LP 12-15 Flashcards
Consequences of Poor Pain Management
Sleep Deprivation
Poor Nutrition
Depression
Anxiety
Agitation
Decreased Activity
Delayed Healing
Lower Quality of Life
The Nature of Pain is
Subjective
whatever the person experiencing it says it is
Types of Pain
Location
Duration
-Acute
-Chronic (3 months +)
Intensity
Etiology
-Physiological
-Neuropathic
Intensity 0-10
1-3 = mild pain
4-6 = moderate pain
7-10 = severe pain
The nurse assessing a client experiencing acute pain does not anticipating assessing which of the following signs or symptoms?
a) increased pulse rate
b) skin warm & dry
c) dilated pupils
d) increased respiratory rate
b) skin warm & dry
Threshold
least amount of stimuli needed for a pain sensation
Tolerance
maximum amount of pain a person is willing to withstand
Hyperalgesia/Hyperpathia
heightened responses to a painful stimuli
-severe pain
Allodynia
non-painful stimuli produces pain
-light touch/wind
Dysesthesia
an unpleasant abnormal sensation
-pin/needles/itching/burning
Sensitization
increased sensitivity
Windup
progressive increase in excitability & sensitivity of spinal cord neurons, leading to persistent increased pain
Nociception
pain receptor
Phases of Nociception
1st-Transduction (ibuprofen)
2nd- Transmission (narcotics)
3rd- Perception (distractions)
4th- Modulation (antidepressants)
African Americans believe pain is
a part of life and should be endured
Hispanic/Latino believe
enduring pain is a sign of strength
Asian Americans
value silence
Janpanese may be stoic
Native Americans pain
Less expressive
Arab Americans pain
express pain to family, not health professionals
FLACC Scale
Face expressions
Leg Movement
Activity
Cry
Consolability
2 months-7years old
PAINAD Scale
Pain
Assesment
IN
Advanced Dementia
PAINAD Scale scores
Noisy Labored Breathing
Occasional Moan
Sad
Tense
Reassured by voice
OLDCARTS
Onset
Location
Duration
Characteristics
Aggravating Factors
Relieving Factors
Treatment
Severity
Drug Tolerance
decreased sensitivity
Physical Dependence Narcotics
-withdrawal signs/symptoms
Addiction
craving for a substance
lack of control
compulsive use
continue use despite harm
Pseudo addiction
results from under treatment of the pain
client becomes so focused on obtaining meds for pain relief that they become angry and demanding
CDC Guidelines for Opioids
Short term (3 days or less, start low)
Not first line or routine for chronic pain
What are NSAIDs?
Nonopioids
work on PNS
Types of NSAIDs?
Ibuprofen
Asprin
Naproxen
What are Opiods?
Narcotics
work on CNS
Types of Opiods
Morphine
Fetanyl
Oxycodone
Tramadol
What is a Coanalgesic?
a med developed for another reason, but has been found to reduce certain pain
Types of Coanalgesic
Tricyclic Antidepressants (nortrityline, amitriptyline)
Anticonvulsants (Gabapentin,Pregablin)
Topical Anesthetic (Lidoderm)
Combination Opioid & Nonopioid analgesics
Vicodin
Percocet
Tylenol #3
NSAIDs Side Effects
gastric ulcers
increased bleeding
renal insufficiency