Comfort and Pain management Flashcards
What is the Pain Process?
Transduction: Activation of pain receptors
Transmission: Conduction along pathways (A delta and C delta fibers)
Perceptions of pain: Awareness of the characteristics of pain
Modulation: Inhibition or modification of pain
What is the pain threshold?
Minimum intensity of. stimulus that is perceived as painful
What are neuromodulators?
Naturally present in spinal cord and brain
Block the release or production of pain transmitting substances
Examples: endorphins, dynorphins, enkephalins
What do endorphins do?
Produced along the CNS pathway
Painblocking chemicals that have prolonged analgesic effects and produce euphoria
What are dynorphins?
Type of endorphin
Has the most potent anagesic effect
What are Enkephalins?
Less potent than endorphins
Reduce pain by inhibiting the release of substance P from the terminals of afferent neurons
What is somatic pain?
Is diffuse or scattered
Tendons
Ligaments
Bones
Blood vessels
Nerves
Muscles
What is visceral pain?
Poorly organized
Originates in body organs
What is cutaneous pain?
Involves skin or subcutaneous tissue
A paper cut would be an example
What is referred pain?
Originates in one part of the body and is perceived in an area distant to that part
What are the responses to pain?
Behavioral (Voluntary)
Physiologic (Involuntary)
Affective (Psychological)
Examples of Behavioral pain
Moving away
Grimacing, moaning, crying
Restlessness
Protecting the painful area
Examples of physiologic pain
Increased blood pressure
Increased pulse and respiratory rate
Pupil dilation
Muscle tension
Examples of affective pain
Exaggerated weeping
Withdrawal
Stoicism
Anxiety
Depression
Fear
Anger
Anxiety
Fatigue
Hopelessness
Insomnia
Powerlessness
What is diffuse pain?
Covers a large area
Hard to point to a specific area without moving the hand over a large surface
When is the adult nonverbal painscale used?
With patients who are unable to communicate verbally
Uses both observable behaviors and physiologic
Pt’s in ICU or with dimentia
When is the Behavioral Pain Scale used? (BPS)
With patients who can’t verbalize
Focuses on observable behaviors and body movements
When is COMFORT painscale used?
Younger kids?
When is CRIES used?
Infants
0-6 months
When is FLACC used?
Used in children and adults who are unable to self report their pain
Face
Legs
Activity
Cry
Consolability
When is Oucher pain scale used?
Children 3-12
When is wonk baker used?
Children
What do the sedation scale numbers mean?
1: Pt alert and awake
2: Pt occasionally drowsy, easy to awake
3: Pt is frequently drowsy and hard to awake; reduce dosage
4: Pt is somnolent with minimal or no response to stimuli; use Noloxone
What is the preffered route of medication for cancer or chronic pt?
Orally if possible
What to avoid when taking analgesics?
Alcohol
Driving
Breastfeeding
Taking on empty stomach
Operating machinery
Keep a diary
