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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
Sleep apnea
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
fibromyalgia
a chronic syndrome- amplification of pain signals accompanied with fatigue, sleep patterns, HIV can start up fibromyalgia
27
Fibromyalgia
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
palliative care
(Recovery Support) | relieving the suffering. they do not have to be dying
29
hospice/comfort care
(Dying Support) | pain and symptom management when there is no cure
30
POLST
transfers patients wants to medical orders that are transferable across settings
31
classification of pain
Location (somatic or viceral) Referral Duration (Acute or Chronic )
32
Cutaneous pain or somatic pain
occurs when pain receptors in tissues (including the skin muscles, skeleton, joint and connective tissues are activated)
33
pain threshold
the point at which a nociceptive stimulus is perceived as painful
34
T/F Acute pain initiate s the autonomic fight or flight response which causes physiological responses
True
35
chronic pain
- lasts longer than the expected time of healing - usually longer than 6 months** - autonomic responses decrease over time
36
What are the kinds of breakthrough pain?
1) incident- short term predictable pain 2) idiopathic- no known cause 3) End-of-dose medication failure
37
what is included in the PNS
cranial nerves (12 pairs), spinal nerves (31 pairs) and autonomic NS
38
Examples of non-traumatic brain injuries
- 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
TBI is the leading cause of death and disability in people under 24
true
40
consciousness is divided into:
arousal and wakefulness content and cognition: functioning cerebral cortex
41
Provoked seizures
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
Unprovoked / Epileptic
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
Tonic-clonic seizures
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
Absence seizures
generalized, nonconvulsive epileptic events and are expressed as mainly as disturbances in consciousness usually in children, a blank stare
45
what is the most useful diagnostic test of seizure
EEG- changes in the brain and electroelecivity
46
Treatments of seizures?
treat underlying and avoiding factors - prophylactic medications factors - surgery or neurostimulation
47
Parkinson's Disease (PD)
dopaminergic neurons in the brain/ cerebral cortex are lost and decrease Dopamine is no longer inhibiting acetylcholine
48
Clinical manifestations of PD
``` tremors muscle rigidity and achy bradykinesia postural and gait instability dysphagia drooling orthostatic hypertension dementia later depression/ anxiety Parkinsonism ```
49
how is PD diagnosed?
``` 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
how to prevent PD and risk factors
no prevention | risk increases with age
51
pharmacologic therapy PD:
``` levodopa dopamine agonists dopamine modifiers (MAO-B) Anticholinergics (inhibits ACH) ```
52
Cognition changes experienced in older adults
They need more time to learn and have to be motivated | -can remember long term but not shorter term
53
Cognition changes experienced in older adults
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
Intellectual disability
significant limitations - affects practical skills - disrupt normal form or function of CNS
55
dementia
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
Alzheimer's Disease (AD)
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
Alzheimer's Disease (AD) patho and etiology
death of neurons follows a specific pattern - blood flow to affected areas decreases - atrophy of cortical area of bain - structural and chemical changes
58
what abnormal characteristics will we see with someone who has dementia?
neurofibrillary tangles- thick protein clots noted, loss of communication between neurons resulting in death in nurons Amyloid plaques in spaces between neurons
59
When the death in neurons occur due to neurofibruallary tangles what is released?
Galanin
60
what is the cure for AD
several medications is known to slow the progression of the disease, no cure
61
Stroke anterior Cerebral what does it effect
impaired foot or leg, sensory loss over toes foot and leg. problems in making decisions or performing acts voluntarily. cognitive affect disorders
62
Is multiple sclerosis treatatble?
NO it is a progressive disease of the CNS and is relapsing and remitting

chronic (7 decks)

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