med surg

Question 1

3 Phases of Illness Trajectory

Answer 1

 Crisis phase- before or immediately after diagnosis
 Chronic phase- trying to live a normal life
 Terminal phase- grief and death

Question 2

What is stress?

Answer 2

 Inability to cope with perceived (real or imagined) demands or threats to an individual mental, emotional, or spiritual well being

Question 3

What does the Cerebral Cortex do?

Answer 3

• Plans a course of action after evaluating stressor considering past experiences and future consequences

Question 4

Limbic System function

Answer 4

• Mediator of emotions, feelings, and behaviour that ensure survival and self-preservation

Question 5

Hypothalamus

Answer 5

connection b/w endocrine and NS

Question 6

How does acute and chronic stress affect IM system?

Answer 6

 Decreased number and function of natural killer cells
 Altered lymphocyte proliferation
 Decreased production of cytokines

Question 7

Nociception

Answer 7

physiological process that communicates tissue damage to the CNS

Question 8

1. Transduction

Answer 8

• Converting stimulus to ap
• Noxious stimuli cause release of chemicals- These substances activate nociceptors and lead to generation of an action potential carried to the spinal cord

Question 9

2. Transmission

Answer 9

• Pain impulse moving from site of transduction to brain

- Peripheral nerve fibers-> spinal cord-> dermatomes

Question 10

3. Perception

Answer 10

• Pain is recognized, defined, and responded to

Question 11

4. Modulation

Answer 11

• Activation of descending pathways that stop or continue the transmission of pain
• Can occur at periphery, spinal cord, brain stem, and cerebral cortex

Question 12

Nociceptive Pain

Answer 12

• Damage to somatic and visceral tissue

- Responsive to opioids and non-opioid

Question 13

Neuropathic Pain

Answer 13

• Damage to CNS or PNS
• Burning, shooting, stabbing, or electrical in nature
• Opioids, anitseizure, antidepressant meds

Question 14

P.A.I.N

Answer 14

pattern, area, intensity, nature

Question 15

Titration

Answer 15

 Dose adjustment based on assessment of the analgesic effect versus adverse effects

Question 16

Mild Pain 1-3

Answer 16

• Step 1 drugs- non-opioids

- ceiling effect

Question 17

Mild to Moderate 4-6

Answer 17

• Step 2 drugs (mu receptors)

- Persist beyond non-opioids

Question 18

Moderate to Severe 4-10

Answer 18

• Step 3, mu receptors agonist
• no ceiling effect
• Potent

Question 19

Persistent pain results in…

Answer 19

• depression
• sleep disturbances
• decrease mobility
• decreased health care use
• physical and social role dysfunction

Question 20

Barriers to Pain Relief

Answer 20

• belief that pain is inevitable
• Fear of using opioids
• Using other words to describe