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Nursing 202 > Pain > Flashcards

Pain Flashcards

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1
Q

Pain

A

A major problem that causes sufering and reduces quality of life
one of the major reasons why people seek healthcare
effective pain relief is a basic human right
If you don’t manage actute pain you are at higher risk of chronic pain

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2
Q

What is the nurses role in pain management

A

Assess pain, document it, and communicate with others
Ensure delivery of aqeduate pain relief measures
Evaluate effectiveness of interventions
Monitor ongoing effectiveness of pain management strategies
Provide education

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3
Q

Why is pain undertreated

A

inadequate skills to assess and treat pain
misconceptions about pain
innacurrate info about opiods
respiratory depression
clients underreporting pain
fear of addiction
belief that it is inevitable
expectations that drugs won’t help
desire to be a good client

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4
Q

What is pain?

A

Subjective-client’s experience and self-report is essential

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5
Q

Nociception

A

physiological process that communicates tissue damage to the central nervous system
mechanism by which pain is percieved (transduction, transmission, perception, modulation)

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6
Q

Perception of pain

A

occurs when pain is recognized, defined and responded to
nociceptive input is percieved as pain in the brain

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7
Q

Dimensions of pain-sensory-discriminative

A

the recognition of the sensation as painful
pattern, area, intensity and nature

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8
Q

Dimensions of pain-motivational affective

A

Emotional response to pain experience
anger, fear, depression, anxiety

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9
Q

Dimensions of pain-behavioural

A

observable actions used to express or control the pain
-facial expressions
-posturing
-adjusting social activities

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10
Q

Dimensions of pain-cognitive evaluative

A

beliefs, attitudes, memories, and meaning attributed to pain
the meaning of pain to the client is important in individual response to pain
the meaning of pain and related responses are critical aspects of nursing pain assessment

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11
Q

Dimensions of Pain-sociocultural

A

demographics, support systems, social roles, past experiences, cultural aspects

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12
Q

Causes and types of pain

A

underlying pathology-nociceptive and neuropathic
duration-acute and persistent

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13
Q

Nociceptive Pain

A

Damage to somatic or visceral tissue
surgical incision, broken bone, or arthritis

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14
Q

Nociceptive pain-somatic

A

aching or throbbing
localized
arises from bone, joint, muscle

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15
Q

Nociceptive pain-visceral

A

tumour involvement or obstruction
arises from internal organs such as the intestine and bladder

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16
Q

Neuropathic Pain

A

Damage to peripheral nerve or central nervous system
burning, shooting, stabbing, or electrical in nature
sudden, intense, short lived, or lingering
difficult to treat (opiods, antiseizure, antidepressant medications

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17
Q

Acute Pain

A

sudden onset
usually within normal time for healing
mild to severe
generally can identify a precipitating event or illness

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18
Q

Acute pain reflects what nervous system?

A

Sympathetic nervous system (increased heart rate, increased respiratory rate, increased blood pressure)

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19
Q

What is the treatment goal for acute pain?

A

pain control with eventual elimination

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20
Q

What is persistent pain

A

gradual or sudden onset
may start as acute injury but continuous past the normal time for healing to occur
mild to severe
3-6 months=chronic
fatigue, with-drawl from others and social interactions

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21
Q

Why assess pain?

A

describe the pain experience and factors that influence it
assist inidentifying the need for pain management
evaluate the effectiveness of pain management
provide an important indicator of the quality of patient care

22
Q

Frequency of assessment

A

Dyring initial assessment
At least once per shift for inpatients
At least once every visit for outpatients and homecare
before, during, and after proceudre
following treatment plan

23
Q

Comprehensive Pain assessment

A

pain history, physical exam and current pain experience
medication use-past and present
functional status
psychosocial impact
meaning of pain
expectations for pain relief

24
Q

Self report of pain

A

primary source of assessment for verbal and cognitive intact people

25
Q

Pain assessment goals

A

To describe the client’s sensory, affective, behavioural, cognitive and sociocultural pain experience, in order to implement pain management techniques and identify goals

26
Q

Pattern of pain

A

onset and duration
acute pain typically increases during wound care, ambulation, coughing deep breathing
associated with injury

27
Q

Breathrough pain

A

transient, moderate to severe
occurs beyond treated pain
rapid onset and brief duration

28
Q

Area of pain

A

localized, all over, referred or radiated from origin to different site
ask client to describe the sites of pain
point to painful areas on the body

29
Q

Intensity of pain

A

reliable measure to determine treatment
rated using scales, adjusted to client age and cognitive ability
numerical, visual descriptors, visual analogue, smiling or crying faces

30
Q

Nature of pain

A

quality or characteristics of the pain (brief Pain Inventory)
Assist in identifying the type of pain (neuro or nociceptive)

31
Q

What are the effects of pain on a client

A

affects sleep, daily activities, relationships, physical acitivty, emotional well-being

32
Q

Somatic Pain examples

A

aching, dull, sharp, pulling, hurts, twisting, like being hit, tense, hard, friction, irritating, grabbing, pounding, stiffness, sore, bruising

33
Q

Somatic pain meaning

A

muscles, bones, soft tissue pain

34
Q

Visceral examples

A

pressure, squeezing, deep, dull, cramping, sickening, constant, steady, tightness, gassy

35
Q

Neuropathic pain examples

A

burning, tingling, shooting, stabbing, jabbing, shouck-like, piercing, radiating, gnawing, pinching

36
Q

Non-verbal pain assessment

A

acute-risk of undertreatment, pointing might work
persistant/chronic-risk of underdetection, may ive little indication of pain, ask how they behave when in pain
unconscious-grimacing, moaning, rigidity, arching, restlesness, shaking (Critical Care observation tool)

37
Q

Tips for nurses when doing cognititively impaired pain assessments

A

remember they feel pain but can’t communicate it
father info from various sources
note any voacalizations
ensure comprehensive assessment physical and environmental factors
pay attention to non verbal behaviours
Feldt tool-assess pain in non-verbal patients

38
Q

Pain behaviours in the non-verbal (cognitively impaired persons)

A

flat affect
decreased interaction
decreased intake
altered sleep patterns

39
Q

Valid and reliable tools for pain?

A

depression screening (patient health questionnaire)
TSK-fear of movement

40
Q

Relevant physical exam for pain

A

review system/vitals
physical appearance
MSK exam and neuro exam
gait
examine painful body locations
consequences (stiffness and atrophy)
signs of neuropathic pain
hyperalgesia, allodynia, parasthesia, skin changes

41
Q

Nonpharmacological Therapy for pain?

A

massage
therapeutic exercise
TENS
Application of heat
Application of cold
Cognitive techniques (distraction, relaxation strategies, self-management)

42
Q

Nursing Managament of pain

A

Effective Management
client report must be believed
communicate concern and assure commitment to client

43
Q

Barriers to effective pain management?

A

tolerance-patient might need more than standard amount
Dependence-might go into withdrawl if they don’t get meds on time
addiction

44
Q

Ethical issues in Pain Management

A

fear of hastening death by administering analgesics
use of placebos in pain assessment and treatment

45
Q

Age related concerns?

A

persistent pain is a problem associated with physical disability and psych problems
the most common sources of pain among older adults are muskoskeletal conditions
despite its high prevalence, pain inn older adults often is inadequately assessed and treated

46
Q

What does persistent pain often result in?

A

depression
sleep disturbance
decreased mobility
decreased health care utilization
physical and social role dysfunction

47
Q

Age related concern with barriers

A

belief that pain is inevitable part of aging
greater fear of using opiods
using words like aching, soreness, or discomfort insteadof pain

48
Q

Age related concerns with treatment

A

metabolize drugs more slowly
greater risk for adverse effects
risk of GI bleed with NSAIDs
multiple drug use interactions
cognitive impairement and ataxia can be axacerbated

49
Q

Ataxia meaning

A

group of disorders that impact coordination, balance and sleep

50
Q

Special populations when considering pain

A

clients with substance abuse problems-they still have the right to recieve effective pain managament (challenging)
establish a treatment plan that will relieve pain andf minimize withdrawl symptoms
interprofessional team approach

Nursing 202 (15 decks)

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