Comfort and pain

Question 1

Occult

Answer 1

hidden

Question 2

Cutaneous

Answer 2

skin or subq tissue
ex: sunburn

Question 3

Somatic

Answer 3

deep in bones, tendons, ligaments and vasculature
ex: sprained ankle

Question 4

Visceral

Answer 4

from organs
ex: cramping, throbbing, nausea, angina, IBS

Question 5

Neuropathic

Answer 5

from damaged or malfunctioning nerves

Question 6

Nociceptive

Answer 6

originates in nociceptors taking pain in from outside
ex: finger prick

Question 7

Physical Pain

Answer 7

can be identified

Question 8

Psychogenic Pain

Answer 8

cause of pain cannot be identified

Question 9

Referred Pain

Answer 9

pain is perceived in an area distant from its point of origin

Question 10

What side of the brain is pain transmitted to?

Answer 10

the opposite

Question 11

Proprioceptive Reflex

Answer 11

activity stops when feeling pain
ex: touching a hot stove

Question 12

Substance P

Answer 12

sensitive fibers on nerves to feel pain and increase firing rate of nerves, assists in transmission of impulses across synapse

Question 13

Transduction

Answer 13

nociceptors can be excited by stimuli which triggers release of biochemical mediators and cause movement of ions across cell membrane which excites nociceptors

Question 14

Modulation

Answer 14

when neurons in thalamus send signals back down dorsal horn of spine; fibers release opoids, norepi, serotonin. sensation of pain is limited or modified

Question 15

Opioid neuromodulators

Answer 15

endorphins and enkephalins

Question 16

Which neuromodulator is more potent

Answer 16

endorphins

Question 17

What endorphin has the most potent analgesic effect?

Answer 17

dynorphin

Question 18

Bradykinin

Answer 18

powerful vasodilator that increases capillary permeability and constricts smooth muscle

Question 19

Prostaglandins

Answer 19

important hormone-like substance that sends pain stimuli to CNS; if increased can cause severe menstrual cramps

Question 20

Gate Control Theory

Answer 20

non-painful input closes “nerve gate” to painful input which prevents pain sensation from traveling to CNS

Question 21

Pain Threshold

Answer 21

minimum of intensity of stimulus that is perceived as painful

Question 22

Adaptation

Answer 22

can effect patients perception of pain
ex walking into a pool vs jumping into it

Question 23

Wong Baker FACES

Answer 23

for adults and kids older than 3

Question 24

Beyer Oucher

Answer 24

for kids who are able to point to a face to indicate the level of pain; pictures of real kids faces

Question 25

CRIES Pain Scale

Answer 25

for neonates, uses vital signs

Question 26

FLACC

Answer 26

for infants and kids 2 months - 7 years who are unable to give pain a number
F- ace
L-egs
A-ctivity
C-ry
C-onsolability

Question 27

Painad

Answer 27

for patients with dementia

Question 28

COMFORT

Answer 28

for patients who cant use numeric rating or faces

Question 29

Non Opioids

Answer 29

acute and chronic, mild to moderate pain, inflammation, fever; OTC

Question 30

NSAID

Answer 30

non opioid, can cause gastric irritation and kidney damage

Question 31

Tylenol

Answer 31

NOT NSAID, reduces pain and fever can cause liver toxicity

Question 32

Asprin

Answer 32

impairs clotting, dont take w blood thinners

Question 33

Opioids

Answer 33

stimulate opioid receptors or bind with pain receptors to block pain impulse

Question 34

mu agonist

Answer 34

opioid, good for break through pain; no max daily dose; cannot be taken with agonist-antagonist

Question 35

Agonist-antagonist

Answer 35

stimulate some opioid receptors but block others
less risk of respiratory depression

Question 36

Adjuvants

Answer 36

may be used as primary therapy in conjunction with opioids

Question 37

WHO Anelgesic Ladder 1

Answer 37

mild or moderate pain w/ non opioid and/or adjuvant therapy
ex Tylenol with lidocaine patch

Question 38

WHO Anelgesic Ladder 2

Answer 38

mild or moderate pain with opioid and possible addition of non opioid/ adjuvant therapy

Question 39

WHO Anelgesic Ladder 3

Answer 39

increase dose/strength of opioid, can also include adjuvant or non opioid

Question 40

Numeric Sedation Scale S

Answer 40

sleepy, easy to arouse, no action

Question 41

Numeric Sedation Scale 1

Answer 41

Awake and alert; no action

Question 42

Numeric Sedation Scale 2

Answer 42

occasionally drowsy, but easy to arouse; no action

Question 43

Numeric Sedation Scale 3

Answer 43

Frequently drowsy, drifts to sleep during conversation; decrease dose

Question 44

Numeric Sedation Scale 4

Answer 44

somnolent with little to no response to stimuli; discontinue opioid and consider narcan

Question 45

Paradoxical Reaction

Answer 45

patient has opposite effect; more pain

Question 46

How many breaths per minute does a patient need to have to give pain meds?

Answer 46

12

Question 47

How many breaths per minute does a patient need to give narcan?

Answer 47

less than 8

Question 48

PCA Pump

Answer 48

has a lockout, ONLY PATIENT CAN PRESS BUTTON

Question 49

Nerve Blocks

Answer 49

regional anesthesia, injected around nerve plexus that supply sensation to rest of body

Question 50

Intraspinal and Epidural Catheter

Answer 50

catheter placed in subarachnoid/ epidural space

Question 51

Spinal Headache

Answer 51

5 days post spinal procedure, CSF will leak out decreasing amount of fluid around brain; patient needs to lay flat