Pain Flashcards
Gate Control Theory of Pain
- sm/lg diameter nerve fibers conduct and inhibit pain stimuli toward brain
- gating mechanism determines the impulses that reach the brain
Definition of pain is:
- whatever the pt describes
- a personal experience infuenced by biologic, psyc, and social
- learned through individual’s life experiences
- serves an adaptive role
Transduction
activation of pain receptors
Transmission
conduction along pathways (A delta/C delta fibers)
Perception of pain
awareness of the characteristics of pain
Modulation
inhibition of modification of pain
Types of pain:
acute/chronic
localized/somatic/visceral/cutaneous/referred
Localized pain
in a specific area
Somatic
deep pain
Visceral
abdomen/thorax not specific
Cutaneous
superficial
Referred pain
moves to a different area in the body (chest pain -> jaw/arm pain)
Acute pain
rapid onset
Chronic
intermittent/persistent
periods of remission and lasts beyond normal healing time
nociceptive
normal pain process (broken bones)
neuropathic
disease/lesion of CNS (not really injured CNS is injured and makes you percieve pain)
Nociplastic
chronic primary pain with misdiagnosis
Intractable
occurs when there is resistance to treatment
Phantom pain
amputation and still feel pain in limb
Behavioral response to pain
-voluntary
- stopping someone from touching/limping
Physiologic
- involuntary
- gaurding reflex
Affective pain response
-psychological
What are cultural and ethnicity variables
family, biological sex, gender, age, religious beliefs, and spirituality
Terms to describe quality of pain
sharp, dull, diffuse, visceral, shifting
Severity terms
- severe or excruciating
- moderate
- slight/mild
Periodicity
-continuous
- intermittent
- brief or transient
NVPS
nonverbal pain scale
- restlessness 0-2
- muscle tension 0-2
- facial expression 0-2
- vocalization 0-2
- wound gaurding 0-2
Behavioral Pain Scale and Checklist for Nonverbal indicators
same as NVPS
Numeric Sedation Scale
S: sleep, easy to arouse: no action necessary
1: awake and alert; no action needed
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 not response to stimuli; discontinue opiod, maybe naloxone
What are general principles for analgesic admin
-ongoing assessment
-management of breakthrough pain
- concern about prescription analgesic abuse
What are some regimens for chronic pain
-give meds orally
- patient should controll the meds through PCA pump rather than PRN
- adjust dose to achieve max benefits w/ minimum side effects
- allow patients as much control as possible
What is different in pain regimens with older adults?
-communication difficulties
- denial of pain
- altered physiologic response (renal/liver fail)
How should the nurse teach about pain
- should include family/caregivers
- explain about pain scales
- safety teaching: no driving, alcohol, CNS depressants
- keep diary of pain/meds
-do not take on an empty stomach
