Concept 27: Pain Flashcards
nociceptors
cells of free nerve endings in the sensation of pain
found in all tissues except CNS
nociception
transmit pain information through the somatosensory system
acute pain
sudden onset and is typically clearly linked to a specific event injury or illness
tissue damage as a result of surgery, trauma, or burns
short-lived and diminish with normal healing
chronic pain
lasting more than 3 months and may last for years
result from underlying medical conidition (pathology)
cancer from tumor growth or osteoarthritis pain from joint degeneration
nociceptive pain
normal functioning of the noxious stimuli (tissue injury) that is being perceived as being painful aka eudynic pain
(sunburn, surgery, or trauma) described as aching, cramping, or throbbing
somatic pain
sharp pain that is well localized to a specific are of injury
visceral pain
arises from within the body cavity
most commonly the thorax, abdomen, and pelvis
respond to stretching, swelling, and oxygen deprivation and pain may radiate to other locations int he back or chest
neuropathic pain
results from pathology or disease of the somatosensory system
pathologic
postherpetic neuralgia, diabetic neuropathy, phantom pain, post-stroke pain syndrome
burning, sharp, and shooting
deafferentation pain
chronic and results from the loss of afferent input to the CNS.
may arise in the peripheral nerve avulsion or in the CNS from spinal lesion or multiple sclerosis
neuralgia pain
lancinating and associated with nerve damage or irritation along the distribution of a single nerve
sympathetic mediated pain
accompanied by edema, changes in skin blood flow, and abnormal sensation such as allodynia, hyperalgesia, and hyperpathia
central pain
lesion in the CNS, usually imvolving spinothalamic cortical pathways, such as a thalamic infarct
burning, electrical quality
mixed pain syndrome
painful condition and syndromes that are not easily categorized and are thought to be unique with multiple underlying and poorly understood mechanism
fibromyalgia and some low back and myofascial pain
pain on physical functioning
none use of affected area and immobility can lead to muscle atrophy and joint contraction, which further promote pain and impair physical functioning.
sympathetic nervous system activation caused by acute pain decreases the release of digestive enzymes in the GI tract and slows digestion
pain med cause constipation can further impair GI function
psychosocial consequence of pain
cause fear, anger, depression, anxiety, and reduced ability to maintain relationships, engage in normal activities, and continue to work.
pain untreated causes negative effects on every aspect of the patient’s life
pain treatment with opioids can include opioid use disorder, characterized by an overwhelming urge to use opioids even when they are no longer medically necessary to treat pain. addiction can effect every aspect of a person’s life, including their relationships, employment, and economic status.
population at risk for pain
- CRITICALLY ILL INFANTS –due to high number of procedures performed (neonatal ICU)
infants, toddlers, and preverbal children do not have the cognitive skills to report and describe pain.
- OLDER ADULTS – pain increases with age
more common in acute care settings and outpatient settings such as nursing homes.
unable to report pain due to reluctance to report or unable due to illness or cognitive impairment.
- SEX, RACE, AND ETHNICITY
WOMEN have a higher chance than men —lower thresholds, hormones
social factors influence access to pain treatment due to income, education, and geographic location
numeric rating scale (NRS)
0-10 scale with no pain on one side , moderate pain in middle, and worst possible pain at the end of scale
faces Pain Scale-Revised (FPS-R_
has six faces ranging from neutral facial expressions to one intense pain and are numbered 0, 2, 4, 6, 8, and 10
the patient is asked to choose the face that best describes their pain
valid and reliable use with children and adult
young children unable to quantify pain until approximately 8 years of age
Wong-Baker FACES Pain Rating Scale
six cartoon faces with word descriptors ranging from smiling face on the left for no pain to frowning on the right for worst pain
numbered 0, 2, 4, 6, 8, and 10 or 0-5
used in adult and children as young as 3 years old.
Verbal Discriptor Scale (VDS)
a series of different words or phrases to describe the intensity of pain
such as
no pain
moderate pain
severe pain
very severe pain
can be present horizontally or vertically
breakthrough pain
determines whether the patient’s treatment is effective
aka pain flare
transitory exacerbation of pain in a patient has relatively stable and adequately controlled baseline pain
incident pain
breakthrough pain is brief and precipitated by voluntary action such as movement
idiopathic pain
not associated with any known cause and often lasts longer than the incident pain
end of dose failure pain
episodes of pain that occurs beofre the next analgesic dose
osteoarthritis pain
condition that cause cartilage in a joint to become stiff and lose elasticity
cartilage wears away causing tendon and ligament to rub against one another, resulting in pain
trigeminal neuralgia
aka tic douloureux
neuropathic pain arising from teh trigeminal (V) cranial nerve
cause extreme sporadic burning or shock-like facial pain that can last seconds to minutes per episode.
postherpetic neuralgia
develops after a case of shingles caused by the herpes zoster virus
thin blisters associated with shingles disappear within few weeks, but when the pain continues after the blisters have disappeared, the burning pain is known as postherpetic
post stroke pain
complex regional pain syndrom
fibromyalgia
