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Nursing Fundamentals > LP 12: Pain & Comfort > Flashcards

LP 12: Pain & Comfort Flashcards

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1
Q

What are the consequences of poor pain management?

A

-Sleep deprivation
-Poor nutrition
-Depression
-Anxiety
-Agitation
-Decreased activity
-Delayed healing
-Lower overall quality of life

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2
Q

What is the Nature of Pain?

A

“Whatever the experiencing person says it is, existing whenever he/she says it does”

Highly subjective
5th vital sign

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3
Q

What are the 3 types of location of pain?

A

-Radiate
-Reffered
-Visceral

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4
Q

What is Radiate Pain?

A

Pain that spreads to other areas (Low back pain spreads to legs).

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5
Q

What is Reffered Pain?

A

Pain that appears to to arise in different areas of the body (cardiac pain is felt in left shoulder or arm)

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6
Q

What is Visceral Pain?

A

Pain that arises from organs or hollow viscera.

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7
Q

What is Acute Pain?

A

Sudden. Short term.

*<3months
*Mild to severe
*Resolves with healing
*Abnormal VS (increased RR,PR,BP) ->Sympathetic nervous system

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8
Q

What is Chronic Pain?

A

Prolonged. Long term.

*>3months
*Mild to severe
*Continues beyond healing
*Pt. appears depressed and withdrawn

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9
Q

What are the intensity types of pain?

A

*Mild 0-3
*Moderate 4-6
*Severe 7-10

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10
Q

What is the Etiology of pain?

A

*Physiological (Nociceptors)
- Somatic (paper cut; sprained ankle)
- Visceral (obstructed bowel)

*Neuropathic (Nerves damaged)
- Peripheral neuropathic pain
- Central

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11
Q

What is Threshold?

A

Least amount of stimuli needed for pain sensation.

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12
Q

What is Pain Tolerance?

A

Max amount of pain a person is willing to withstand.

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13
Q

What is Hyperpathia/Hyperalgesia?

A

Heightened responses to a painful stimuli (severe pain to a paper cut)

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14
Q

What is Allodynia?

A

When non-painful stimuli produces pain (light touch, contact with linens, wind)

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15
Q

What is Dysesthesia?

A

Unpleasant abnormal sensation (needles, pinds, itching, burning)

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16
Q

What is Sensitization?

A

Increased sensitivity of a receptor after repeated activation by a noxious stimuli

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17
Q

What is Windup?

A

Progressive increase pain.
Pain gets out of control.

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18
Q

What are Nociceptors?

A

The make up the physiology of Pain

-Transduction
-Transmission
-Perception
-Modulation

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19
Q

Transduction

A

Harmful stimuli trigger the release of biochemical mediators which sensitize nociceptors.

-Affect PNS.
-NSAIDs are used (Ibuprofen, aspirin, naproxen)

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20
Q

Transmission

A

Process of transmiting pain from site of incident to the brain.

Pain travels through the spinal cord to the brain.

Opioids/Narcotics are used

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21
Q

Perception

A

Becoming consious of pain. (Brain)

Distraction is used (nonpharmacological intervations)

22
Q

Modulation

A

Descending system (Antidepressants)

Pain signals are sent back down through the dorsal horn to the spinal cord.

23
Q

What are some responses to unrelieved pain?

A

-Affects appetite
-Decresed mobility
-Emotional disorder
-Interferes with sleep
-Lowers qualit of life
-Slows healing
-Windup phenomenon occurs.

24
Q

What factors affect pain experience?

A

-Ethnic and cultural values (Some show emotions or pain, some others don’t)

-Developmental stage (babies can’t talk)

-Environment and support people (Having someone to talk to)

25
Q

DEVELOPMENTAL STAGES OF PAIN

A
26
Q

Infants

A

-Perceive pain

Relieved with sweet pacifiers, or tactile stimulation.

27
Q

Toddler/Preschool

A

Respond to pain with crying and anger

Relieved with distractions. Get down to their level and distract them

28
Q

School-age

A

Try to be brave

Relieved with imagery, behavioral rehearsal.

29
Q

Adolescents

A

Want to be brave in front of peers.

Provide privacy

30
Q

Adults

A

Fear of what pain means may prevent from taking actions.

Focus on client’s control

31
Q

Older adults

A

Multiple conditions. Fear of treatment.

Clarify misconceptions

32
Q

What does History of Pain consist of?

A

-Location (Where does it hurt)
-Intensity (Pain scale)
-Quality (Description of pain)
-Patterns (Onse; What triggers it; What makes it better

33
Q

What is FLACC scale?

A

Pain scale used for children 2 months of age to 7 years old

-Facial expretions
-Leg movement
-Activity
-Cry
-Consolability

34
Q

What is PAINAD Scale?

A

Pain
Assessment
IN
Advanced
Dementia

35
Q

What does OLDCARTS stand for?

A

Onset
Location
Duration
Characteristics
Aggravating factors
Relieving factors
Treatment
Severity

36
Q

What are the Observations of Behavioral and Physiological Responses?

A

-Facial expressions
-Vocalization
-Purposeless body movements
-Rhythmic body movements

37
Q

What is Drug Tolerance?

A

Decreased sensitivity to a drug’s analgesic effect.

38
Q

What is Physical Dependence?

A

An expected physical response when a patient with long-term opioid therapy has a significantly decrease or withdrawal.

39
Q

What is Addiction?

A

A chronic, relapsing treatable disease influenced by genetic, psychosocial and environmental factorss

40
Q

What is Pseudoaddiction?

A

When the pt becomes angry and demanding for the undertreatment of pain.

41
Q

What are short-term CDC guidelines for opioids?

A

-Start low, go slow
-3 days or less; rarely over 7 days
-Do not prescribe ER/LA opioid for acute pain

(Extended Release; Long Acting)

42
Q

Nonopioids/NSAIDs

A

-Work on PNS
->Ibuprofen, naproxen, aspirin (anti-inflammatory, analgesics, and antipyretics)
->Acetaminophen works on CNS (analgesic and antipyretics)

43
Q

Opiods/ Narcotics

A

-Work on CNS
->Morphene, Fentanyl, Oxycodone, Tramadol

44
Q

Coanalgesics

A

Medication used for another reason, but has been found to reduce pain

45
Q

What are types of Coanalgesics?

A

-Antidepressants
->Amitriptyline; Nortriptyline

-Anticonculsants
->Gabapantin; Pregabalin

-Topical Local Anesthetics
->Lidoderm

46
Q

What are the Combinations of Opioids and Nonopioids Analgesics?

A

*Vicodin: 5mg hydrocodone and 300mg acetaminophen.

*Percocet: 5mg oxycodone and 325mg acetaminophen

*Tylenol #3: 30mg codeine and 325mg acetaminophen.

47
Q

What are the side effects of Nonopioids?

A

-NSAIDs: GI distress; such gastric ulcers, bleeding, renal insufficiency.

-Acetaminophen: Hepatotoxicity (limit to 4g/day)

48
Q

What are the side effects of Opioids?

A

-Constipation (stool softner)
-Respiratory depression (Narcan)
-Sedation
-Urinary retantion (cath)
-Nausea and vomiting (antiemetic)
-Pruritus (Benedryl)

49
Q

What is Capnography?

A

Monitors the conentration of CO2 in resp gasses.

50
Q

What are some physical intervantions for pain?

A

-Cutaneous Stimulation
-Reflexology
-Immobilization
-Transcutraneous Electrical Nerve Stimulation (TENS)

51
Q

What are some Cognitive-Behavioral Interventions for Pain?

A

-Distraction (TV, musicl, pet)
-Relaxation Response
-Repatterning unhelpful thinking
-Facilitationg coping, spiritual interventions

52
Q

What is a Nonpharmacological Invasive Technique?

A

Nerve blocking - When meds go directly into the nerve to block pain

Nursing Fundamentals (14 decks)

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