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NURSING EXAM 3 > PAIN > Flashcards

PAIN Flashcards

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1
Q

transduction

A

convert noxious stimuli to electrical impulses. ex. mechanical (skim knee) thermal (burns) chemical (chemical reaction)

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2
Q

histamine

A

inflammatory response

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3
Q

lactic acid

A

nociceptor activation

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4
Q

bradykinin

A

vasodilator. Important with mediating pain response at the site before the signal gets to the central nervous system.

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5
Q

prostaglandins

A

send pain stimuli to the CNS

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6
Q

substance P

A

synthesized receptors to feel pain. Makes nerves more sensitive and quick to respond

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7
Q

serotonin

A

smooth muscles and promote vasoconstriction

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8
Q

transmission

A

a- fibers: acute localized pain is sent to the CNS
ex. stub a toe
c- fibers: defuse aching burning type pain
reflex arc: reflex from the pain

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9
Q

perception

A

Individual interpretation of stimuli.
Increased Sensitivity to Thermal Pain and Reduced Subcutaneous Lidocaine Efficacy in Redheads

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10
Q

threshold

A

lowest intensity of stimulus that causes recognition of pain

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11
Q

modulation

A

Regulation or inhibition of pain sensation

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12
Q

neuromodulators

A

they inhibit the production of pain-transmitting nerves. Both pain and stress activate these modulators. (endogenous opioid compounds)

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13
Q

endorphins

A

produced at neuro synapsis. Released when things like relaxation techniques are used.
ex. Pain medicine (morphine) through IM injection then IV. causes a distraction which will improve pain response.

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14
Q

enkephalins

A

less potent and thought to reduce pain by inhibiting substance P. (what our body produces to help manage pain.)

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15
Q

gate control theory

A

Provides ideas for pain relief emphasizing multiple dimensions of pain and; relationship between pain and emotions. The motor receptor will be accepted first.
ex. sensory, emotional, behavioral, cognitive

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16
Q

cutaneous: superficial

A

paper cut

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17
Q

somatic: diffuse/ scattered

A

sprained ankle

18
Q

visceral: body organs due to stretch/ spasm

A

cholangitis –> Often guard/ splinting and when you touch them their muscles contract because they are protecting themselves

19
Q

Nociceptive pain

A

feels sharp, aching, or throbbing. normally external injury
ex. stubbing toe, sport injury, dental procedure

20
Q

neuropathic pain

A

Abnormal function of peripheral nervous system or central nervous system
ex. Burning, electric, tingling, stabbing

21
Q

Allodynia

A

pain after non-painful stimuli
touch and it shouldn’t hurt but it does. The majority is feet and fingers

22
Q

phantom pain

A

amputation but still experience pain even though its not there.

23
Q

psychogenic

A

Physical cause of the pain can not be identified. Results from a mental event may be more severe than a physical event.
ex. Think of ‘Never have I ever. Devi dad died, ended up in wheelchair

24
Q

intractable pain

A

intractable. cause cannot be removed.
ex. headaches, migraines

25
Q

PQRST PAIN ASSESSMENT

A

P: provokes
Q: quality
R: radiates
S: severity
T: time

26
Q

Interventions

A

Remove or alter the source of pain.
Alter factors that contribute to pain tolerance
Fatigue
Misunderstanding of cause of pain
Fear
Establish trusting relationship

27
Q

Nonpharmacologic Interventions

A

Establish trusting relationship & acceptable pain level
Distraction/ Humor
Music/ Imagery/Relaxation
Cutaneous stimulation
Acupuncture/ Massage/therapeutic touch
Heat/Cold
Elevation
Pet therapy

28
Q

Pharmacologic Interventions

A

giving meds to relieve pain

29
Q

non-opioids: more local reaction to pain. scheduled

A

Aspirin (ASA)
Analgesic
Anti-inflammatory
NSAIDs
Analgesic
Anti-inflammatory
Acetaminophen
Analgesic
Corticosteroids
Anti-inflammatory

30
Q

Adjuvant Analgesics

A

Tricyclic antidepressants
Antihistamines
Caffeine
Muscle relaxants
Anticonvulsants
Antiemetic

31
Q

opioid analgesics: alter perception of pain

A

morphine, codeine, oxycodone, meperidine, fentanyl, hydromorphone

32
Q

hydromorphone

A

1 mg of hydromorphone ≈ 7-10 mg of morphine!
So, your ordered dose of hydromorphone should be 7-10 times less than that of morphine

33
Q

opioid antagonist

A

naloxone

34
Q

INVASIVE pain management

A

PCA: patient controlled analgesia
IV: nerve block, epidural, intrathecal
used to control post-op pain, chronic pain, severe
cancer pain

35
Q

Opioid Side effects

A

Most Serious:
Respiratory Depression
Apnea
Respiratory Arrest
Circulatory Depression
Hypotension/ Shock
Common:
Constipation
↓ peristalsis
↓ intestinal secretions
Nausea & Vomiting
Sedation
Dizziness
Pruritus
Headache
Dry Mouth

36
Q

Numeric Sedation Scale POSS

A

S: sleep, easy to arouse: no action necessary
1: awake and alert; no action necessary
2: occasionally drowsy, but easy to arouse; no action
necessary
3: frequently drowsy, drifts off to sleep during
conversation; reduce dosage
4: somnolent with minimal or no response to stimuli;
discontinue opioid, consider use of naloxone

37
Q

break through pain

A

need another intervention to break through pain.

38
Q

opioid concerns

A

reluctant to take pain medication r/t fear of addiction

39
Q

physical dependence

A

withdrawal syndrome arises if drug discontinued, dose substantially reduced, or antagonist administered

40
Q

tolerance

A

greater amount of drug needed to maintain therapeutic effect, or less of effect over time

41
Q

pseudoaddiction

A

behavior suggestive of addiction; caused by undertreatment of pain

42
Q

addiction( psychological dependence)

A

a psychiatric disorder characterized by continued compulsive use of substance despite harm

NURSING EXAM 3 (6 decks)

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