💉- Ethics, Pain & Pressure Ulcer Test Flashcards
1
Q
Moral outrage
A
Belief that others are acting immorally
Powerlessness:
- can’t prevent a “wrong”
- respond with “whistleblowing”
2
Q
List 5 factors that affect moral decisions
A
Developmental stage Values Ethical framework Ethical principals Professional guidelines
3
Q
List 3 things that affect ethical decisions
A
Values , attitudes , beliefs
4
Q
What is moral or ethical agency
A
For nurses is the ability to base their practice on professional standards of ethical conduct and to participate in ethical decision making
5
Q
Values
A
Belief about the worth of something
Freely chosen; often learned
6
Q
Attitudes
A
Feelings toward person, object, idea
What a person thinks
7
Q
Beliefs
A
Something that one accepts as true
Not always bases on fact
8
Q
Name the 5 principles of ethics
A
Nonmaleficence Beneficence Fidelity Veracity Justice
9
Q
Nonmaleficence
A
Do no harm
10
Q
Beneficence
A
Duty to do good
11
Q
Fidelity
A
Loyalty
12
Q
Veracity
A
Tell the truth
13
Q
Justice
A
Be fair
14
Q
List the 5 professional nursing values
A
Altruism Autonomy Human dignity Integrity Social justice
15
Q
Altruism
A
Being concerned about well being of others
16
Q
Autonomy
A
Right to choose what they do/informed consent
17
Q
Human dignity
A
Having respect for people
18
Q
Integrity
A
Nursing code of ethics
19
Q
Social justice
A
Treating everybody fairly
20
Q
What does it mean to be an advocate
A
You work to protect and support another persons rights
- commitment is always to patient not co worker or institution
- promoting the patients dignity
- evaluating the patients autonomy
- acting as the patients voice when they can’t
21
Q
What does HIPAA stand for
A
The health insurance portability and accountability act
22
Q
EMTALA
A
Emergency medical treatment and active labor act
Requires healthcare facilities to provide emergency medical treatment to patients regardless of ability to pay and citizenship status
23
Q
PSDA
A
Patient self determination act
Recognizes the patients right to make decisions regarding his own healthcare
24
Q
ADA
A
Americans with disabilities act
Provides protection against discrimination of individuals with disabilities
25
What do nurse practice acts do
Statutory laws passed by EACH STATE's legislative body that define the practice of nursing ; scope of practice
26
Where can the nursing practice acts he located
On the state board of nursing website
27
American nurses association code of ethics
Describes the standards of professional responsibility for nurses and provides insight into ethical and acceptable behavior
Is not a law
28
The ANA guarantees the patient the right to
Dignity, privacy and safety
29
What is criminal law
Wrongs or offenses against society
Ex: felonies and misdemeanors
30
What is civil law
Disputes between individuals
Ex: contact law and tort law
31
What are tort laws
Wrongs done to one person by another person that do not involve contracts
32
What are Quasi-intentional torts ? And give 2 examples
Involve actions that injure a persons reputation
Ex: libel or slander
33
Libel
Is the written or published form of defamation of character
34
Slander
Is the spoken or verbal form of defamation of character
35
What are Intentional torts ? And list 4 examples
An action taken by one person with the intent to harm another person
Ex:assault/battery, false imprisonment, invasion of privacy and fraud
36
Fraud
Is the false representation of significant facts by words or by conduct
37
What are unintentional torts ? And give 2 examples
Negligence and malpractice
38
Malpractice
Failure to act as a 'reasonable and prudent' nurse / failure to do what a reasonable and prudent nurse would do in the same situation
39
Plaintiff
The person bringing the lawsuit
40
Defendant
The person who must defend against the lawsuit
41
To win and recover damages (money) in a malpractice lawsuit , the plaintiff must prove what 4 things
Duty
Breach of duty
Causation
Damages
42
Where would find national patient safety goals
On the joint commission website
43
List 5 safety risks in the healthcare facility
- falls
- equipment failure/accidents
- fire
- restraints
- never events
44
What are NEVER events
Can cause serious injury or death to a patient and should never happen in a hospital
45
List 8 examples of NEVER events
```
1 foreign objects
2 air embolism
3 wrong blood
4 pressure ulcers
5 infections from urinary or IV catheters
6 uncontrolled blood sugar
7 surgical site infections
8 vte (deep vein thrombosis)
```
46
What does the acronym RACE stand for
R- rescue
A- activate
C- confine
E- extinguish
47
What does the acronym PASS stand for
P- pull
A- aim
S- squeeze
S- sweep
48
What is a restraint
Anything that restricts a patients freedom to move
49
List 5 hazards to healthcare workers
```
1 biological hazards (infectious diseases/biological weapons)
2 back/neck/body injuries
3 needle stick injuries
4 radiation exposure
5 violence
```
50
What are the 3 domains of learning
Cognitive , psychomotor , affective learning
51
What is cognitive learning
Is storing and recalling information in the brain
Ex: asking a question over something you just said / lecture and test questions
52
What is psychomotor learning
Is learning a skill that requires both mental and physical activity
Ex: demonstrating how to perform an action, like an insulin injection / skill lab and check offs
53
What is affective learning
Is changes in feelings, beliefs, attitudes and values
Ex: how do you feel about a diagnosis? What are your fears / clinical experiences and reflective journaling
54
How can you determine that learning occurred
You must document your teaching and the clients verbalized response
55
Body mechanics
Is the way we move our bodies
56
What are the 4 components of body mechanics
Body alignment (posture)
Balance
Coordination
Joint mobility (bend, sit, move, etc)
57
What is isometric exercise
Muscle contraction without motion
58
What is isotonic exercise
Movement of joint with muscle contraction (free weights)
59
What is isokinetic exercise
Using equipment to provide resistance against movement (weight machines)
60
Aerobic exercise
The amount of oxygen taken in during activity meets the bodies needs (walking, jogging, bicycling)
61
Anaerobic exercise
Amount of oxygen taken in during activity doesn't meet the bodies needs (lifiting, sprinting)
62
List 4 nursing measures to promote activity and exercise
- promote exercise
- positioning patients
- helping the client out of bed
- assisting with ambulation
63
What is a trochanter roll
Goes from top of the hip to knee; to prevent external hip rotation
64
What is orthopneic position
Sitting at a 90degree angle with tray over bed and elbows laying on top in a triangle
65
What is fowlers position
Is a semi sitting position, in which the head of the bed is elevated 45-60 degrees
66
Semi-fowlers position
Head of the bed is elevated only 30 degrees
67
High fowlers position
Head of the bed is elevated to 90degrees
68
What is lateral position
Side-lying position with the top hip and knee flexed and placed in front of the rest of the body
69
Prone position
That patient lies on his abdomen with his head turned to one side
70
Sims position
Is a semi prone position
Used to give enemas
71
Supine position
Patients lies on his back with head and shoulders elevated on a small pillow
72
What are conditioning exercises
Things that you have the patient do to make sure they can stand before ambulation
73
Health
Could be considered as the highest level of physical, emotional and social functioning possible for any given individual
74
Illness
Could be considered anything that prevents an individual from achieving their highest possible level of health
75
Meaningful work
Is doing something that you enjoy
That contributes to health
76
Competing demands
Is when life still goes on even though you're sick
A factor that disrupts health
77
Acute
Nature of illness
Sudden onset and lasts short time
Ex: cold
78
Chronic
Nature of Illness
6 months or greater
Ex: diabetes , AIDS
79
Remission
Symptoms are minimal to none
80
Exacerbation
Symptoms 'flare-up'
81
Hardiness
Ones ability to survive, will to live, adapting to change
82
Burn-out
Too many demands over too long a period
83
What is psychosocial health
Includes our mental health, emotions and how we interact with those around us
84
Self-concept
Who YOU think you are
85
Development level
Is the part of self-concept where the older you get the less you're concerned about what others think
86
Role performance
Is a component of self concept ; things that we do (behavior and actions) to fulfill a certain role
87
True or false: low levels of anxiety are necessary
True
88
Depressed mood is typically marked by
A sense of emptiness
89
List 6 signs of depression
- depressed mood most of the day nearly everyday for at least 2 weeks/diminished interest or pleasure in activities the person previously enjoyed
- insomnia or hypersomnia
- loss of energy
- feelings of worthlessness
- diminished ability to concentrate
- recurrent thoughts of death
90
What is depersonalization
The feeling that people are doing things 'to' you instead of 'with' you
Lack of control over what's being done to them
91
List 9 warning signs of suicide
```
1 withdrawal
2 desire to be left alone
3 risk-taking behavior
4 changes in routine
5 changes in eating
6 giving away belongings
7 personality changes
8 saying goodbye
9 talking about suicide
```
92
Affect
Feelings
93
Anhedonia
A loss of interest or pleasure in previously enjoyable activities
94
What are the 4 health and illness roles of the nurse
Promote health
Prevent illness
Restore health
Facilitate coping
95
What is health promotion
"A desire to increase your well being"
Finding ways to help ourselves, or our patients, heal or maintain a state of physical, spiritual and mental well-being
96
What is Primary prevention ? And give examples
Activities are designed to prevent or slow the onset of disease
Ex: diet, exercise, wearing sunscreen etc
97
What is secondary prevention ? And give examples
Involves screening activities and education for detecting illnesses in the early stages
Ex: screenings (breast, testicular exams) BP and diabetes screening, tb skin test
Education
Family counseling
98
What is Tertiary prevention ? Give examples
Focuses on stopping the disease from processing and returning the individual to the pre-illness phase
Ex: medications: Lipitor (treats high cholesterol) , surgical/rehab/PT
99
Stratum corneum
The outermost layer of skin
100
Stratum germinativum
The innermost layer is the epidermis, continually produces new cells pushing the older cells towards the skin surface
101
Partial thickness
Loss of epidermis
Caused by trauma
Not caused by ischemia
102
Full thickness
- total loss of epidermis and dermis
| - may extend to subcutaneous, fascia, muscle, bone
103
Clean wounds
Uninflected wounds with minimal inflammation
Don't involve gi, gu or respiratory tract
104
Clean-contaminated wounds
Surgical incisions involving gi, gu or respiratory tract
105
Contaminated wounds
Include open, traumatic wounds or surgical incisions in which a major break in asepsis occurred
106
Infected wounds
Bacteria present and causing damage
107
Primary intention healing
When a wound involves minimal or no tissue loss and has edges that are well approximated
108
Secondary intention healing
Occurs when a wound involves extensive tissue loss, which prevents wound edges from approximating or should not be closed
Left open to heal
109
Tertiary intention healing
Initially healed through secondary intention
Later closed to approximate edges
110
Stage I of the healing process
Inflammatory Phase (cleansing)
Last from 1 to 5 days and consists of: hemostasis and inflammation
111
Stage II of the healing process
Proliferation Phase (granulation)
Occurs from days 5 to 21. Healthy cells work to replace lost tissue
Granulation tissue is formed, but is very friable
112
Friable
Easily crumbled
113
Stage III of the healing process
Maturation Phase (epithelialization)
Granulation tissue becomes scar tissue
Scar tissue is stronger than granulation, but never as strong as the original tissue
114
Serous exudate
Straw colored (yellow) clear and watery drainage from clean wounds
115
Sanguineous exudate
Bloody drainage , that indicates damage to capillaries
From full thickness wounds
116
Serosanguineous exudate
Combination of serous and sanguineous
Typically from fresh wounds
117
Purulent exudate
Thick, foul odor, pus; yellow or blue/green
WBC's ,bacteria, debris
118
What could the presence of blue-green purulent exudate mean
Pseudomonas aeruginosa is present
119
Purosanguienous exudate
Combination of sanguineous and purulent
Infected wound that is causing vascular damage
120
Hematoma
Red-blue collection of blood under the skin, which forms as a result of bleeding that can't escape to the surface
121
Dehiscence
Separation of wound layers
122
Evisceration
Total separation of the layers of a wound with internal viscera protruding through the incision
123
Fistula
An abnormal passage connecting two body cavities or a cavity and the skin
124
How long can it take a pressure ulcer to form
Can occur after only 2 hours
125
Friction
Damages the outer protective epidermal layer, decreasing the amount of pressure needed to develop skin lesions
126
Shearing
Occurs when the epidermal layer sliders over the dermis, causing damage to the vascular bed
127
List 4 Intrinsic factors creating a risk for pressure ulcers
Internal factors that alter skin and tissue integrity or oxygen delivery capabilities
Immobility
Impaired sensation
Poor nutrition
Dehydration
128
List 4 extrinsic factors that can create a risk for pressure ulcers
External factors that contribute to the development of pressure ulcers
Friction
Shearing
Exposure to moisture
Compression
129
Pressure Ulcer Stage I
Intact skin, non blanchable redness
130
Pressure ULCER stage II
Partial thickness; affecting the epidermis or partial dermis
No slough or Eschar present
131
Pressure ulcer stage III
Full thickness; subcutaneous fat is visible , but no muscle tendon or bone
Slough or eschar may be present
132
Pressure ulcer stage IV
Full thickness; muscle tendon and/or bone exposed
133
Suspected deep tissue injury
Intact skin that appears purple or maroon; blood filled blister
134
Unstageable
Base of wound is covered with slough or eschar
135
Venous stasis ulcers
Irregularly shaped lesions caused by venous congestion, often from damage to valves in the veins
Occurs usually between the inside ankle and the knee ; not necessarily over a bony prominence
136
Diabetic foot ulcers
Occur when diabetes causes the narrowing of arteries, decreasing oxygenation to the feet that result in delayed healing and tissue necrosis
137
Arterial ulcers
Occur when there is a non-pressure-related blockage of arterial blood to an area causing ischemia and tissue necrosis
Usually occurs over the lower leg, ankle robbing areas of the foot
138
The Braden scale
Is used to identify persons at risk for developing pressure ulcers
139
Periwound
Is the skin surrounding the wound
140
Maceration
Is caused by excessive moisture for periods of time
141
Epiboly
Closed or rolled wound edges
142
Debridement
Is the removal of devitalized tissue or foreign material from a wound
143
Senescent
Cells that are alive but not functioning
That can be removed by debridement
144
List 9 points to include in client teaching about wound care
1 characteristics of healthy skin
2 appearance of skin that has experienced unrelieved pressure
3 skin care and hygiene
4 protection of the skin and prevention of pressure ulcers
5 importance of adequate nutrition
6 techniques for turning and positioning
7 importance of frequent position changes
8 use of pressure-redistributing devices
9 skin changes that should be reported to healthcare professionals
145
The acronym WOUND stands for what as a teaching tool for wound care
```
Wet --> dry it
Open --> cover it
Unclean --> clean it
Necrotic --> don't scrub it
Dry --> moisten it
```
146
Sensory deprivation
Is a state of RAS depression caused by a lack of meaningful stimuli
147
RAS
Reticular activating system - located in the brain stem, controls consciousness and alertness
148
Sensory overload
Develops when either environmental or internal stimuli - or a combination of both - exceed a higher level than the patients sensory system can effectively process
149
List 4 nursing interventions for sensory deprivation
- focus on prevention
- support senses (glasses, hearing aids)
- orientation (calendar, view of environment)
- provide stimuli (regular contact, touch, tv, radio etc)
150
Nursing interventions for sensory overload
Minimize stimuli
```
Less light , noise
Less tv, radio
Calm tone
Reduce noxious odors
Provide rest
Teach stress reduction
```
151
What is pain
Whatever the patient says it is, existing whenever the patient says it does
152
It's the 6 origins of pain
The site where pain is felt; and not necessarily the source of pain
```
Superficial
Visceral
Somatic
Radiating/referred
Phantom
Psychogenic
```
153
Superficial pain
Arises in the skin or the subcutaneous tissue
Ex: touching a hot object or getting a paper cut
154
Visceral pain
Caused by the stimulation of deep internal pain receptors
Most often in the stomach, brain or thorax - described as tight, pressure, or crampy pain
155
Deep somatic pain
Originates in the ligaments tendons, nerves, blood vessels and bones
Ex: fracture or sprain, arthritis and bone cancer can cause deep somatic pain - described as achy or tender
156
Radiating pain
Starts at the origin but extends to other locations
157
Referred pain
Occurs in an area that is distant from the original site
Ex: the pain from a heart attack may be experienced down the left arm
158
Phantom pain
Is pain that is perceived to originate from an area that has been surgically removed
159
Psychogenic pain
Refers to pain that is believed to arise from the mind
Ex: the patient perceives the pain despite the fact that no physical cause can be identified
160
The acronym WOUND stands for what as a teaching tool for wound care
```
Wet --> dry it
Open --> cover it
Unclean --> clean it
Necrotic --> don't scrub it
Dry --> moisten it
```
161
List 9 points to include in client teaching about wound care
1 characteristics of healthy skin
2 appearance of skin that has experienced unrelieved pressure
3 skin care and hygiene
4 protection of the skin and prevention of pressure ulcers
5 importance of adequate nutrition
6 techniques for turning and positioning
7 importance of frequent position changes
8 use of pressure-redistributing devices
9 skin changes that should be reported to healthcare professionals
162
Senescent
Cells that are alive but not functioning
That can be removed by debridement
163
Debridement
Is the removal of devitalized tissue or foreign material from a wound
164
Epiboly
Closed or rolled wound edges
165
Maceration
Is caused by excessive moisture for periods of time
166
Periwound
Is the skin surrounding the wound
167
The Braden scale
Is used to identify persons at risk for developing pressure ulcers
168
Arterial ulcers
Occur when there is a non-pressure-related blockage of arterial blood to an area causing ischemia and tissue necrosis
Usually occurs over the lower leg, ankle robbing areas of the foot
169
Diabetic foot ulcers
Occur when diabetes causes the narrowing of arteries, decreasing oxygenation to the feet that result in delayed healing and tissue necrosis
170
Venous stasis ulcers
Irregularly shaped lesions caused by venous congestion, often from damage to valves in the veins
Occurs usually between the inside ankle and the knee ; not necessarily over a bony prominence
171
Unstageable
Base of wound is covered with slough or eschar
172
Suspected deep tissue injury
Intact skin that appears purple or maroon; blood filled blister
173
Pressure ulcer stage IV
Full thickness; muscle tendon and/or bone exposed
174
Pressure ulcer stage III
Full thickness; subcutaneous fat is visible , but no muscle tendon or bone
Slough or eschar may be present
175
Pressure ULCER stage II
Partial thickness; affecting the epidermis or partial dermis
No slough or Eschar present
176
Pressure Ulcer Stage I
Intact skin, non blanchable redness
177
List 4 extrinsic factors that can create a risk for pressure ulcers
External factors that contribute to the development of pressure ulcers
Friction
Shearing
Exposure to moisture
Compression
178
List 4 Intrinsic factors creating a risk for pressure ulcers
Internal factors that alter skin and tissue integrity or oxygen delivery capabilities
Immobility
Impaired sensation
Poor nutrition
Dehydration
179
Shearing
Occurs when the epidermal layer sliders over the dermis, causing damage to the vascular bed
180
Friction
Damages the outer protective epidermal layer, decreasing the amount of pressure needed to develop skin lesions
181
How long can it take a pressure ulcer to form
Can occur after only 2 hours
182
Fistula
An abnormal passage connecting two body cavities or a cavity and the skin
183
Evisceration
Total separation of the layers of a wound with internal viscera protruding through the incision
184
Dehiscence
Separation of wound layers
185
Hematoma
Red-blue collection of blood under the skin, which forms as a result of bleeding that can't escape to the surface
186
Purosanguienous exudate
Combination of sanguineous and purulent
Infected wound that is causing vascular damage
187
What could the presence of blue-green purulent exudate mean
Pseudomonas aeruginosa is present
188
Purulent exudate
Thick, foul odor, pus; yellow or blue/green
WBC's ,bacteria, debris
189
Serosanguineous exudate
Combination of serous and sanguineous
Typically from fresh wounds
190
Sanguineous exudate
Bloody drainage , that indicates damage to capillaries
From full thickness wounds
191
Serous exudate
Straw colored (yellow) clear and watery drainage from clean wounds
192
Stage III of the healing process
Maturation Phase (epithelialization)
Granulation tissue becomes scar tissue
Scar tissue is stronger than granulation, but never as strong as the original tissue
193
Friable
Easily crumbled
194
Stage II of the healing process
Proliferation Phase (granulation)
Occurs from days 5 to 21. Healthy cells work to replace lost tissue
Granulation tissue is formed, but is very friable
195
Stage I of the healing process
Inflammatory Phase (cleansing)
Last from 1 to 5 days and consists of: hemostasis and inflammation
196
Tertiary intention healing
Initially healed through secondary intention
Later closed to approximate edges
197
Secondary intention healing
Occurs when a wound involves extensive tissue loss, which prevents wound edges from approximating or should not be closed
Left open to heal
198
Primary intention healing
When a wound involves minimal or no tissue loss and has edges that are well approximated
199
Infected wounds
Bacteria present and causing damage
200
Contaminated wounds
Include open, traumatic wounds or surgical incisions in which a major break in asepsis occurred
201
Clean-contaminated wounds
Surgical incisions involving gi, gu or respiratory tract
202
Clean wounds
Uninflected wounds with minimal inflammation
Don't involve gi, gu or respiratory tract
203
Full thickness
- total loss of epidermis and dermis
| - may extend to subcutaneous, fascia, muscle, bone
204
Partial thickness
Loss of epidermis
Caused by trauma
Not caused by ischemia
205
Stratum germinativum
The innermost layer is the epidermis, continually produces new cells pushing the older cells towards the skin surface
206
Stratum corneum
The outermost layer of skin
207
What is Tertiary prevention ? Give examples
Focuses on stopping the disease from processing and returning the individual to the pre-illness phase
Ex: medications: Lipitor (treats high cholesterol) , surgical/rehab/PT
208
What is secondary prevention ? And give examples
Involves screening activities and education for detecting illnesses in the early stages
Ex: screenings (breast, testicular exams) BP and diabetes screening, tb skin test
Education
Family counseling
209
What is Primary prevention ? And give examples
Activities are designed to prevent or slow the onset of disease
Ex: diet, exercise, wearing sunscreen etc
210
What is health promotion
"A desire to increase your well being"
Finding ways to help ourselves, or our patients, heal or maintain a state of physical, spiritual and mental well-being
211
What are the 4 health and illness roles of the nurse
Promote health
Prevent illness
Restore health
Facilitate coping
212
Anhedonia
A loss of interest or pleasure in previously enjoyable activities
213
Affect
Feelings
214
List 9 warning signs of suicide
```
1 withdrawal
2 desire to be left alone
3 risk-taking behavior
4 changes in routine
5 changes in eating
6 giving away belongings
7 personality changes
8 saying goodbye
9 talking about suicide
```
215
What is depersonalization
The feeling that people are doing things 'to' you instead of 'with' you
Lack of control over what's being done to them
216
List 6 signs of depression
- depressed mood most of the day nearly everyday for at least 2 weeks/diminished interest or pleasure in activities the person previously enjoyed
- insomnia or hypersomnia
- loss of energy
- feelings of worthlessness
- diminished ability to concentrate
- recurrent thoughts of death
217
Depressed mood is typically marked by
A sense of emptiness
218
True or false: low levels of anxiety are necessary
True
219
Role performance
Is a component of self concept ; things that we do (behavior and actions) to fulfill a certain role
220
Development level
Is the part of self-concept where the older you get the less you're concerned about what others think
221
Self-concept
Who YOU think you are
222
What is psychosocial health
Includes our mental health, emotions and how we interact with those around us
223
Burn-out
Too many demands over too long a period
224
Hardiness
Ones ability to survive, will to live, adapting to change
225
Exacerbation
Symptoms 'flare-up'
226
Remission
Symptoms are minimal to none
227
Chronic
Nature of Illness
6 months or greater
Ex: diabetes , AIDS
228
Acute
Nature of illness
Sudden onset and lasts short time
Ex: cold
229
Competing demands
Is when life still goes on even though you're sick
A factor that disrupts health
230
Meaningful work
Is doing something that you enjoy
That contributes to health
231
Illness
Could be considered anything that prevents an individual from achieving their highest possible level of health
232
Health
Could be considered as the highest level of physical, emotional and social functioning possible for any given individual
233
Acute pain
- short duration rapid in onset
- varies in intensity
- lasts up to 6 months
234
Chronic pain
- last 6 months or longer
- interferes with daily activities
- can be related to a progressive disorder
235
Intractable pain
- both chronic and highly resistant to relief
| - should be approached with multiple methods of pain relief
236
Transduction
Activation of nociceptors by stimuli
-mechanical, thermal, chemical
237
Nociceptive pain
Occurs when pain receptors, called nociceptors respond to stimuli that are potentially damaging
May occur as a result of trauma, surgery or inflammation - it is mostly commonly described as aching
Ex: visceral and somatic
238
Neuropathic pain
Chronic pain that arises when injury to one or more nerves results in repeated transmission of pain signals even in the absence of painful stimuli
Described as burning, numbness, itching and "pins and needles" prickling pain
239
Mechanical stimuli
External forces that result in pressure or friction against the body
Ex: surgical incisions, friction or skin shearing from sliding down in bed, etc
240
Thermal stimuli
Result from exposure to extreme heat or cold
241
Chemical stimuli
Can be internal or external
Ex: lemon juice in a cut or chest pain experienced during a heart attack
242
Transmission
Conduction of pain message to spinal cord
243
A-delta fibers
Myelinated fibers that Transmit fast pain impulses from acute, focused mechanical and thermal stimuli
244
C fibers
Unmyelinated fibers that transmit slow pain impulses from mechanical, thermal or chemical stimuli
Ex: bump your knee, the lingering ache in the tissue will be carried by C fibers
245
Substance P
Neurotransmitter which carries pain impulses across the synapses
- some pain messages enter the reticular formation of the brain stem
- others are transmitted to the thalamus where they are directed to 3 regions of the brain (somatosensory, limbic system, frontal)
246
Somatosensory
Physical sensations
247
Limbic system
Emotional reactions to stimuli
248
Frontal cortex
Thought and reason
249
List 3 nonverbal signs of pain
Elevated pulse/blood pressure
Crying, moaning
Grimacing
250
What 3 words are universally used to describe pain
Pain , hurt and ache
251
What is moral distress
Inability to carry out a moral decision
```
Perceived constraints:
Physicians
Administrators
Other nurses
Law/threat of lawsuit
```
