Comfort

Question 1

pain is what?

Answer 1

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

Question 2

pain is what the person…?

Answer 2

says it is, existing whenever they say it does

Question 3

pain is accompanied by?

Answer 3

suffering

Question 4

how many americans suffer chronic pain annually?

Answer 4

75 million

Question 5

how many americans suffer acute pain annually?

Answer 5

25 million

Question 6

how much does pain cost?

Answer 6

$100 billion

Question 7

inadequate pain relief hastens?

Answer 7

death

Question 8

barriers preventing effective pain relief by healthcare providers?

Answer 8

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

Question 9

opioids should be saved for when?

Answer 9

when it is really needed

Question 10

barriers preventing effective pain relief by patients?

Answer 10

possible addiction
side effects

Question 11

pain can be?

Answer 11

psychological and emotional stressors

Question 12

decreased sleep =

Answer 12

increased pain perception

Question 13

managing pain decreases?

Answer 13

suffering and hospital readmission
*prevents acute from turning to chronic

Question 14

past bad/untreated pain experiences increases?

Answer 14

anxiety

Question 15

people respond to pain based on?

Answer 15

ability to tolerate pain and past experiences with pain

Question 16

two effectors of pain?

Answer 16

culture and gender

Question 17

when are opioids good?

Answer 17

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

Question 18

transduction

Answer 18

activation of pain receptors

Question 19

transmission

Answer 19

signal travels up spinal cord to higher centers

Question 20

perception

Answer 20

awareness of characteristics of pain

Question 21

pain threshold

Answer 21

lowest intensity of stimulus that causes pain recognition

Question 22

modulation

Answer 22

inhibition or modification of pain

Question 23

who believes they will become addicted?

Answer 23

elderly

Question 24

when do we treat pain?

Answer 24

as soon as patient says they are in pain

Question 25

what should we educate patients about side effects?

Answer 25

meds to treat side effects

Question 26

what is one opioid not a shot?

Answer 26

fentanyl patch

Question 27

what is happening with the opioid crisis?

Answer 27

prescribed less decreased treatment of pain

Question 28

what in converted in electrical impulse in transduction?

Answer 28

stimulus

Question 29

what are the peripheral pain receptors?

Answer 29

nociceptors

Question 30

pain tolerance?

Answer 30

greatest level of pain able to endure

Question 31

gate control theory explains why

Answer 31

different people interpret similar painful stimuli differently

Question 32

gate open?

Answer 32

allow sensations to be felt

Question 33

gate closed?

Answer 33

less transmission up to brain

Question 34

gate mechanisms determine the impulse

Answer 34

that reaches the brain

Question 35

what are some things that close the gate?

Answer 35

music back rub warm compress

Question 36

chronic pain is difficult to describe because

Answer 36

it is poorly localized

Question 37

3 responses to pain?

Answer 37

physiological behavioral affective

Question 38

physiological pain?

Answer 38

increased: pulse, BP, RR

Question 39

who might not have a physiological response to pain?

Answer 39

chronic pain *adapted to feeling

Question 40

behavior involuntary or voluntary?

Answer 40

voluntary

Question 41

behavioral responses?

Answer 41

grimacing, moaning, protecting

Question 42

affective pain response?

Answer 42

fear, anger, depression

Question 43

anxiety does what to pain?

Answer 43

aggravates it

Question 44

nonverbal indicators of pain include which responses?

Answer 44

behavioral voluntary

Question 45

nonverbal pain indicators?

Answer 45

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

Question 46

when should pain be assessed?

Answer 46

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

Question 47

why is it important to assess sedation?

Answer 47

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

Question 48

steps of pain assessment?

Answer 48

intensity location quality aggravating/alleviating factors goals

Question 49

somatic means?

Answer 49

body *muscle, tendon, bone

Question 50

somatic descriptors?

Answer 50

aching deep dull gnawing throbbing sharp stabbing

Question 51

visceral means?

Answer 51

organs *gallstones, kidney stones, pancreatitis

Question 52

visceral descriptors?

Answer 52

cramping squeezing pressure referred

Question 53

referred pain?

Answer 53

perceived at location different from site of painful stimulus

Question 54

neuropathic descriptors?

Answer 54

burning numbness radiating shooting tingling touch sensitive

Question 55

neuropathic examples?

Answer 55

herpes zoster peripheral neuropathy

Question 56

cutaneous means?

Answer 56

superficial, skin, SUBQ sharp burning sensation

Question 57

phantom limb pain?

Answer 57

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

Question 58

attractable pain

Answer 58

severe, constant, relentless, debilitating, uncurable

Question 59

attractable pain leads to

Answer 59

bed/house bound early death

Question 60

what does acetaminophen over max doses effect

Answer 60

renal

Question 61

NSAIDS do not work for?

Answer 61

GI irritation stomach bleeding

Question 62

common opioids?

Answer 62

morphine codeine fentanyl

Question 63

what is adjuvant?

Answer 63

used for other reasons but enhances opioids affects

Question 64

level one of pyramid?

Answer 64

non-opioid and adjuvant

Question 65

level two pyramid?

Answer 65

opioid non-opioid adjuvant

Question 66

level three pyramid?

Answer 66

increased dose or frequency of opioid non-opioid adjuvant

Question 67

goal of pyramid?

Answer 67

freedom of pain

Question 68

gold standard opioid?

Answer 68

morphine

Question 69

common side effects of morphine?

Answer 69

N/V morphine itch

Question 70

codeine can cause what issues?

Answer 70

stomach

Question 71

fentanyl takes how long?

Answer 71

12 hours *lasts 3 days

Question 72

how much stronger is fentanyl than morphine?

Answer 72

8-10

Question 73

adjuvant drugs?

Answer 73

anticonvulsants tricyclic antidepressants steroids anti anxiety

Question 74

PCA

Answer 74

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

Question 75

common drugs for PCA?

Answer 75

morphine fentanyl hydromorphone

Question 76

PCA has what settings?

Answer 76

lock out

Question 77

break through pain?

Answer 77

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

Question 78

what is ordered for breakthrough pain?

Answer 78

PRN

Question 79

physical dependence

Answer 79

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

Question 80

psychological dependence

Answer 80

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

Question 81

tolerance

Answer 81

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

Question 82

placebo

Answer 82

harmless pill prescribed for psychological benefit *not ethical

Question 83

why do elderly have more dramatic adverse effects?

Answer 83

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

Question 84

metabolized in

Answer 84

liver

Question 85

excreted in

Answer 85

kidney

Question 86

pain threshold for everyone?

Answer 86

the same

Question 87

pain tolerance for everyone?

Answer 87

different