Lesson 5 Flashcards
When does nociceptive pain develop?
Develops when functioning and intact nerve fibers in the periphery and the CNS are stimulated (triggered by events outside the NS from actual or potential tissue damage)
Where does somatic pain come from?
The joints, bones, muscles, and other soft tissues
Where does visceral pain come from?
The internal organs
What are the 4 phases of nociceptive pain?
Transduction, transmission, perception, modulation
Is nociceptive pain predictable and time-limited based on the extent of the injury?
Yes
Can nociceptive pain turn into neuropathic pain?
Yes, over time when pain has been poorly controlled
What is neuropathic pain?
Pain that does not adhere to the typical and predictable phases of nociceptive pain
Neuropathic pain implies an ____ of the pain message from an injury to the nerve fibers.
Abnormal processing
“Pain caused by a lesion or disease of the somatosensory nervous system”
Which pain is more difficult to assess and treat?
Neuropathic
Describe acute pain behaviors
- Short term
- Self limiting
- Follows a predictable trajectory
- Dissipates after injury heels
- Self protective (warns individual of actual or threatened tissue damage)
When is chronic pain diagnosed?
When pain continues for 6 months or longer (can last 5, 10, 15, or 20 years beyond initial instance of pain)
How is chronic pain behaviors divided into?
Malignant and nonmalignant
In chronic pain, does pain stop when the injury is heeled?
No
Myth: Clients with chronic pain must be malingering
Pain indicates pathology or injury and should not be considered a “normal process of aging” and not something to tolerate or accept later in life
Myth: Clients with demential do not feel pain
People with demential DO fee pain. The somatosensory cortex is generally unaffected by demential of the Alzheimer type (must assess body language instead of verbal communication for pain)
Myth: Infants don’t experience pain to the same degree that adults do
Infants have the same capacity for pain as adults
-Sensory fibers and neurotransmitters are developed by 20 weeks of gestation
For infants and pain, when are inhibitory neurotransmitters sufficient?
Until birth at full term
A ____ infant is rendered more sensitive to painful stimuli.
Preterm
When do you use the 0-10 pain scale?
It is a numerical scale used on ages 7+
When do you use the NIPS pain scale?
Infants 0-3 months
When do you use the faces pain scale?
3-7
What does the FLACC pain scale stand for?
Faces, legs, activity, cry, consolability
When do you use the FLACC behavior pain scale?
Ages 3 months- 7 years old; or individuals who are unable to communicate their pain
What is the “gold standard” of pain assessment?
Self-report; Pain is SUBJECTIVE and cannot be measured with a device
-Nurses need to listen to the patient’s description of pain and ask questions regarding the pain, to understand how to best help the patient (PQRST is helpful)
What does PQRST stand for?
P-provacation and palliation (when is it worse? when is it better?)
Q- quality and quantity (Describe what it feels like)
R- Region and radiation (Show me the location where it hurts)
S- Severity (0-10 pain scale)
T- Timing (when did it start to hurt? how long does it last?
When should the nurse undergo a thorough pain assessment?
When the pain is so unbearable, nurses can abbreviate the PQRST method
If the patient just had surgery on their leg and wake up and are crying out in pain, you do not need to ask once again where the pain is. You would know. That is what it means by an “abbreviated PQRST”
What is the most important vital sign?
Pulse oximetry
What are the 5 things the pulse oximetry can show us?
CO BP Oxygen saturation Blood gas analysis HR -Basically it lets us know how well blood is being pumped from the heart
Why is tachypnea alone not a good indicator of hypoxemia?
Tachypnea can have many origins
Ex: tachypnea is a normal response to fever, fear, or exercise
Why is cyanosis not a good indicator of hypoxemia?
Cyanosis can be a nonspecific sign
What are the most common causes of an inaccurate pulse oximetry reading?
Movement
Ambient light
Cold extremities (from decreased blood flow)
Nail polish
What is a normal O2 saturation level?
93-100%
What is an abnormal O2 saturation level?
When looking at O2 Saturation levels, what must you consider?
If they are on oxygen
How much oxygen they are being given
Respiration rate
