Comfort Flashcards
pain is what?
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
pain is accompanied by?
suffering
how many americans suffer chronic pain annually?
75 million
how many americans suffer acute pain annually?
25 million
how much does pain cost?
$100 billion
inadequate pain relief hastens?
death
barriers preventing effective pain relief by healthcare providers?
poor assessment on pain
inadequate knowledge of pain management
biases/judgements
opioids should be saved for when?
when it is really needed
barriers preventing effective pain relief by patients?
possible addiction
side effects
pain can be?
psychological and emotional stressors
decreased sleep =
increased pain perception
managing pain decreases?
suffering and hospital readmission
*prevents acute from turning to chronic
past bad/untreated pain experiences increases?
anxiety
people respond to pain based on?
ability to tolerate pain and past experiences with pain
two effectors of pain?
culture and gender
when are opioids good?
post op
-allows mobility
-reverses anesthesia
-returns reflexes
-bowel movements
-lung expansion
-eat and drink
-healing
-decreases pain
-decreases PONV
transduction
activation of pain receptors
transmission
signal travels up spinal cord to higher centers
perception
awareness of characteristics of pain
pain threshold
lowest intensity of stimulus that causes pain recognition
modulation
inhibition or modification of pain
who believes they will become addicted?
elderly
when do we treat pain?
as soon as patient says they are in pain
what should we educate patients about side effects?
meds to treat side effects
what is one opioid not a shot?
fentanyl patch
what is happening with the opioid crisis?
prescribed less
decreased treatment of pain
what in converted in electrical impulse in transduction?
stimulus
what are the peripheral pain receptors?
nociceptors
pain tolerance?
greatest level of pain able to endure
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
gate mechanisms determine the impulse
that reaches the brain
what are some things that close the gate?
music
back rub
warm compress
chronic pain is difficult to describe because
it is poorly localized
3 responses to pain?
physiological
behavioral
affective
physiological pain?
increased: pulse, BP, RR
who might not have a physiological response to pain?
chronic pain
*adapted to feeling
behavior involuntary or voluntary?
voluntary
behavioral responses?
grimacing, moaning, protecting
affective pain response?
fear, anger, depression
anxiety does what to pain?
aggravates it
nonverbal indicators of pain include which responses?
behavioral
voluntary
nonverbal pain indicators?
moaning
crying
grimacing
guarding
reduced social interaction
difficulty concentrating
changes in eating
when should pain be assessed?
regular intervals
new reports of pain
after pharm and non pharm
intervention
why is it important to assess sedation?
guides best intervention
*don’t want to give opioid with sedation because they are depressors
steps of pain assessment?
intensity
location
quality
aggravating/alleviating factors
goals
somatic means?
body
*muscle, tendon, bone
somatic descriptors?
aching
deep
dull
gnawing
throbbing
sharp
stabbing
visceral means?
organs
*gallstones, kidney stones, pancreatitis
visceral descriptors?
cramping
squeezing
pressure
referred
referred pain?
perceived at location different from site of painful stimulus
neuropathic descriptors?
burning
numbness
radiating
shooting
tingling
touch
sensitive
neuropathic examples?
herpes zoster
peripheral neuropathy
cutaneous means?
superficial, skin, SUBQ
sharp burning sensation
phantom limb pain?
perception of sensations that occur following partial or complete amputation
*resolves with time
attractable pain
severe, constant, relentless, debilitating, uncurable
attractable pain leads to
bed/house bound
early death
what does acetaminophen over max doses effect
renal
NSAIDS do not work for?
GI irritation
stomach bleeding
common opioids?
morphine
codeine
fentanyl
what is adjuvant?
used for other reasons but enhances opioids affects
level one of pyramid?
non-opioid and adjuvant
level two pyramid?
opioid
non-opioid
adjuvant
level three pyramid?
increased dose or frequency of
opioid
non-opioid
adjuvant
goal of pyramid?
freedom of pain
gold standard opioid?
morphine
common side effects of morphine?
N/V
morphine itch
codeine can cause what issues?
stomach
fentanyl takes how long?
12 hours
*lasts 3 days
how much stronger is fentanyl than morphine?
8-10
adjuvant drugs?
anticonvulsants
tricyclic antidepressants
steroids
anti anxiety
PCA
patient controlled analgesia
*patient must be A&O to receive
*inhibits overdose
*can be in combination with continuous infusion
common drugs for PCA?
morphine
fentanyl
hydromorphone
PCA has what settings?
lock out
break through pain?
flare up of moderate to severe pain
occurs even during constant meds
what is ordered for breakthrough pain?
PRN
physical dependence
body adapts to presence of opioid and suffers withdrawal if opioids stop
*not addiction
psychological dependence
compulsive drug use
cravings
need opioids rather than other pain relief
*is addiction
tolerance
physiological result of chronic opioid use
larger dose required to maintain level of analgesia
placebo
harmless pill prescribed for psychological benefit
*not ethical
why do elderly have more dramatic adverse effects?
decreased liver and renal function
*need to watch for cumulative effects
metabolized in
liver
excreted in
kidney
pain threshold for everyone?
the same
pain tolerance for everyone?
different
