Comfort + Pain Management Flashcards
Is pain always what the patient says?
Yes
Pain is a personal experience based on what kinds of factors?
Psychological, biological, and social factors
Pain can have an adverse effect with-
Function + Socialization
Can pain occur in the absence of an obvious stimuli?
Yes
The process of sensory receptors responding to potentially damaging stimuli by sending nerve signals to the spinal cord and brain =
Nociception
Activated by thermal heat or cold =
Thermal Receptors
Activated by excess pressure of mechanical deformation (For example, skin incisions)
Mechanical Nociceptors
What’s detected by nociceptors and are transmitted into energy?
Noxious Stimuli
Whenever noxious stimuli is detected by nociceptors and are transmitted into energy, what is this process creating?
An Action Potential
What are pain signals transmitted from to the spinal cord and then the brain?
Nociceptors
Visceral structures are sensitive to-
Stretch, ischemia, and inflammation
What type of pain is diffuse, difficult to locate, and often referred to a distant, usually superficial, structure
Visceral Pain
What type of pain may be accompanied with nausea and vomiting. May be described as sickening, deep, squeezing, and dull =
Visceral Pain
What type of pain is initiated by stimulation of nociceptors in ligaments, bones, tendons, blood vessels, fascia, and muscles =
Deep Somatic Pain
Does deep somatic pain include sprains and broken bones?
Yes
What type of pain can be described as a dull, aching, poorly localized pain =
Deep Somatic Pain
What type of pain is started by the activation of nociceptors in the skin or other superficial tissue + is sharp, well-defined, and clearly located =
Superficial Pain
What types of injuries produce superficial pain?
Minor Wounds + Minor (1st degree) Burns
IASP =
International Association for the Study of Pain
What type of pain is defined by the IASP as caused by a lesion or a disease of the somatosensory nervous system?
Neuropathic Pain
What kind of pain is typically described by PT’s as “burning” or “like pins and needles”?
Neuropathic Pain
What disease processes can cause neuropathic pain?
Diabetes Mellitus, Strokes, and HIV
Why is neuropathic pain generally undertreated?
Because it typically doesn’t respond to analgesics (painkillers)
What meds are usually used to combat neuropathic pain?
Tricyclic Anti-depressant + Gabapentin
If pain from retained gas in the colon causes pain to be perceived in the shoulder, does that mean that the pain is considered radiating?
Yes, because it is causing pain to be perceived at a location other than the site of the painful stimulus
Nurses must consider what kinds of factors while assessing/providing holistic care for PT’s in pain?
Biological, Psychological, Social Factors
What kind of pain has a limited duration and is associated with a specific cause?
Acute Pain
What kind of pain usually causes a physiological response resulting in increased pulse, respirations, and BP?
Acute Pain
Chronic pain is ongoing and persistent for longer than-
6 Months
Chronic pain usually causes a change in vital signs or diaphoresis.
True or false?
False, it usually doesn’t.
What does chronic pain affect that can influence daily functioning?
Psychological, behavioral, and social functioning
Osteoarthritis, spinal conditions, fibromyalgia, and peripheral neuropathy all cause what kind of pain?
These are all chronic conditions, so it causes chronic pain
What kind of pain continue even after the original injury or illness has been healed/ resolved?
Chronic Pain
Is it possible to suffer chronic pain even if there hasn’t been any previous injury or illness?
Yes
Muscle tension, immobility, low energy, changes in appetite, and emotional pain are all effects of what kind of pain on the body?
Chronic Pain
Depression, anger, and fear of re-injury are all considered to be what kind of pain?
Emotional Pain
Are older adults at an increased risk for under-treatment of pain?
Yup
It’s estimated that up to what percentage of older adults in the community have pain due to chronic conditions?
70%
It’s estimated that up to what percentage of older adults living in long-term care centers have pain due to chronic conditions?
Up to 85%
Why is pain often under-assessed in older adults?
Because they are less likely to report it + it can present atypically with confusion and agitation
Is pain described as the 5th vital sign?
Yup
Pain assessment and pain management began to undergo significant changes when?
1990s
What trends led to liberal prescribing of opioid pain meds for acute + chronic pain?
Healthcare providers began focusing on pain scores
What encouraged + incentivized the aggressive treatment of pain in the 1990s?
Pain Scores
What resulted from the push to effectively manage pain?
An Opioid Crisis
Do pain management and the opioid crisis continue to influence each other as they evolve?
Yup
Pain treatment plans must -
Balance pain control, optimize functioning, and enhance quality of life all while minimizing the risk of opioid misuse
Reduced response to pain meds when the same dose has been given repeatedly, requiring a high dose of the drug to achieve the same level of response =
Tolerance
A patient is receiving morphine for palliative care, why would the dosage of the morphine need to increase over time?
Tolerance
Withdrawal symptoms that occur when a chronic pain med is suddenly reduced/stopped because of physiological changes that occur to chronic exposure to a medication =
Physical Dependence
What are some symptoms of withdrawal?
Diaphoresis (sweating), goose bumps, vomiting, anxiety, insomnia, and muscle pain
A PT take’s someone else’s pain medication but it’s to reduce pain. Is this still considered misuse?
Yup
Significant impairment/ distress from a pattern of substance use (includes alcohol, drugs, or prescription meds) =
Substance Abuse Disorder
Inability to abstain, impaired behavior control, cravings, diminished recognition of problems, dysfunctional emotional response =
Addiction
Substance Abuse Disorder can be characterized by using more substance than planned or using for more time than planned.
True or false?
True
Substance Abuse Disorder can be characterized by an inability to cut down.
True or false?
True
Substance Abuse Disorder can be characterized by cravings/ intense urges.
True or false?
True
Substance Abuse Disorder can be characterized by spending a substantial amount of the day obtaining, using, or recovering.
True or false?
True
Substance Abuse Disorder can be characterized by spending a large amount of money.
True or false?
True
Substance Abuse Disorder can be characterized by an inability to meet important professional or social obligations.
True or false?
True
How many characterizations of substance abuse disorder do you have to experience in order to have a substance abuse disorder?
2 or more characterizations
Substance Abuse Disorder can be characterized by persistent usage despite knowing its causing problems.
True or false?
True
Substance Abuse Disorder can be characterized by engaging in risky behaviors, like driving under the influence.
True or false?
True
Pain assessment and management standards were recently revised and published when and by who?
2018, The Joint Commission (TJC)
The revised standards by The Joint Commission requires hospitals to identify what as an organizational priority?
Pain Assessment + Pain Management (Including Safe Opioid Prescribing)
