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chronic > Comfort/ Intracranial regulation patho and chronic > Flashcards

Comfort/ Intracranial regulation patho and chronic Flashcards

1
Q

neuropathic pain,

A

direct injury or dysfunction in sensory nerve fiber

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2
Q

nociceptive pain [somatic and visceral],

A

refers to the normal functioning of physiologic systems that lead to the perception of noxious stimuli (injury) as being painful

Visceral: hard to pinpoint exactly where it is, organ pain

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3
Q

how chronic pain differs from acute pain.

A

acute pain-
disturbed sleep pattern
Risk for infection
impaired skin integrity

Chronic pain-
insomnia 
hopelessness
imbalanced nutrition
social isolation
self-care deficit
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4
Q

what is the brain sensory path?

A

1) foot injury
2) sensory neuron
3) spinal cord
4) brain thalamus
5) Brain cerebral cortex
6) interpretation of pain
7) motor neuron
8) response

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5
Q

what scale can be used to determine if they have a sleep/rest disorder

A

Epworth Sleepiness Scale,

out of 21 and high score means more likely to have a sleeping disorder

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6
Q

What are some Sleep Disorders Diagnosis?

A 
Insomnia 
Sleep Deprivation
Readiness for Enhanced Sleep
Disturbed Sleep Pattern
Fatigue
Wandering
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7
Q

Diagnosing criteria of Fibromyalgia?

A
  • symptoms and pain present for at least 3 months
  • person does not have another disorder that would explain the pain
  • number of painful areas on the body out of 19 parts

levels of severity of these symptoms: Fatigue, waking unrefreshed, cognitive problems

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8
Q

Medications that help with pain control

A

Opioids
Non-opioids
Adjuvant analgesics

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9
Q

What are some examples of Opioids?

A

Morphine
Fentanyl
Oxycodone
Methadone

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10
Q

What are some examples of Non-opioid analgesic agents that are commonly used for pain?

A 
Acetaminophen
NSAIDS
-Aspirin
-Ibuprofen
-Naproxen
-Indomethacin
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11
Q

What are some examples of Adjuvant analgesics that are commonly used for pain?

A

Anticonvulsants
Antidepressants
Multipurpose drugs

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12
Q

what is the whos 3 steps of pain management

A 
Mild pain  step 1
Nonopioid analgesic (with/without adjuvant)

Persists, mild to moderate pain  step 2
Combination of opioid
(with/without nonopioid)
(with/without adjuvant)

Persists, moderate to severe pain  step 3
Opioid administered around the clock
(with/without nonopioid)
(with/without adjuvant)

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13
Q

When do we use the Faces rating scale

A

recommended to rate pain for individuals 3 years or older also good for people who do not speak engligh

6 faces and a rating 0-5

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14
Q

What scale of pain do we use for a baby?

A

FLACC Rating Scale (Face, Legs, Activity, Cry, Consolability)
2 months - 7 years to individuals who are unable to communicate their pain

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15
Q

Why is illness trajectory important?

A

helps give client individualized care

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16
Q

End of life diagnosis for the family

A
  • Caregiver role strain
    -compromised family coping
    -decisional conflict
    -hopelessness
    grieving
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17
Q

What are some sympathetic responses to pain?

A

Increased BP and pulse

  • increased respiration
  • diaphoresis
  • pallor and dilated pupils
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18
Q

How would we reverse an opoid OD?

A

Naloxone(narcan)

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19
Q

When do we use the PAINAD scale?

A

in adults with advanced demetia/ unable to communicate

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20
Q

Oucher scale when is it used?

A

0/10 numbers and photos usually used for preschool children

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21
Q

what is a pain flow sheet?

A

Helps us understand pain on a longer scale and what interventions were done and how well they worked.

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22
Q

What scale of pain do we use for a baby?

A

CRIES

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23
Q

What sleep disorders are considered dyssomnias?

A

insomnia
hypersomnia
narcolepsy
sleep apnea

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24
Q

narcolepsy

A

people with this have a high leukocyte antigen

  • possible autoimmune disease
  • hypocretin deficiency?

onset between 15-30

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25
Q

Sleep apnea

A

is a dyssomnia category, two types of sleep apnea, central and obstructive. Most people will have obstructively seen with snoring the difference between the two is that resp muscles continue to function

risk factors age obesity and neck circumference hypertension and heart failure

26
Q

fibromyalgia

A

a chronic syndrome- amplification of pain signals
accompanied with fatigue, sleep patterns,

HIV can start up fibromyalgia

27
Q

Fibromyalgia

A

condition is not progressive and is a heightened sense of pain with the pain pathways not working correctly

onset can be repetitively doing the same motion or traumatic event

28
Q

palliative care

A

(Recovery Support)

relieving the suffering. they do not have to be dying

29
Q

hospice/comfort care

A

(Dying Support)

pain and symptom management when there is no cure

30
Q

POLST

A

transfers patients wants to medical orders that are transferable across settings

31
Q

classification of pain

A

Location (somatic or viceral)
Referral
Duration (Acute or Chronic )

32
Q

Cutaneous pain or somatic pain

A

occurs when pain receptors in tissues (including the skin muscles, skeleton, joint and connective tissues are activated)

33
Q

pain threshold

A

the point at which a nociceptive stimulus is perceived as painful

34
Q

T/F Acute pain initiate s the autonomic fight or flight response which causes physiological responses

A

True

35
Q

chronic pain

A
  • lasts longer than the expected time of healing
  • usually longer than 6 months**
  • autonomic responses decrease over time
36
Q

What are the kinds of breakthrough pain?

A

1) incident- short term predictable pain
2) idiopathic- no known cause
3) End-of-dose medication failure

37
Q

what is included in the PNS

A

cranial nerves (12 pairs), spinal nerves (31 pairs) and autonomic NS

38
Q

Examples of non-traumatic brain injuries

A
  • hypoxia (blood is there but lacks oxgyen)/ischemia (blockage in blood flow)
  • Excitatory amino acids (too much or too little)
  • Cerebral edema
  • Increased intracranial pressure (ICP)
39
Q

TBI is the leading cause of death and disability in people under 24

A

true

40
Q

consciousness is divided into:

A

arousal and wakefulness

content and cognition: functioning cerebral cortex

41
Q

Provoked seizures

A

can happen with metabolic changes, tumors, drug abuse, infections and brain injury

Febrile- common in children 6 - 60 months who have high fevers (temp over 104)

42
Q

Unprovoked / Epileptic

A

not provoked by other illnesses or circumstances.

1st category: focal seizures: begin in one area/hemisphere
symptoms depend of the one area effected
may or may not affect LOC

2nd category: begin with both hemispheres
-tonic clonic and absence seizures

43
Q

Tonic-clonic seizures

A

generalized
a sharp tonic contraction of muscles with the extension of the extremities and immediate loss of consciousness

time the seizure and check for hypoglycemia

44
Q

Absence seizures

A

generalized, nonconvulsive epileptic events and are expressed as mainly as disturbances in consciousness

usually in children, a blank stare

45
Q

what is the most useful diagnostic test of seizure

A

EEG- changes in the brain and electroelecivity

46
Q

Treatments of seizures?

A

treat underlying and avoiding factors

  • prophylactic medications factors
  • surgery or neurostimulation
47
Q

Parkinson’s Disease (PD)

A

dopaminergic neurons in the brain/ cerebral cortex are lost and decrease
Dopamine is no longer inhibiting acetylcholine

48
Q

Clinical manifestations of PD

A 
tremors
muscle rigidity and achy 
bradykinesia
postural and gait instability 
dysphagia
drooling
orthostatic hypertension
dementia later
depression/ anxiety
Parkinsonism
49
Q

how is PD diagnosed?

A 
Patients medical history ANNNND 
2/4 cardinal manifestations
-tremor
-rigidity
-bradykinesia
-postural changes

also look at neurological examination and confirmation of diagnosis comes from a positive effect from levodopa

50
Q

how to prevent PD and risk factors

A

no prevention

risk increases with age

51
Q

pharmacologic therapy PD:

A 
levodopa 
dopamine agonists
dopamine modifiers (MAO-B)
Anticholinergics (inhibits ACH)
52
Q

Cognition changes experienced in older adults

A

They need more time to learn and have to be motivated

-can remember long term but not shorter term

53
Q

Cognition changes experienced in older adults

A

They need more time to learn and have to be motivated

  • can remember long term but not shorter term
  • perception
  • cognitive ability (less multitasking)
54
Q

Intellectual disability

A

significant limitations

  • affects practical skills
  • disrupt normal form or function of CNS
55
Q

dementia

A

not a disese but symptoms that affect the brain.
steady onset that is the irreversible loss of brain function
-personality changes
-Alzheimer’s disease is a type of Dementia

56
Q

Alzheimer’s Disease (AD)

A

fatal complications, gradual loss of cognitive function, and change in affect

after age 65

Two types:
Familial- early-onset strongly inherited
Sporadic - late-onset no pattern of inheritance

57
Q

Alzheimer’s Disease (AD) patho and etiology

A

death of neurons follows a specific pattern

  • blood flow to affected areas decreases
  • atrophy of cortical area of bain
  • structural and chemical changes
58
Q

what abnormal characteristics will we see with someone who has dementia?

A

neurofibrillary tangles- thick protein clots noted, loss of communication between neurons resulting in death in nurons

Amyloid plaques in spaces between neurons

59
Q

When the death in neurons occur due to neurofibruallary tangles what is released?

A

Galanin

60
Q

what is the cure for AD

A

several medications is known to slow the progression of the disease, no cure

61
Q

Stroke anterior Cerebral what does it effect

A

impaired foot or leg, sensory loss over toes foot and leg. problems in making decisions or performing acts voluntarily. cognitive affect disorders

62
Q

Is multiple sclerosis treatatble?

A

NO it is a progressive disease of the CNS and is relapsing and remitting

chronic (7 decks)

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