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VET 2050 SP24 > Pain > Flashcards

Pain Flashcards

1
Q

What are some common clinical signs of pain in dogs and cats?

A

4 JG

Tachycardia, increased respiratory rate, restlessness, increased temperature, increased BP, abnormal posturing, inappetence, aggression, frequent movement, facial expression, trembling, depression, and insomnia

Bassert, J. M., Beel, A. D., & Samples, O. M. (2021, March 25). McCurnin’s clinical textbook for Veterinary Technicians and nurses. McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses - 10th Edition. (p. 903)

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2
Q

What are more subtle clinical signs of pain that can be seen in cats and dogs?

A

4 JG

Anxiety, nausea, pupil enlargement, licking, staring, and chewing at the surgical site or wound, poor mucous membrane color, salivation, and head pressing

Bassert, J. M., Beel, A. D., & Samples, O. M. (2021, March 25). McCurnin’s clinical textbook for Veterinary Technicians and nurses. McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses - 10th Edition. (p. 903)

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3
Q

What are the pain management standards according to AAHA?

A

4 JG

Pain assessment for every patient, regardless of presenting complaint

Assessment should be recorded in the medical record

Use of preemptive pain management

Appropriate pain management for anticipated level and duration

Pain management for all surgical procedures

Reassessment for pain throughout the procedure

Medical and chronic pain also treated

Teaching clients to recognize pain in their pets

Bassert, J. M., Beel, A. D., & Samples, O. M. (2021, March 25). McCurnin’s clinical textbook for Veterinary Technicians and nurses. McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses - 10th Edition. (p. 906)

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4
Q

What are the principles of administering analgesia?

A

4 JG

The best way to treat pain is to prevent it

Using drug combinations, which often produces better pain relief compared with single agents

Matching analgesics (based on dosage and duration of action) to the degree of expected surgical pain

Maintain an analgesic plane once pain control is established

Adopting the approach of “don’t quit till the pain quits”

Bassert, J. M., Beel, A. D., & Samples, O. M. (2021, March 25). McCurnin’s clinical textbook for Veterinary Technicians and nurses. McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses - 10th Edition. (p. 908)

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5
Q

What are the general signs of pain in horses and farm animals? What about GI pain?

A

4 JG

General signs
Decreased interest in food or anorexia
Lethargy
Excitement, restlessness
Pawing
Vocalizing (mainly cattle)
Bruxism
Reluctance to move
Lying down more frequently or for longer periods than usual
Any abnormal behavior

GI signs
Kicking or looking at the abdomen
Violently trying to roll
Stretching out in an abnormal posture (especially horses)
Standing with the abdomen tucked (especially cattle)
“Dog sitting” (especially foals)

Bassert, J. M., Beel, A. D., & Samples, O. M. (2021, March 25). McCurnin’s clinical textbook for Veterinary Technicians and nurses. McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses - 10th Edition. (p. 917)

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6
Q
A
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7
Q

What is the difference between acute and chronic pain?

A

Acute pain is described as a sharp stabbing sensation.
Chronic pain is described as a dull, persistent throbbing.

Student #10, AM
McCurnin 10th edition, page: 906

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8
Q

What is multimodal analgesia?

A

Multimodal analgesia is the process of using drug combinations, which often produces better pain relief compared with single agents.

Student #10, AM
McCurnin 10th edition, page: 908

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9
Q

After temperature, pulse, respiration, and blood pressure, what is known as the “fifth vital sign?”

A

Pain is considered to play such an important role in overall health and well-being that it is now regarded as the fifth vital sign.

Student #10, AM
McCurnin 10th edition, page: 904

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10
Q

What is an effective technique for managing a variety of pain states?

A

IV administration of lidocaine via CRI

Student #10, AM
McCurnin 10th edition, page: 911

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11
Q

What anticonvulsant drug plays an important role in the reduction of neuropathic pain and central sensitization?

A

Gabapentin

Student #10, AM
McCurnin 10th edition, page: 914

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12
Q

What are some posture signs of pain in dogs?

A

Tail between legs
Arched/hunched back
Twisted body to protect pain site
Drooped head
Prolonged sitting position
Tucked abdomen
Lying in flat, extended position

Student #11, JM
McCurnin 10th edition, page: 903

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13
Q

What are some posture signs of pain in cats?

A

Tucked limbs
Arched or hunched head and neck or back
Tucked abdomen
Lying flat
Slumped body
Drooped head

Student #11, JM
McCurnin 10th edition, page: 903

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14
Q

What are the two classifications of opioids?

A

Agonists: stimulate the opioid receptors
Antagonists: block particular opioid receptors

Student #11, JM
McCurnin 10th edition, page: 911

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15
Q

Why do horses generally receive better analgesic treatment than other large animals?

A
  1. They are more likely to be treated as “companion animals.”
  2. They generally are performance animals, and pain can affect their performance.
  3. They may become violent and dangerous when in acute pain (especially GI pain).
  4. Most horses do not have an absolute economic value such as cattle or pigs, so owners are more likely to spend money on their care.

Student #11, JM
McCurnin 10th edition, page: 921

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16
Q

What block is achieved with an SQ injection of either bupivacaine or a bupivacaine/lidocaine combination and is very effective in a feline declaw procedure?

A

Circumferential Ring Block

Student #11, JM
McCurnin 10th edition, page: 910

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17
Q

What are some temperament signs in dogs that may indicate pain?

A

13 TN McCurnin 10th Ed

Aggression, clawing, attacking and/or biting, attempting to escape.

pg 903

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18
Q

What are some temperament signs in cats that may indicate pain?

A

13 TN McCurnin 10th Ed

Aggression, biting, scratching, chewing, attacking, trying to escape and/or hiding

pg 903

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19
Q

What are the two phases of wind-up?

A

13 TN McCurnin 10th Ed

Hyperalgesia: less and less stimulation is required to initiate pain.
Allodynia: Interpretation of normally harmless sensations as pain

pg 906-907

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20
Q

What are some monitoring signs for patients taking NSAIDs?

A

13 TN McCurnin 10th Ed

Hydration status, stool quality, urine production, general observations

pg 909

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21
Q

What are some monitoring signs for patients taking opioids?

A

13 TN McCurnin 10th Ed

Mentation, blood pressure, respiratory, and sedation nature.

pg 909

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22
Q

Define hyperalgesia

A

Less stimulation is required to elicit pain

DM,12, McCurnin 10th Ed. Pg. 906

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23
Q

General signs of pain in large animals

A

1) decreased interest in food, anorexia
2) lethargy
3) excitement, restlessness
4) pawing
5) vocalizing (especially cattle)
6) bruxism (especially goats/sheep)
7) reluctance to move
8) lying down more frequently or for longer periods than usual, getting up and down frequently in succession
9) any abnormal behavior (per animal)

DM,12, McCurnin 10th Ed. Pg. 917

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24
Q

Additional signs of GI pain in large animal

A

1) kicking or looking at abdomen
2) violently trying to roll
3) stretching out in abnormal posture (especially horses)
4) standing with abdomen “tucked” (especially cattle)
5) “dog sitting” (especially foals with GI pain)

DM,12, McCurnin 10th Ed. Pg. 917

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25
Q

Define dysphoria

A

Dysphoria is an emotional state characterized by anxiety, depression or unease, and does not specify a cause.

Student #6, MH
Mccurnin’s 10th edition, page 904

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26
Q

What negative effects can pain have on a mammals pulmonary system?

A

Tachypnea
Hypoxemia
Pulmonary edema
Pulmonary hypertension
Respiratory acid-base imbalance

Student #6, MH
Mccurnin’s 10th edition, page 906

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27
Q

What are the three phases of nociception?

A

Transduction
Transmission
Modulation

Student #6, MH
Mccurnin’s 10th edition, page 906

28
Q

What is the main advantage of using morphine as a CRI for pain management?

A

Using it as a CRI prevents the peaks and valleys typically seen with opioid bolus dosing. It can also reduce unwanted side effects.

Student #6, MH
Mccurnin’s 10th edition, page 913

29
Q

What things are technicians responsible for in pain management?

A

Assessing patients
Identifying or predicting pain
Providing nonpharmacologic comfort and care
Differentiating pain from other stress
Requesting appropriate analgesia and or sedation
Helping to develop appropriate protocols for pain management
Administering medications, performing analgesia techniques
Monitoring and treating drug effects
Assessing patient postoperatively
Communicating with the clients
Logging controlled substances

Student #6, MH
Mccurnin’s 10th edition, page 923

30
Q

Define allodynia

A

Second phase of wind-up, after hyperalgesia. Allodynia is when normally pleasant stimuli become painful.

DM,12, McCurnin 10th Ed. Pg. 906

31
Q

Is Phenylbutazone allowed in dairy cattle?

A

It’s use is completely prohibited in dairy cattle 20 months of age or older

DM,12, McCurnin 10th Ed. Pg. 922

32
Q

Best source for updated information on withdrawal times

A

Food Animal Residue Avoidance Databank at www.farad.org

DM,12, McCurnin 10th Ed. Pg. 922

33
Q

What is the definition of allodynia?

A

Nerve fibers that normally carry pleasure or neutral information are recruited and become part of the pain transmission process.

Student: #2, AF
Source: McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 29, Page 906)

34
Q

What is multimodal analgesia?

A

Synergistic effects obtained by combining two or more classes of analgesic drugs to alter more than one phase of nociception (transduction, transmission, modulation, and perception).

Student: #2, AF
Source: McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 29, Page 908)

35
Q

What are examples of topical analgesia?

A
  • Lidocaine
  • Bupivacaine
  • Tetracaine
  • Epinephrine

Student: #2, AF
Source: McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 29, Page 910)

36
Q

What is the mechanism of action for Alpha-2 Agonists?

A

Inhibits the release of the excitatory neurotransmitter norepinephrine to produce analgesia and sedation.

Student: #2, AF
Source: McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 29, Page 912)

37
Q

What are general signs of pain in horses and farm animals?

A
  • Decreased interest in food or anorexia
  • Lethargy
  • Excitement, restlessness
  • Pawing
  • Vocalization (especially cattle)
  • Bruxism
  • Reluctance to move
  • Lying down more frequently or for longer periods that usual
  • Any abnormal behavior

Student: #2, AF
Source: McCurnin’s Clinical Textbook for Veterinary Technicians and Nurses – 10th Edition (Chapter 29, Page 917)

38
Q

What are some indications for gabapentin therapy?

A

8 JM

-Chronic degenerative conditions like cancer, osteoarthritis.
-Dermatological conditions that cause excessive licking or scratching (ear infections, etc)
-pain or limping not associated with current inflammation

McCurnin’s 10th ed pg 914

39
Q

This newer type of NSAID is proposed to be safer on the GI tract than others in the past?

A

grapiprant or Galliprant
#8 JM
McCurnin’s 10th ed pg 909

40
Q

What types of environmental care can be taken to help a painful patient feel more comfortable?

A

Clean cage, padding, bedding, keeping stress and noise to a minimum, careful positioning to reduce pressure on painful areas.
#8 JM
McCurnin’s 10th ed pg 907

41
Q

Nocita can provide pain relief for up to ____ hours

A

72 hours
#8 JM
McCurnin’s 10th ed 910

42
Q

This NMDA receptor agonist can be given as a CRI for wind up pain

A

Ketamine
#8 JM
McCurnin’s 10th ed pg 917

43
Q

Pain triggers a series of physiologic changes that increase, what?

A

Stress.

TM, #7, McCurnin’s (electronic version) 10th ed. Location 45708 of 67848 (1 out of 5 cards)

44
Q

What is the negative effect of pain in mammals with regards to the cardiovascular system?

A

Arrhythmias.

TM, #7, McCurnin’s (electronic version) 10th ed. Location 45721 of 67848 (2 out of 5 cards)

45
Q

What are the negative effects of pain in mammals with regards to the gastrointestinal system?

A

Nausea and vomiting

TM, #7, McCurnin’s (electronic version) 10th ed. Location 45721 of 67848 (3 out of 5 cards)

46
Q

What are the negative effects of pain in mammals in regards to the metabolic system?

A

Cachexia, increased oxygen demand, and negative nitrogen balance.

TM, #7, McCurnin’s (electronic version) 10th ed. Location 45732 of 67848 (4 out of 5 cards)

47
Q

What is the negative effects of pain in mammals in regards to immune function?

A

Hemorrhage.

TM, #7, McCurnin’s (electronic version) 10th ed. Location 45732 of 67848 (5 out of 5 cards)

48
Q

Where does the pain pathway start?

A

The pain pathway begins at the site of tissue damage (evidenced by localized redness, heat, and swelling - classic signs of inflammation)

Student #3, AF
McCurnin 10th edition page 906
Card 1

49
Q

What do nociceptors convert when there is pain?

A

These specialized nerve endings convert mechanical, chemical, and thermal energy into electrical impulses once their threshold is exceeded.

Student #3, AF
McCurnin 10th edition page 906
Card 2

50
Q

What are NSAIDs used for, and how do they reduce pain?

A

Chronic and acute pain.
Reduces the inflammatory response.
#5 ZZ
Bassert, J. M., Beal, A. D., Samples, O. M., & McCurnin, D. M. (2022). McCurnin’s clinical textbook for Veterinary Technicians and nurses. Elsevier. (pg 909).

51
Q

True or false: Pigs require different medications for pain than other large animals?

A

False. Even though pigs are not commonly treated for pain, when they are any medications for large animals are safe and effective.
#5 ZZ
Bassert, J. M., Beal, A. D., Samples, O. M., & McCurnin, D. M. (2022). McCurnin’s clinical textbook for Veterinary Technicians and nurses. Elsevier. (pg 923)

52
Q

What are some Nonpharmacologic options to treat pain?

A

Thermotherapy, massage, therapeutic exercise, aquatic therapy, acupuncture, electrical stimulation, therapeutic ultrasonography, extracorporeal shock-wave therapy, and low-level laser among others.

Student #3, AF
McCurnin 10th Edition page 914
Card 4

53
Q

Should gabapentin be stopped abruptly?

A

No. Even if being used for pain, patients who are on gabapentin should be weaned off.
#5 ZZ
Bassert, J. M., Beal, A. D., Samples, O. M., & McCurnin, D. M. (2022). McCurnin’s clinical textbook for Veterinary Technicians and nurses. Elsevier. (pg 914)

54
Q

When giving an equine patient potent opioids what is a side effect that can be considered adverse?

A

Excitement. A sedative should be given along side it.
#5 ZZ
Bassert, J. M., Beal, A. D., Samples, O. M., & McCurnin, D. M. (2022). McCurnin’s clinical textbook for Veterinary Technicians and nurses. Elsevier. (pg 922)

55
Q

When is wind-up most evident?

A

Wind-up will be most evident in the postoperative period once the patient has regained consciousness.

Student #3, AF
McCurnin 10th Edition page 914
Card 5

56
Q

What does the suffix “-caine” mean in regards to medication?

A

It means the drug blocks a nerve.
#5 ZZ
Bassert, J. M., Beal, A. D., Samples, O. M., & McCurnin, D. M. (2022). McCurnin’s clinical textbook for Veterinary Technicians and nurses. Elsevier. (pg 910)

57
Q

What location can a block of lidocaine be given to in animals undergoing dental procedures to help ease pain of extractions?

A

Infraorbital Foramen
#1 CE
McCurnin 10th Editon pg 911

58
Q

What is a common side effect of opioids (particularly hydromorphone and morphine)?

A

Emesis is a common side effect of hydromorphone and morphine.
#1 CE
McCurnin 10th Edition pg 911

59
Q

What are some examples of drugs commonly used in a CRI?

A

Fentanyl, lidocaine, and morphine are all examples of common CRI drugs.
#1 CE
McCurnin 10th Edition pg 913

60
Q

What is the most common, and potent analgesic medications that can be used in hospitalized patients?

A

Opioids tend to be the most commonly used analgesic medications used
#1 CE
McCurnin 10th Edition pg 910

61
Q

What is known as a “rescue” drug for patients experiencing a rough recovery after anesthesia and can provide both sedation and analgesia?

A

Dexmedetomidine (Dexdomitor)
#1 CE
McCurnin 10th Edition pg 913

62
Q

What analgesia is an excellent choice for all ruminants but can easily be overdosed with sheeps and goats?

A

9 RP, McCurnin 10th Ed, pg 923

local anesthetic agents

63
Q

T/F
All drugs used in ruminants can be used in camelids.

A

9 RP, McCurnin 10th Ed, pg 923

True

64
Q

what are adverse effects of Alpha 2 Agonists and what should we be monitoring for?

A

9 RP, McCurnin 10th Ed, pg 909

adverse effects: bradycardia, cardiac arrhythmias, hypertension, peripheral vasoconstriction

monitoring: femoral pulse rate and quality, HR and rhythm, BP

65
Q

what are adverse effects of local anesthetics and what should we be monitoring for?

A

9 RP, McCurnin 10th Ed, pg 909

adverse effects: none unless given CRI then nausea, vomiting, neurologic signs and seizures

monitoring: observe regularly for muscle tremors and GI upset

66
Q

what are adverse effects of opioids and what should we be monitoring for?

A

9 RP, McCurnin 10th Ed, pg 909

adverse effects: sedation, low BP, respiratory depression

monitoring: mentation, BP, resp rate and nature

VET 2050 SP24 (10 decks)

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