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U of R SCHOOL OF NURSING > NUR 362 - PAIN > Flashcards

NUR 362 - PAIN Flashcards

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1
Q

Definition of Pain

A

pain is whatever the experiencing person says it is, existing whenever the person says it does

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2
Q

Acute pain

A

meaningful, linear, reversible, well defined
recent onset identified cause
observable signs (tachycardia, hypertension, pallor)
time limited: subsides when pain is treated and goes away

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3
Q

Chronic pain

A 
meaningless, cyclical, irreversible
> 6 mo. duration
won't see observable signs (patient adjusted to chronic cycle of pain) 
increased appetite
difficulty sleeping
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4
Q

Somatic pain symptoms

A 
well localized
aching
stabbing
throbbing
can pinpoint where is
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5
Q

Visceral pain symptoms

A

poorly localized
deep aching
pressure referred
cannot pinpoint where pain is

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6
Q

Neuropathic pain symptoms

A

burning
shooting
tingling

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7
Q

Causes of somatic pain

A

cutaneous nociceptors

musculoskeletal

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8
Q

Causes of visceral pain

A

stretching

distension in internal organs

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9
Q

Causes of neuropathic pain

A

primary dysfunction in nervous system

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10
Q

Examples of somatic pain

A

bone
joint
skin
connective tissue injuries

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11
Q

Examples of visceral pain

A

bowel obstruction
MI
pancreatic tumor

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12
Q

Examples of neuropathic pain

A

TMJ
diabetic neuropathy
post stroke pain

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13
Q

Pain processes

A

transduction
transmission
pain perception
modulation

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14
Q

Gate control theory

A

pain impulses controlled by gating mechanism in substantial gelatinous of the dorsal horn of spinal cord to permit or inhibit transmission

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15
Q

A-alpha fibers

A

muscle sensory

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16
Q

A-beta fibers

A

skin sensory

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17
Q

A-delta fibers

A

prickling, sharp, localized

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18
Q

C-fibers

A

dull, aching, diffuse

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19
Q

Pain threshold

A

how much pain a person can experience when they start to feel pain

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20
Q

Pain tolerance

A

how much pain a person can experience without distress

21
Q

Pain assessment is NOT

A

relying primarily on changes in vital signs
deciding whether person looks in pain
knowing how much a procedure should “hurt”
assuming a sleeping patient does not pain
assuming patients will tell you when they are in pain

22
Q

Pain assessment IS

A

asking and believing the patient

23
Q

Subjective assessment of pain

A

eight dimensions
documentation
document pain before giving medication
reassessment of pain within 30-60 minutes after pain med is given, if patient is still in pain then document and notify provider

24
Q

Pain assessment tools

A

0-10 scale (adults)
wong-baker faces scale (pediatrics)
verbal scale (mild, moderate, severe)

25
Q

Correlation between 0-10 scale and verbal scale

A 
1-4 = mild
5-6 = moderate
7-10 = severe
26
Q

Objective data for pain

A

vital signs
observation (facial expression, movement, ability to do ADLs)
physical exam

27
Q

Assessment of cognitively impaired

A

agitation is often sign of pain

observe: facial movement, body movement, behavioral changes, daily activity changes

28
Q

5 steps in ensuring effective pain management

A 
1 = history (prior and current pain)
2 = assessment
3 = pharmacologic interventions
4 = non-pharmacologic interventions
5 = reassessment
29
Q

WHO Analgesic Ladder

A

step 1 - patients with mild pain intensity (1-4) receive NSAIDs
step 2 - patients with unrelieved progression (5-6) receive oral opioid analgesics or low-dose opioid meds
step 3 - patients with severe pain (7-10) receive higher-dose IV opioids and more frequent dosing

30
Q

Non-opioid analgesic

A

mild to moderate pain

ex: NSAID

31
Q

opioid analgesic

A

moderate to severe pain

ex: morphine prototype

32
Q

adjuvant analgesics

A

drugs with primary indication other than pain

ex: antidepressants, steroids

33
Q

adjuvants

A

drugs without analgesic properties that can be critical in pain management in certain populations
ex: muscle relaxants, sleep medications

34
Q

short acting drugs

A 
morphine
hydromorphine (dilaudid) 
codeine
hydrocodone (Vicodin, portable)
oxycodone (Percocet)
demerol
fentayl
35
Q

long acting drugs

A

MS contin
oxycontin
transdermal fentanyl

36
Q

drug routes

A 
oral
transmucosal
nasal
rectal
transdermal
parental (SQ, IM, IV, epidural, intrathecal)
37
Q

loading dose

A

given at beginning of infusion for immediate relief

38
Q

continuous dose

A

dose continually infused

39
Q

bolus dose

A

single doses at prescribed times

40
Q

lockout

A

time between boluses when no drug is delivered

41
Q

demands

A

times bolus button pushed

42
Q

side effects of medication

A 
constipation
sedation
N/V
respiratory depression
itching/hives
reversal agent - narcan (Naloxone)
43
Q

tolerance

A

patient receives drug continuously over a long period of time, then develops a neuroadaptive response to require a larger dose to produce the same effect

44
Q

dependence

A

physiologic adaptation that is characterized by the development of withdrawal symptoms such as diaphoresis, anxiety, tachycardia, or nausea when the drug is stopped abruptly

45
Q

addiction

A

chronic neurobiology disease that has genetic, psychosocial, and environmental influences in which the patient has impaired control over drug use and craving despite harm

46
Q

psuedoaddiction

A

drug-seeking, produced not by true drug addiction, but by the under-treatment of pain

47
Q

non-pharmacological methods of basic comfort

A

positioning for body alignment
regular turning
appropriate lighting, low noise
cutaneous stimulation - heat, cold, massage

48
Q

non-pharmacological methods of cognitive/behavioral comfort

A 
relaxation
meditation
distraction
biofeedback
guided imagery

U of R SCHOOL OF NURSING (12 decks)

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