Module 7 Flashcards
pain
the feeling of discomfort strong enough to be intrusive and to effect or interfere with normal activity.
surgical patients expierence what type of pain?
postoperative pain
myocardial infarction
a heart attack
is pain one of the vital signs?
yes it is the fifth vital sign
is there an accurate way to measure pain?
no there is not.
fentanyl patch
replaced every 72 hours, and can be managed at home by the patient
gait control theory
pain transmission is viewed as being controlled by a gate mechanism in the central nervous system, which basically states opening the gate allows the transmission of pain sensation, and closing the gate blocks this transmission.
endorphins
are endogenous, naturally occurring, opiate like peptides reduce or block the perception of pain. they attach to nerve endings in opiod receptors and block pain transmission.
acute pain
usually associated with an injury, medical condition, or surgical procedure. short duration. can be accompanied by an increase in heart rate, blood pressure, and respiratory rate. and it may worsen in the presence of anxiety or fear.
examples of acute pain
burns, bone fractures, pneumonia, sickle cell crisis, herpes, inflammations, infections, angina.
chronic pain
months, or even years. many medical problems come from chronic pain.. arthritis and back problems are chronic pain
nociceptive pain
involves injury to tissues in which receptors called nociceptors are located, the pain can be caused by trauma, burns, or surgery.
4 phases of nociceptive pain
- transduction begins when tissue damage causes the release of substances that stimulate the nociceptors and start the sensation of pain. 2. transmission involves movement of pain sensation to the spinal cord. 3. perception occurs when pain impulses reach the brain and the pain is recognized and 4. modulation occurs when neurons in the brain send signals back down the spinal cord by release of nerotransmitters
treatment for nociceptive pain
NSAIDS in stage 1 , opiods stage 2 , distraction and guided imagery during 3 stage
neuropathic pain
usually associated with a dysfunction of the nervous system, specifically an abnormalitiy in processing sensations. pain receptors become sensitive to stimuli and send pain signals.
how can neuropathic pain be treated?
NSAID family, but also increasingly with adjuvant medications
phantom pain
occurs after the loss of a body part from amputation.
observable indicators of pain
moaning, crying, irritability, inability to sleep, grimacing or frowning, restlessness, and a rigid posture in bed.
stoic patients
may show none of those outward expressions.
detectable signs of pain
blood pressure, heart rate, respiration’s, or the presence of nausea, or diaphoresis
nursing diagnosis may include what regarding pain?
readiness for enhanced comfort, acute pain, chronic pain, fatigue, self-care deficit, deficient knowledge, sleep, anxiety, fear.
TENS
Transcutaneous electrical nerve stimulation, uses a small electrical stimulator attached to electrodes to block pain. the patient can control the intensity and interval of the current with the dials on stimulator. it requires a physicians order.
percutaneous electrical nerve stimulation
a treatment showing promise for relief of lower back pain. an electrical current is sent through thin needle probes positioned in the soft tissues and muscles of the back.
binders and braces
binders are clothed wrapped around a limb or body part. a brace is a device to immobilize joints
4 categories of pain medication
NSAIDS, COX-2 Inhibitors, Narcotics or opioids, Adjuvant Analgesics.
analgesic
pain relieving
bolus
concentrated dose give rapidly
PCA
patient controlled analgesia, most common method used for injectable opiods in acute pain. doses controlled by the patient.
how many hours of sleep does an adult need every night
7 hours
NREM
non-rapid eye movement. is the time when the body recieves the most rest. divided into 3 stages.1. transition stage, last a few minutes 2. person falls into a deeper sleep, last 10-20 minutes. stage 3. delta sleep, 20-40 minute the deepest stage of sleep
REM
rapid eye movement sleep. vivid dream occurs, last 20 minutes. 25% of night spent in REM sleep. begins about 90 minutes after falling asleep , very difficult to awaken
newborns require how much sleep
16 hours of sleep per day. and they spend 80% of time in REM Sleep.
age 1 sleep
12-14 hours a day.
school age children
10-11 hours of sleep per night.
insomnia
is difficulty in getting to sleep or staying asleep at night. can be short term, or chronic. most common sleep disorder
sleep apnea
a condition in which the person stops breathing for brief periods during sleep. three types of sleep apnea: Obstructive, Central and mixed- complex
obstructive apnea
is the most common. caused by relaxtion of soft tissues. these indvid usually do not remember waking .
central apnea
caused by failure of the brain to communicate with the resp muscles.
snoring
caused by vibration and or obstruction of the air passages at the back of the mouth and nose. sleeping on the side may help with snoring.
narcolepsy
is a sudden-onset, recurrent, uncontrollable brief episodes of sleep during normal hours of wakefulness in a well-rested person. lasts from a few seconds to more than 30 minutes. usally began at age 25. it is not inherited.
medications for sleep
sedatives and hypnotics are sometimes presribed to promote sleep.
Stage I NREM
very light sleep, only a few minutes long, can be awakened easily, feels relaxed.
Stage II NREM
deeper sleep, 10-20 min in length, requires slightly more stimulation, increased relaxtion
Stage III NREM
Deep Sleep, 15-30 min in length, difficult to awaken, person seldom moves,
Stage IV NREM
called delta sleep, deepest sleep, 15-30 min, very difficult to awaken, repair of tissue, peeing in bed can occur,
