exam 2 pain management Flashcards
Physiologically unstable patients are least likely
to receive a standardized pain assessment and to receive pain medications
A patient’s response to prescribed pain treatment can be influenced by factors unrelated to actual pharmacological treatments.
These factors include:
Perceived effective communication
Perceived responsiveness
Perceived empathy
Pain catastrophizing
is an exaggerative cognitive response to an anticipated or actual painful stimulus and affects how individuals experience and express pain.
Examples Of Catastrophizing
Magnification: the response that symptoms that can be or are greater than expected. Ex: “I´m afraid that
something serious might happen”
Rumination: when an individual focuses repeatedly on attributes of an event that evoke a negative emotional response. Ex: “I can´t stop thinking about how much it hurts“
Helplessness: the belief that there is nothing that anyone can do to improve a bad situation. Ex: “There is nothing I can do to reduce the intensity of my pain”.
Caucasian and African American populations have approximately equal proportions of fast and slow metabolizers, whereas nearly ___of certain Asian groups are fast acetylators
90%
4 pain classifications
underlying etiology, anatomic location, temporal nature
intensity
tylenol adult dose
325-650 mg PO q 4-6h
max: 4g/day
tylenol pediatric dose
15mg/kg PO q 4-6h
max: 90mg/kg/day
is the result of direct tissue injury from a noxious stimulus. can be further classified as somatic or visceral pain.
nociceptive pain
result of released inflammatory mediators that control nociceptive input and are released at sites of tissue inflammation
inflammatory pain
result of injury to nerves leading to an alteration in sensory transmission. It can be central or peripheral in nature
neuropathic pain
A-delta-fiber activity located in peripheral tissues
somatic
C fiber activity located in deeper tissues such as organs
visceral pain
pharm tx for nociceptor pain
May include both opiate and non-opiate medications depending on injury.
pharm tx for inflammatory pain
Anti-inflammatory agents
pharm tx for neuropathic pain
Tricyclic,
selective norepinephrine
reuptake inhibitors
gabapentinoids,
or antidepressants
pharm tx for somatic pain
Topical and/or local anesthetics, opiates,
non-opiates
pharm tx for visceral pain
opiates
pharm tx for acute pain
opiates, non-opiates
pharm tx for chronic pain
depends on nature of pain
A neurophysiological response to noxious injury that should
resolve with normal wound healing.
acute pain
Pain that extends beyond the time for normal wound healing with resultant development of multiple neurophysiological changes
chronic pain
An acute exacerbation of a chronic pain syndrome
acute on chronic pain
Sensory dermatome S2-S4
perineum
Sensory dermatome S1
lateral foot
Sensory dermatome L3-L4
knee and distal thigh
Sensory dermatome T12
inguinal ligament
Sensory dermatome T10
umbilicus
Sensory dermatome T4
Nipple
Sensory dermatome T1-T2
inner aspect of forearm
Sensory dermatome T6
Tip of xyphoid process
bicep tendon action
contraction of bicep
Sensory dermatome C6-7
thumb and index finger
Sensory dermatome C5-C4
shoulder clavicle
bracioradialis tendon action
elbow flexion and/or forearm pronation
triceps tendon action
elbow extension or contraction of the triceps muscle
patellar tendon action
knee extension
Tibialis posterior tendon action
plantar flexion/inversion of the foot
achiles tendon action
plantar flexion of the foot
OPQRST stands for
onset of event
provocation and palliation of s/s
quality
region and radiation
severity
timing
cautious with toradol why?
bleeding bc it alters plt function
anyone you give ketamine to in large doses you need?
a. drying agent, they drool
prolly glyco
