatic, visceral, cutaneous pain

Its normal processing of pain that damages normal tissues

Opiates and synthetics

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10
Q

What is neuropathic pain?

A

is pain that is caused by injury to or abnormal functioning of peripheral nerves or the CNS

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11
Q

What are some characteristics of neuropathic pain?

A

burning or stabbing in varying durations

Allodynia - pain that occurs after a normally weak or nonpainfull stimuli

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12
Q

What is pain called that is resistant to therapy?

A

intractable

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13
Q

What is phantom pain?

A

pain that remains after a body part is removed

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14
Q

What is psychogenic pain?

A

Pain that doesnt have a identifiable physical source

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15
Q

Does pain always have a pure origin?

A

no, it often has physical and psychogenic properties

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16
Q

what is referred pain?

A

pain that can originate in one part of the body but be perceived in an area distant from tits point or origin.

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17
Q

what are some behavioral (voluntary) responses to pain?

A 
moving away from stimuli
grimacing, moaning, crying
restlessness
protecting the area and refusing to move
speech will slow down or speed up depending on the pain 
unpurposeful body movements
changing postures
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18
Q

What are some physiologic ( involuntary responses to pain) sympathetic responses

A

increased blood pressure, increased pulse an respiratory rates

pupil dilation

muscle tension and rigidity

pallor

increased adrenaline

increased blood glucose

19
Q

What are involuntary responses when pain is deep and severed (parasympathetic)

A 
Nausea and vomiting 
fainting or unconciousness
decreased blood pressure
decreased pulse rate
prostration (lying stretched out on the ground)
rapid and irregular breathing
20
Q

What are some affective (psychological) responses to pain?

A 
exaggerated weeping and restlessness
withdrawl
stoicism
anxiety
depression
fear
anger
anorexia
fatigue
hopelessness
Powerlessness
21
Q

if the patient doesnt have an obvious response to pain, does that mean they are not experienceing pain?

A

no

22
Q

what are some factors that affect pain?

A

culture

age/developmental stage

support/environment

past experiences

meaning of pain ( are they being punished )

emotions/ fatigue

communication or cognitive development

23
Q

what main emotion can exacerbate pain, and what can we do to minimize it?

A

anxiety

pts who were taught preoperatively about what to expect post op required less pain medication

24
Q

how often should you assess for pain?

A

whenever a person takes vitals

25
Q

what are some basic methods to assess pain given by McCaffery and Pasero?

A

patients self report
report of person close to them
nonverbal behaviors
physiologic measured signs

26
Q

what is PQRSTU?

what are some questions you would ask to go with each letter of the anacronym?

A

Provocative (what were you doing when the pain started?)

Quality ( describe your pain for me)

Region/radiating (where is your pain?)

Severity ( pain scales)

Timing ( onset, frequency, duration)

You ( how does this pain affect you?)

27
Q

In addition to PQRSTU, what other things are important to assess regarding pain?

A

relieving factors
concomitant symptoms - symptoms that appear along side the pain

patients expectations for pain relief

28
Q

Can a childs pain affect them into adulthood?

how early can a child affectively indicate that pain is present?

A

it can affect their response in adulthood

as early as 2 years

29
Q

when would you use the wong baker faces scale?

A

adults and children >3 years old, especially older adults

30
Q

when would you use the comfort scale?

A

in critically ill pediatric patients, adults, and infants who cannot use the NRS scale or faces

31
Q

When would you use the cries scale?

A

neonates 0-6 months

32
Q

when would you use FLACC

A

infants and children 2mos - 7 years who cannot validate the presence or quantify their pain

33
Q

0-10 NRS

A

Adults and children greater than 9 years old

34
Q

when would you use a checklist of nonverbal indicators?

A

adults who are unable to validate the presence or quantify pain using faces or NRS

35
Q

when would you use the oucher pain scale?

A

helpful with older children that can point to a face

36
Q

when would you use PAINAD?

A

dementia patients

37
Q

when would you use FPS-R

A

young children with a 0-10 faces scale

38
Q

When would you use a payen behavioral scale

A

usefull when you have intubated adults

39
Q

what are some nonpharmacological relief measures?

Give examples?

A

distraction ( Lamaze)

Humor ( funny shows)

Music (anything that helps them relax)

Imagery (happy thoughts)

relaxation (progressive muscle relalxation)

Cutaneous stimulation ( massage, acupuncture, TENS, etc)

Acupuncture

PENS ( acupuncture with electricity)

BIOFEEDBACK

THerapeutic touch

40
Q

what is the difference between physical dependence, tolerance, and addiction?

A

Physical dependence is where the body physiologically becomes accustomed to the opioid and suffers withdrawl symptoms if stopped

Tolerance is when the body needs a higher dose to achieve the same effect

Addiction is a pattern of use other than for pain control

41
Q

when are the characteristics of addiction?

A

craving
compulsive use
lack of control over it
continued use despite harm

42
Q

how long does it take for tolerance and physical dependence to take place with opiates?

A

about 4 weeks

43
Q

What pain medication schedule is best for chronic cancer pain?

What about for post operative pain?

A

Regular administration (ATC) not p.r.n.

Continuous IV

44
Q

What are the types of breakthrough pain?

What is the best way to treat Breakthrough pain?

A

Incident is treated with short activating opiates P.r.n

End of dose is treated by increasing ATC dose or shortening the interval between doses

Idiopathic (uknown cause) requires treatment with dosage and intervals

Nursing fundamentals (22 decks)

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