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FOUNDATIONS 310 > Pain > Flashcards

Pain Flashcards

1
Q

“An unpleasant sensory or emotional experience associated with actual or potential tissue damage” is

A

pain

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2
Q

Is pain a vital sign?

A

Should be checked as often as vital signs

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3
Q

Is pain subjective?

A

Yes, determined by pt not nurse

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4
Q

How long can acute pain last?

A

up to 6 months

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5
Q

Components of acute pain

A
  1. Inflammatory (redness, swelling, tenderness)

Not always present but…..
Sympathetic nervous system rxn (tachycardia/pnea, HTN)

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6
Q

Acute pain is considered a _____ mechanism

A

protective

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7
Q

How long does chronic pain last?

A

> 6 months

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8
Q

Chronic pain is no longer considered protective and is considered_______

A

a disease or condition

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9
Q

How do you treat chronic pain?

A

-complex, no set way or method

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10
Q

What is Nociceptive Pain?

A

acute pain from surgery, injury, or active disease process

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11
Q

What does somatic pain feel like?

A

aching, throbbing pain in bones, joints or skin

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12
Q

What is visceral pain? what does it feel like?

A

organ related, poorly localized, cramping, squeezing, heavy

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13
Q

What are the 4 phases that nociceptive pain transmits through?

A
  1. Transduction (prostaglandins released to potentiate action potential)
  2. Transmission (substance P is released: significant pain messenger)
  3. Perception
  4. Modulation

(tiny tiger paw massage)

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14
Q

Which phase of nociceptive pain releases prostaglandins? why?

A

Transduction , potentiate action potential

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15
Q

Which phase of nociceptive pain releases Substance P? why?

A

Transmission, significant pain messenger

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16
Q

Which 2 phases offer treatment?

A

transduction and transmission

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17
Q

What kind of pain medication is used in transduction phase of nociceptive pain?

A

NSAIDs or Steroids

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18
Q

What kind of pain medication is used in transmission phase of nociceptive pain?

A

Opioids

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19
Q

What causes neuropathic pain?

A

-damage to somatosensory nervous systems from nerve damage, chemotherapy, radiation

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20
Q

What are the symptoms/pain descriptions of neuropathic pain?

A

-tingling, electric like, pins, and needles, number characteristic

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21
Q

What is Allodynia?

A

things that cause pain that normally do not cause pain

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22
Q

What is Hyperalgesia?

A

a heightened feeling of pain

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23
Q

How do we treat neuropathic pain?

A

antidepressants
SNRI’s(selective NORepinephrine reuptake inhibitors)
Antiseizure (gabapentin, pregabalin)

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24
Q

2 issues with neuropathic pain

A

allodynia

hyperalgesia

25
Q

What is Nociplastic or central pain?

A

-similar to nociceptive pain that does NOT HAVE DISCERNIBLE SOURCE

26
Q

How is nociplastic or central pain described?

A

like nociceptive or neuropathic - electric, sharp

27
Q

Example of nociplastic or central pain?

A

fibromyalgia

28
Q

Treatment goals for Nociplastic or central pain?

A
  • complex
  • focus on RESTORING sleep/activity tolderance
  • NOT OPIOIDS
29
Q

Newborn and infant pain scales?

A

Neonatal Pain, Agitation and sedation Scale (N-PASS)
FLACC behavioral pain assessment

*newborn/infant pain is underrated

30
Q

Toddler and preschoolers pain assessment scale?

A

Wong-baker FACES Scale

31
Q

Toddler preschool pain manifests as

A

distrust

32
Q

School aged and adolescent pain scale?

A

0-10

33
Q

Persistent pain in school aged/adolescent can cause what?

A

developmental regression

34
Q

How do school aged/adolescents manifest pain?

A

-may hide pain

35
Q

Older Adult pain tools?

A

Checklist for Nonverbal Pain Indicators (CNPI)

Critical Care Pain Observation Tool (CPOT)

36
Q

Physiological effects of pain- what increases?

A 
BP
HR
RR+ shallow
CBG
O2 needs
Lactate
Ketones
37
Q

Physiological effects of pain, what decreases?

A

Immune response

Ability to think/learn/decisions

38
Q

When asking about location of pain try to distinguish between somatic and visceral.
What do those feel like?

A

somatic = localized

visceral =vague or radiating

39
Q

When assessing quality of pain distinguish between…

A

nociceptive: aching, sharp, deep, gnawing
neuropathic: shocklike, burning, tingling, numb

40
Q

Physical non-pharmacological pain management

A
  • heat
  • cold
  • Transcutaneous Electrical Nerve Stimulation
  • Massage
41
Q

When is heat contradindicated?

A

-areas of bleeding, topical ointments, burned/irradiated skin

42
Q

When is cold contraindicated?

A
  • poor circulation
  • raynaud syndrome
  • radiated skin
43
Q

Cognitive and Behavioral Pain Management options

A
  • distraction
  • relaxation
  • imagery
  • mindfulness
44
Q

When would you want to use distraction for pain mgmt and how would you do it?

A
  • short duration of pain

- match type of distraction to something patient enjoys

45
Q

When to use relaxation for pain management?

A

-useful for all types of pain

46
Q

4 categories for pharmacological pain mgmt?

A
  • nonopioid
  • opioid
  • adjuvant analgesic (gabapentin, pregabalin)
  • adjuvant (anxiolytics or sleep meds)
47
Q

What does a patient need to be in order to usa PCA Pump?

A

cognitively alert

48
Q

What safety parameters installed for PCA Pump?

A
  • minimum time interval b/w doses
  • maximum dose allowed over time period
  • specific dosing mg or mcg
49
Q

Who can push the PCA button?

A

ONLY patient

50
Q

what 2 things must be added to monitor patient on PCA pump?

A

O2 sat, end tidal CO2

51
Q

When is PRN dosing more appropriate?

A

-someone is a few days post op and working towards discharge

52
Q

Benefits of around the clock dosing?

A

therapeutic drug levels and reduced harmful side effects

53
Q

Can RNs do spinal analgesia?

A

NO

54
Q

What size dose needed with spinal analgesia?

A

smaller dose

55
Q

Common side effect of spinal analgesia?

A

hypotension

56
Q

what are opioid side effects?

A

sedation
respiratory depression
constipation
vasodilation and hypotension

57
Q

which 4 populations are at risk of opioid side effects?

A

-opioid naive
-elders
-use of other sedative meds
obstructive sleep apnea

58
Q

what is POSS?

A

Pasero Opioid Induced Sedation Scale

59
Q

How do you score POSS?

A

s= sleep, easy to around
1=awake/alert
2=slightly drowsy easily arousable
3=frequent drowsy, arousable, drifts to sleep during conversations
4=somnolent, minimal or no response to physical stimulation

FOUNDATIONS 310 (28 decks)

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