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Med-Surg Nursing > objective 8 > Flashcards

objective 8 Flashcards

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1
Q

Referred to as the 5th
vital sign
Assessment should be
automatic
Treatment of pain is a
basic human right

A

pain

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2
Q
  • Whatever and whenever the
    person experiencing pain says it is
  • Unpleasant sensory and emotional
    experience associated with actual
    or potential tissue damage
  • Multidimensional and entirely
    subjective
  • Pain can be experienced in the
    absence of identifiable tissue
    damage.
A

pain

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3
Q

what are the dimensions of pain and the pain process?

A
  • Multidimensional experience
  • Physiological
  • Sensory–discriminative
  • Motivational–affective
  • Cognitive–evaluative
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4
Q

Physiological process that
communicates tissue damage to the central nervous
system

A

nociception

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5
Q

what are the mechanisms of which pain is percieved?

A
  • Transduction
  • Transmission
  • Perception
  • Modulation
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6
Q
  • Conversion of a mechanical,
    thermal, or chemical stimulus into
    a neuronal action potential
  • Occurs at the nociceptors
A

transduction

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7
Q

The movement of pain
impulses from the site of
transduction to the brain.

A

transmission

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8
Q

what are the 3 segment’s involved in transmission?

A
  • Transmission along peripheral nerve fibres to
    spinal cord
  • Dermatomes
  • Dorsal horn processing
  • Transmission to thalamus and cerebral cortex
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9
Q

what are the causes of pain?

A

by underlying pathology
by duration

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10
Q

what are the types of pain?

A

nociceptive
neuropathic
acute
persistent

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11
Q
  • Damage to somatic or
    visceral tissue
  • Surgical incision, broken
    bone, or arthritis
  • Usually responsive to
    opioid and nonopioid
    medications
  • Aching or throbbing
  • Localized
  • Arises from bone, joint,
    muscle, skin, or connective
    tissue
  • Tumour involvement or
    obstruction
  • Arises from internal organs
    such as the intestine and
    bladder
A

nociceptive pain

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12
Q
  • Damage to peripheral nerve or central nervous system
  • Burning, shooting, stabbing, or electrical in nature
  • Sudden, intense, short-lived, or lingering
  • Difficult to treat
  • Opioids, antiseizure,
    antidepressant medications
  • Can be central or peripheral in origin
A

neuropathic pain

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13
Q
  • Sudden onset
  • Usually within the normal time for healing
  • Mild to severe
  • Generally can identify a precipitating event or illness
    Course of pain decreases over time and goes away as
    recovery occurs
A

acute pain

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14
Q

what are the manifestations that reflect SNS activation?

A
  • Increased heart rate
  • Increased respiratory rate
  • Increased blood pressure
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15
Q

Gradual or sudden onset
May start as acute injury but continues past the normal time for
healing to occur
Mild to severe
Cause may be unknown; original cause of pain may differ from
mechanisms that maintain the pain
Persists and may be ongoing,
episodic, or both

A

persistent pain

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16
Q

what are the behavioral manifestations of persistent pain?

A
  • Changes in affect
  • Decreased physical movement/activity
  • Fatigue
  • Withdrawal from others and social interaction
17
Q
  • specialized medical care for
    people living with a serious
    illness
  • care is focused on providing
    relief from the symptoms and
    stress of the illness
  • goal is to improve quality of
    life for both the patient and
    the family.
A

palliation/relief measures

18
Q
  • Comprehensive pain centres
    treat patients on an inpatient or
    outpatient basis.
  • The goal of palliative care is to
    learn how to live life fully.
  • Hospices are programs for end-
    of-life care
A

pain clinics, palliative care, hospices

19
Q

what are the basic principles of pain treatment?

A

Routine assessment is
essential for effective
management.
Unrelieved acute pain
complicates recovery.
Clients’ self-report of pain
should be used whenever
possible.
HEALTH PROVIDERS HAVE A
RESPONSIBILITY TO ASSESS
PAIN ROUTINELY, TO ACCEPT
CLIENTS’ PAIN REPORTS, TO
DOCUMENT THEM, AND TO
INTERVENE IN ORDER TO
MANAGE PAIN.
THE BEST APPROACH
TO PAIN
MANAGEMENT
INVOLVES CLIENTS,
FAMILIES, AND
HEALTH PROVIDERS.

20
Q

what are the barriers to effective pain management?

A
  • Tolerance
  • Dependence
  • Addiction
21
Q
  • Need for increased dose to maintain same degree of pain control
  • Not as common as once thought
  • Rotate drug if tolerance develops
  • Drug tolerance is not synonymous with addiction
A

tolerance

22
Q
  • Expected response to ongoing exposure to pharmacological agents
    manifested by withdrawal syndrome when blood levels drop
    abruptly
  • To avoid withdrawal, drug should be tapered
A

physical dependence

23
Q
  • A primary, chronic, neurobiological disease, with genetic,
    psychosocial, and environmental factors influencing its
    development and manifestations
  • Characterized by impaired control over drug use, compulsive use,
    continued use despite harm, and craving
  • Tolerance and physical dependence are not indicators of addiction.
A

addiction

24
Q

what is PQRSTU?

A

provocative/palliative factors
quality
region/radiation
severity
timing
how is pain affecting U

25
Q

A cognitive and/or physical
strategy

A

relaxation

26
Q

A cognitive strategy that creates
a positive psychophysiological
response

A

guided imagery

27
Q

Application of touch and movement to
muscles, tendons, and ligaments without
manipulation of the joints

A

massage

28
Q

Applications of heat and cold relieve
pain and promote healing

A

heat and cold

29
Q

A cognitive strategy that refocuses
attention away from the pain

A

distraction

30
Q
  • A catheter is placed into the epidural
    space below the second lumbar
    vertebra, where the spinal cord ends
  • Require much smaller doses of opioids
    to achieve the same pain relief
  • Highly effective for controlling acute
    pain during labor; after surgery; or after
    trauma to the chest, abdomen, pelvis or
    lower limbs
  • Provide excellent pain relief, minimal
    side effects, and high patient
    satisfaction
A

epidural analgesia

31
Q

Used for selected medications (e.g., opioids, insulin)
Benefits patients with poor venous access
* Provides pain relief to patients who are unable to
tolerate oral pain medications
* Allows patients greater mobility
* Onset of action about 20 minutes
* Better pain control than intramuscular injections
* Lower rates of infection
1500 mls in 24 hours max

A

hypodermoclysis continuous subcutaneous meds

32
Q

used to reduce pain by temporarily or permanently
interrupting transmission of nociceptive input
* generally involve one-time or continuous infusion of local
anaesthetics into a particular area to produce pain relief. Such relief is
also referred to as regional anaesthesia
* often are used during and after surgery to manage pain.

A

nerve blocks

33
Q

are performed for severe pain that is
unresponsive to all other therapies.
* destroy nerves, thereby interrupting
pain transmission

A

neuroablative interventions

34
Q

involves electrical stimulation of the brain and
the spinal cord

A

neuroaugmentation

Med-Surg Nursing (13 decks)

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