Pain Flashcards
What is the pain response like for neontes
subtle
How many children experience chronic pain
15-20%
How early does a fetus feel pain
20 weeks
How is pain addressed in pediatrics
self-report, behavioral observations, or physiological measures
Oral sucrose
sucrose by mouth, alone or in combination with other analgesic measures, can be effective for pain control in newborns exposed to mild or moderately painful procedures
What can cause some older adults from reporting pain
cognitive impairment
What is important in dealing with older adults pain
nonverbal cues
What is common in patients with Alzheimer’s
unreliable behavioral cues and self-reporting of pain
What is common in pain with older adults
persistent pain
What are older adults at risk for
under treatment with nurses, over treatment of drugs
Transduction
activation of nociceptors by chemical, thermal, or mechanical stimuli
Mechanical stimuli
external forces that result in pressure or friction against the body
Thermal stimuli
extreme exposure to heat or cold
Chemical stimuli
internal and external reactions
Transmission
conduction of pain messages to the spinal cord through a-fibers or c-fibers
A-fibers
large in diameter, myelinated fibers, quick impulses of pain
C-fibers
slower, smaller, unmyelinated fibers that transmit slow impulses of pain
Pain perception
the ability to recognize and interpret pain through the frontal cortex
Pain perception for individuals
each person has a different perception of pain, but it stays the same for each individual
Pain modulation
changing pain perception
Adena
significant pain from non-painful stimuli
What does a release of substrates create
an inflammation response
What is the most common cause of pain
inflammation
How are pain signals facilitated or inhibited
endogenously
Endogenous
neurons in the brain stem activate descending nerve cells that conduct impulses
Gate control theory
pain impulses can be modulated at the spinal level, pain is produced or inhibited
What causes pain to change
duration, quality, and intensity
Sympathetic response
acute pain activities, fight or flight, protective response, minimize blood loss
Parasympathetic response
consistent pain, away from danger, pain receptors transmit pain message so you are aware of any injuries, protective response
How does unrelieved pain impact the endocrine system
cause an extensive release of hormones, insulin and testosterone decrease
How does unrelieved pain impact the cardiovascular system
lead to clotting, hyper-coagulation, increase in heart rate/blood pressure/cardiac output/oxygen demands, the heart has to work harder, chest pain
How does unrelieved pain impact the musculoskeletal system
impaired muscle function, fatigue, problems with ADLs
How does unrelieved pain impact the respiratory system
shallow breathing, limited thoracic and abdominal movement, higher risk for pneumonia, cannot fully expand lungs, retains carbon dioxide (hypercapnia)
How does unrelieved pain impact the genitourinary system
hormone shifts that can decrease urinary output and fluid overload, low potassium
How does unrelieved pain impact the gastrointestinal system
intestinal secretions increase, smooth muscle tone increases, motility decreases
Cutaneous/superficial pain
pain that rises from the skin
Deep somatic pain
pain originating from ligaments, tendons, nerves, blood vessels, bones
What is deep somatic pain described as
localized, aching, tender
Examples of deep somatic pain
fractures, sprains, arthritis, bone cancer
Visceral pain
pain caused by stimulation of deep internal pain receptors
Where is visceral pain found
abdominal cavities, cranium, thoracic cavities
Describe visceral pain
not localized, tight, pressure, crampy
Examples of visceral pain
menstrual cramps, labor, GI infections, bowel disorders, bowel cancers
Radiating pain
pain that starts at an origin and stems to other locations
Examples of radiating pain
a sore throat the extends into the ears, heartburn
Referred pain
pain that is distant from the origin
Examples of referred pain
heart attack that causes pain in the arm or the jaw
Phantom pain
pain in areas that have been amputated
Describe phantom pain
burning, itching, deep pain
Psychogenic pain
pain from the mind, stressful situation can cause pain, there is no physical cause
How is pain classified by its cause
nociceptive or neuropathic
What is nociceptive pain
when pain receptors respond to stimuli that are potentially damaging
Nociceptors
sensory nerves that responsed to pain found in skin, joints, artery walls, and most internal organs
Where is the highest concentration of nociceptors found
the skin
Where is the lowest concentration of nociceptors found
organs
What causes nociceptive pain
trauma, surgery, inflammation
thermal/chemical/ mechanical stimuli
What is neuropathic pain
complex, chronic pain coming from an injury to one or more nerves resulting in repeated transmission of pain signals through the nerve
What is neuropathic pain most commonly caused by
diabetes, stroke, tumor, alcoholism, amputation, infection, or shingles
How is pain classified by its duration/onset
acute, chronic, intractable
How can pain be classified
by its cause, duration/onset, or its description
Acute pain
short-term pain, less than 6 months, protective in nature
How is acute pain resolved
when stimuli disappears and the tissue is healed
Chronic pain
6 months or longer, interferes with ADLs
Intractable pain
chronic and highly resistant to relief
What is the best way to handle intractable pain
multiple methods of pain relief
How is pain classified by its description
quality, periodicity, and intensity
Quality
what the pain is described as
sharp, dull, burning, stabbing, etc
Periodicity
occurrence of pain
episodic, constant
Intensity
magnitude of experienced pain
mild, distracting, intolerable, severe
What is pain influenced by
emotions, past experiences with pain, developmental stage, sociocultural factors, communication skills, cognitive impairments
COLDSPAA
Character
Onset
Location
Duration
Severity
Pattern
Associated factors
Affect on the patient
A complete pain history includes
location, quality, intensity, aggravating/alleviating factors, timing, duration, impact on ADLS, impact on mobility, psychological/social factors
What is the 5th vital sign
pain
Visual analog scale (VAS)
horizontal line, no pain on the left, worst pain on the right
Visual analog scale uses
best for adults with no cognitive impairment, some patients have a hard time using because it is abstract, simple, quick
Numeric pain intensity scale
horizontal line with numbers 0-10, 0 being no pain 10 being the worst pain
Numeric pain intensity scale uses
the patient should be able to count, use numbers 0-5 if the patient is cognitively impaired
Simple descriptive pain intensity scale
uses different adjectives on a horizontal line to describe pain
mild, moderate, severe
Simple descriptive pain intensity scale uses
can be time consuming, used if an individual has cognitive impairment
FACES pain rating scale
point to a face that best describes their pain and how they are feeling, it is important to describe what each face means
FACES pain rating scale uses
best for cognitive impairment and children 3 years and older
FLACC pain scale
a behavioral pain assessment scale for nonverbal patients
FLACC pain scale assessment
assess observation of face, legs activity, cry, and consolability
FLACC pain scale rating
0 means no pain, 3 means pain
What pain scale is used
the pain scale best for the patient’s age, level of development, and level of education. the scale used should stay the same for each patient
General impression of pain
observe posture, body position, facial expressions, face, legs, activity, cry, and consolability, inspect joints and muscles
How many women die annually from pregnancy complications
700
American Indian, Alaskan Native, and Black women are how many times more likely to die from pregnancy compared to white women
2-3 times
