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Fundamentals NUR 220 > Comfort > Flashcards

Comfort Flashcards

1
Q

pain is what?

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage

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2
Q

pain is what the person…?

A

says it is, existing whenever they say it does

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3
Q

pain is accompanied by?

A

suffering

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4
Q

how many americans suffer chronic pain annually?

A

75 million

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5
Q

how many americans suffer acute pain annually?

A

25 million

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6
Q

how much does pain cost?

A

$100 billion

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7
Q

inadequate pain relief hastens?

A

death

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8
Q

barriers preventing effective pain relief by healthcare providers?

A

poor assessment on pain
inadequate knowledge of pain management
biases/judgements

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9
Q

opioids should be saved for when?

A

when it is really needed

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10
Q

barriers preventing effective pain relief by patients?

A

possible addiction
side effects

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11
Q

pain can be?

A

psychological and emotional stressors

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12
Q

decreased sleep =

A

increased pain perception

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13
Q

managing pain decreases?

A

suffering and hospital readmission
*prevents acute from turning to chronic

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14
Q

past bad/untreated pain experiences increases?

A

anxiety

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15
Q

people respond to pain based on?

A

ability to tolerate pain and past experiences with pain

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16
Q

two effectors of pain?

A

culture and gender

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17
Q

when are opioids good?

A

post op
-allows mobility
-reverses anesthesia
-returns reflexes
-bowel movements
-lung expansion
-eat and drink
-healing
-decreases pain
-decreases PONV

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18
Q

transduction

A

activation of pain receptors

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19
Q

transmission

A

signal travels up spinal cord to higher centers

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20
Q

perception

A

awareness of characteristics of pain

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21
Q

pain threshold

A

lowest intensity of stimulus that causes pain recognition

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22
Q

modulation

A

inhibition or modification of pain

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23
Q

who believes they will become addicted?

A

elderly

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24
Q

when do we treat pain?

A

as soon as patient says they are in pain

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25
Q

what should we educate patients about side effects?

A

meds to treat side effects

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26
Q

what is one opioid not a shot?

A

fentanyl patch

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27
Q

what is happening with the opioid crisis?

A

prescribed less
decreased treatment of pain

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28
Q

what in converted in electrical impulse in transduction?

A

stimulus

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29
Q

what are the peripheral pain receptors?

A

nociceptors

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30
Q

pain tolerance?

A

greatest level of pain able to endure

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31
Q

gate control theory explains why

A

different people interpret similar painful stimuli differently

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32
Q

gate open?

A

allow sensations to be felt

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33
Q

gate closed?

A

less transmission up to brain

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34
Q

gate mechanisms determine the impulse

A

that reaches the brain

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35
Q

what are some things that close the gate?

A

music
back rub
warm compress

36
Q

chronic pain is difficult to describe because

A

it is poorly localized

37
Q

3 responses to pain?

A

physiological
behavioral
affective

38
Q

physiological pain?

A

increased: pulse, BP, RR

39
Q

who might not have a physiological response to pain?

A

chronic pain
*adapted to feeling

40
Q

behavior involuntary or voluntary?

A

voluntary

41
Q

behavioral responses?

A

grimacing, moaning, protecting

42
Q

affective pain response?

A

fear, anger, depression

43
Q

anxiety does what to pain?

A

aggravates it

44
Q

nonverbal indicators of pain include which responses?

A

behavioral
voluntary

45
Q

nonverbal pain indicators?

A

moaning
crying
grimacing
guarding
reduced social interaction
difficulty concentrating
changes in eating

46
Q

when should pain be assessed?

A

regular intervals
new reports of pain
after pharm and non pharm
intervention

47
Q

why is it important to assess sedation?

A

guides best intervention
*don’t want to give opioid with sedation because they are depressors

48
Q

steps of pain assessment?

A

intensity
location
quality
aggravating/alleviating factors
goals

49
Q

somatic means?

A

body
*muscle, tendon, bone

50
Q

somatic descriptors?

A

aching
deep
dull
gnawing
throbbing
sharp
stabbing

51
Q

visceral means?

A

organs
*gallstones, kidney stones, pancreatitis

52
Q

visceral descriptors?

A

cramping
squeezing
pressure
referred

53
Q

referred pain?

A

perceived at location different from site of painful stimulus

54
Q

neuropathic descriptors?

A

burning
numbness
radiating
shooting
tingling
touch
sensitive

55
Q

neuropathic examples?

A

herpes zoster
peripheral neuropathy

56
Q

cutaneous means?

A

superficial, skin, SUBQ
sharp burning sensation

57
Q

phantom limb pain?

A

perception of sensations that occur following partial or complete amputation
*resolves with time

58
Q

attractable pain

A

severe, constant, relentless, debilitating, uncurable

59
Q

attractable pain leads to

A

bed/house bound
early death

60
Q

what does acetaminophen over max doses effect

A

renal

61
Q

NSAIDS do not work for?

A

GI irritation
stomach bleeding

62
Q

common opioids?

A

morphine
codeine
fentanyl

63
Q

what is adjuvant?

A

used for other reasons but enhances opioids affects

64
Q

level one of pyramid?

A

non-opioid and adjuvant

65
Q

level two pyramid?

A

opioid
non-opioid
adjuvant

66
Q

level three pyramid?

A

increased dose or frequency of
opioid
non-opioid
adjuvant

67
Q

goal of pyramid?

A

freedom of pain

68
Q

gold standard opioid?

A

morphine

69
Q

common side effects of morphine?

A

N/V
morphine itch

70
Q

codeine can cause what issues?

A

stomach

71
Q

fentanyl takes how long?

A

12 hours
*lasts 3 days

72
Q

how much stronger is fentanyl than morphine?

A

8-10

73
Q

adjuvant drugs?

A

anticonvulsants
tricyclic antidepressants
steroids
anti anxiety

74
Q

PCA

A

patient controlled analgesia
*patient must be A&O to receive
*inhibits overdose
*can be in combination with continuous infusion

75
Q

common drugs for PCA?

A

morphine
fentanyl
hydromorphone

76
Q

PCA has what settings?

A

lock out

77
Q

break through pain?

A

flare up of moderate to severe pain
occurs even during constant meds

78
Q

what is ordered for breakthrough pain?

A

PRN

79
Q

physical dependence

A

body adapts to presence of opioid and suffers withdrawal if opioids stop
*not addiction

80
Q

psychological dependence

A

compulsive drug use
cravings
need opioids rather than other pain relief
*is addiction

81
Q

tolerance

A

physiological result of chronic opioid use
larger dose required to maintain level of analgesia

82
Q

placebo

A

harmless pill prescribed for psychological benefit
*not ethical

83
Q

why do elderly have more dramatic adverse effects?

A

decreased liver and renal function
*need to watch for cumulative effects

84
Q

metabolized in

A

liver

85
Q

excreted in

A

kidney

86
Q

pain threshold for everyone?

A

the same

87
Q

pain tolerance for everyone?

A

different

Fundamentals NUR 220 (21 decks)

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