Exam 4 - Pain Flashcards
what is acute pain caused by
trauma
surgery
what is chronic pain caused by
disease
healed tissue injury
somatic
skin and other MSK structures
visceral
organs
what describes somatic superficial pain?
sharp and burning
what describes deep somatic pain?
dull aching and cramping
visceral pain
poorly localized radiates dull ache sharp/stab
what is neuropathic pain?
from a nerve injury
what does neuropathic pain feel like?
pooly localized
shooting
burning
fire
how is pain transmitted
C-Fibers
Delta A fibers
what are rapid A- delta fibers?
rapid response
found in skin and muscle
feels prickly and sharp
what are C fibers
slow and more diffuse
found in muscle, periosteum, organs
unmyelinated, thermal, chemical, and mechanical impulse
what are the three pain theories
specificity
gate control
neuromatrix
specifiticty theory
input of pain travels to brain that processes
gate control theory
occurs in spinal cord
can change impulse before heading to brain
neuromatrix theory
whatever the brain says it is, it is
relief of associated symptoms rest empathy diversion humor faith
all do what?
alleviate pain
nausea vomitting fever lack of sleep poor nutrition anxiety fear depression anger
all do what?
increase pain
how does acute pain effect the patient
inhibit coughing and deep breathing
enhance muscle reflex contraction
activation of stress
how does chronic pain effect the patient
cause sleep disturbance reduce energy decrease socialization decrease immune cause depression
Pain = Stress =
delayed healing
how to assess pain
precipitating factors aggravating factors localization of pain characterization duration physical signs
PQRST
Precipitating factors Quality or quantity region or radiation severity scale timing
what are assessment categories
localized
raditating
referred
projected
three main analgesic classifications
opioid
nonopioid
adjuvant
what are the receptors for opioids
mu
kappa
delta
which receptor is most important
mu
what receptor doesn’t matter with opioid
delta
what are the classifications of opioids
agonist
antagonist
agaonist-antagonist
what do the agonist target?
kappa and mu receptors
what do antagonist target?
used to reverse effects of opioids
what do agonist antagonist target
block mu and activate kappa
what happens when you give a agonist with an agonist antagonist?
it will act as an antagonist
agonist opioids
fentanyl
codeine
hydromorphone
oxycodone
antagonist opioid
narcan (naloxone)
combination drugs
norco (hydrocodone and acetaminaphen)
vicoprofen
agonist antagonist
buprenorphine
sedating adjuvants
anti emetic
anti anxiety
muscle relaxants
anti histamine
non sedating adjuvants
glucocorticosteroids
anti convulsant
anti depressant
local anestetic
side effects of opioids
sedation and resp depression
types of COX inhibitors
anti inflammatory
anti pyretic
analgesics
what is a FLACC scale
face legs activity cry consolibility
CRIES scale
cry o2 hr and bp facial expression sleep
what is a non pain scale on the FLACC scale
0
what is a non pain scale on the cries scale
0
non seizure medication
gabapentin
antinausea
ondanestron and zofran
non opioid analgesic IV
toradol
how should you deliver narcan
every 2 to 3 minutes
0.2 mg to 0.4 mg
who should you not give morphine too?
gall bladder patients
no head injuries
pancreas
miosis
pin point pupils
Complementary alternative medicine
massage and other things
how should you administer pain meds in elderly?
low and slow
how should you administer pain meds in every one else for doses?
high to low
