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Pain Flashcards

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1
Q

What is pain

A

Physical or emotional, what the PT says it is, SUBJECTIVE

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2
Q

What are the two types of pains

A

Prevent injury )hot stove) or resulr from injury (fracture)

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3
Q

What does unrelieved pain result from

A

Failure to ASSESS, ACCEPT, or INITIATE

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4
Q

How does age affect pain

A

Infants can’t VERBALIZE, older people have lots of PROBLEMS

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5
Q

How does fatige affect pain

A

Increases sensitivity

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6
Q

How does genetic sensitivity affect pain

A

In/decrease tolerance

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7
Q

How does cognitive function effect pain

A

Reporting pain

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8
Q

How does prior experiences effect pain

A

in/decrease sensitivity, positive/negative experience

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9
Q

How does anxiety and fear affect pain

A

Increase sensitivity to pain

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10
Q

How does a support system affect pain

A

Can help cope

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11
Q

How does the culture affect pain

A

Can make people more/less likely to show pain

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12
Q

What must nurses be aware of regarding pain

A

Their own attitudes and expectations

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13
Q

What do all pts have the right to

A

Effective pain management

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14
Q

What must nurses do related to caring for pain

A

Assess, advocate, monitor, evaluate, educate, document

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15
Q

What does the ANA say about pain

A

We have the ethical RESPONSIBILITY, INDICIDUALIED, MULTIMODAL

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16
Q

What is nociception

A

The sensation of tissue injust is conducted from pain RECEPTORS to the brain

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17
Q

What are the 4 steps of nociception

A

Transduction, transmission, perception, modulation

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18
Q

What is transduction

A

At the TISSUE, they convert pain into ELCETRICAL impulse

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19
Q

What is transmission

A

The impulse TRAVELS, regulated by NEUROTRANSMITTERS

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20
Q

What can increase pain tranmission lead to

A

inflammatory response

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21
Q

What can decrease pain transmission

A

analgesias

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22
Q

What are the inflammatory neurotransmitters

A

Substace P, prostagladins, bradykinin, histamine

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23
Q

What are the analgesia neurotransmitters

A

Serotonin and endorphins

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24
Q

What is perception

A

Recognition of pain in the brain

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25
Q

What influences perception of pain

A

thoughts and emotions

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26
Q

What is the pain threshold

A

Point in which someone FEELS pain

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27
Q

What is pain tolerance

A

Amount of pain the pt will BEAR

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28
Q

What is modulation

A

The brain changes the perception by sending INHIBITORY input

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29
Q

What are inhibitory inputs

A

Endogenous endorphins

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30
Q

Why are there pain theories

A

Because it’s not completely understood

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31
Q

What is the specificity theory of pain

A

Understanded that pain receptors existed

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32
Q

What is the sensory interaction theory

A

large vs. small nerve fibers

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33
Q

What is the gate control theory

A

Thoughts and emotions influence pain, wheither the pain goes up to the brain or not

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34
Q

What substances close the gate

A

Opioids, massage, nonpainful stimuli, topical analgesics

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35
Q

What is the neuromatrix theory

A

Each person has a unique network of neurons and that’s why pain is different for each person

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36
Q

What type of pain is protective

A

Acute

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37
Q

How does acute pain resolve

A

With tissue healing, 3-6 months

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38
Q

What type of pain is associated with trauma, surgery, acute, disease, and labor

A

Acute

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39
Q

What is the physiological response of acute pain

A

Fight or flight response

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40
Q

What is the behavioral response of acute pain

A

Grimacing, moaning, guarding

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41
Q

What is the intervention of acute pain

A

Treat the underlying cause

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42
Q

What type of pain is not protective

A

chronic

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43
Q

What is chronic pain

A

ongoing or repeated pain, interfers with ADLs

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44
Q

What are the causes of chronic pain

A

May not have a know cause: arthritis, fibromyalgia, neuropathy

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45
Q

What is the physiological response with chronic pain

A

Does NOT alter vitals, depression, decreased level of functioning

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46
Q

What can chronic pain lead to

A

disability

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47
Q

What are the interventions of chronic pain

A

Symptomatic releif

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48
Q

What is nociceptive pain

A

most COMMON, physical pain that is caused by tissue DAMAGE

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49
Q

What is the type of physcial pain with nociceptive pain

A

Throbbing, aching, sharp, burning

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50
Q

What can cause nociceptive pain

A

Surgery, inflammation, injurt, trauma

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51
Q

What are the two types of nociceptive pain

A

Somativ, visceral

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52
Q

What is somatic pain

A

INjury to the skin, muscles, bones, and joints

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53
Q

What is visceral pain

A

From the internal organs

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54
Q

What type of pain is caused from sunburns, lacerations, fractures, sprains, arthritis, bone cancer

A

Somatic

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55
Q

What type of pain is caused from appendicitis, pancreatitis, IBS, bladder distention, cancer

A

Visceral

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56
Q

What type of pain can cause reffered pain in other body locations

A

visceral

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57
Q

What are the interventions for nociceptive pain

A

non/opioid meds

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58
Q

What are the two types of symtpoms to nociceptive pain

A

Reffered and radiating

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59
Q

What is referred pain

A

Originates in one area but hurts in another

60
Q

What is radiating pain

A

Extends from source ot an adjacent area

61
Q

What type of symptom is heart attack

A

Reffered

62
Q

What type of symptom is sciatica

A

Radiating

63
Q

What is neuropathic pain

A

Results from nerve injury but continue after stimuli are gone

64
Q

What are the symptoms of neuropathic pain

A

Intense, shootin, burning, pins and needles

65
Q

Is neuropathic chronic

A

Usally

66
Q

What type of pain can neuropathies, tumors, infection, and chemotherapy cause

A

Neuropathic

67
Q

What type of pain can CVA, viral infections, phantom limbs, DM lead to

A

Neuropathic

68
Q

what are the interventions of neuropathic pain

A

Adjucant meds: antidepressants, antispasmodics, muscle relaxers

69
Q

What is psychogenic pain

A

Perceived pain with no physical cuase

70
Q

What can effect psychogenic pain

A

Mental, emotional, or behavioral factors

71
Q

What typ eof pain are headaches, backache, stomachaches

A

Psychogenic

72
Q

What can peripheral neuropathy from DM cause

A

alterations in pain pathways which can alter perception of apin

73
Q

What are the physiologic alterations caused by pain

A

The body reacts and over time that can cause issues, Ex. increase RR can lead to pneumonia

74
Q

What are some factors that influence pain

A

Age, gender, diasbilities, culture, wthnicity, religion

75
Q

What is pain

A

SUBJECTIVE

76
Q

How does the nurse assess pain

A

Asking quesiotions. SOCRATES, OLDCARTS, OPQRSTU

77
Q

What does OPQRSTU stand for

A

Onset, precipitating/palliative, quality, region, severity, timing, understanding

78
Q

What is the most reliable indicator of pain

A

Pts self report

79
Q

What is the numeric scale

A

0-10, with a verbal and acitivty tolerance scale

80
Q

What is the wong-baker faces sclae

A

Used for people who have a hard time communicating, use for kids <3

81
Q

What is the FLACC scale

A

OBservational, kids 2 months- 7 years old, or pts with cognitive disabilities

82
Q

What are the scores for the FLACC tool

A

0: relaxed
1-3: mild
4-6: moderate
7-10 Severe

83
Q

What objective data can you collect to complement the pts self report

A

Vital signs, behaviors, psychological response

84
Q

When should you assess pain

A

When getting vitals

85
Q

What can an elevated HR and BP indicate

A

Acute pain, need for med

86
Q

What can a decreased HR and CP indicate

A

chronic pain

87
Q

Are vitals accurate over a long period of time

A

No

88
Q

What type of pain is related to burns, MI, amputation as evidence by tissue damage, EKG changes, incision

A

Acute

89
Q

What type of pain is related to cancer, arthritis, DM as evidence by burning feeling, malignacny

A

Chronic

90
Q

What can indicate a difficulty of coping with pain

A

Prolonged pain, poor concentration, inability ot ask for help

91
Q

How do you know if your goal statement works

A

If your goal was meat with a YES or NO

92
Q

When can you use just nonpharmacologica pain management

A

Mild pain but use is concurrently with meds for severe or chronic pain

93
Q

What are the nonpharmacologica pain management things you can do

A

Repositioning, skin stimulation, distraction, relaxation, imagery, acupuncture, reduction of painful stimuli, elevation of swollen limbs, naurolgic and neurosurgical pain therapies

94
Q

What does skin stimualtion do

A

interrupt pain pathways, heat increases blood flow, cold helps inflammtion

95
Q

Me are somethings you can do to distract your pt

A

ambulation, deep breahting, TV, vistors, conversation

96
Q

What are some relaxation tecniques

A

meditation, yoga, prayer

97
Q

What are the neurologic and neurosurgicla pain therapies

A

Spinal cord stim, TENS

98
Q

What is the spinal cord stim

A

Device implanted to treat chronic neuroligc pain, tingling sensations alters pain perception

99
Q

What are the three classes of pharmacologic pain management

A

Nonopioids, opioids, adjuvants

100
Q

What are the mainstay for relieving pain

A

Analgesics

101
Q

What class is appropriate for mild to moderate pain

A

Nonopioids

102
Q

What class is appropriate for moderate to severe pain

A

Opioids

103
Q

What class enhances the effects of nonopioids

A

Adjuvants

104
Q

What are the two therapeutic stategies to manage pain

A

Mulitimodal analegesia and preemptive analgesia

105
Q

What is mulimodal anagesia

A

Using more than one type of agent

106
Q

What are the benefits of mulimodal analgesia

A

More effective, lower dosese, less side effecrts

107
Q

What is preemptive analgesia

A

Giving meds before a painful event

108
Q

What are some nonopioids drugs

A

Acetaminophen, NSAIDs, aspirin

109
Q

What should you know about acetaminophen

A

Hepatotoxicity, max 4g/day

110
Q

What should you know about NSAIDs

A

Renal function, bleeding, w/ food

111
Q

What should you know about aspirin

A

Monitor for salicylism+ tinnits, vertigo

112
Q

What drugss are used for pain post-op, MI, or cancer

A

Opioids

113
Q

What drugs are opioids

A

Morphine, fentabyl, codeine

114
Q

How should you manage giving opioids

A

Short-term sceduled meds rather than PRN

115
Q

What are the adverse effects of opiods

A

Constipation, orthostatic hypoteneion, urinary retention, sedation, RESPIRATORY DEPRESSION

116
Q

What must you check before giving opioids

A

Vitals

117
Q

What are the risks of opioid use

A

Tolerance, dependence, addiction, accidental ingestion

118
Q

What is drug tolerance and what should you do about it

A

Body gets use to meds and is less effective, use a difference drug

119
Q

What is physicla dependence

A

Body can not function and will have withdrawal symptoms

120
Q

What is addiction

A

Psycholoigcal or emotion dependence, compulsively takes the drug

121
Q

What can substance use disorders lead to

A

Disability, health issues, interfers with life

122
Q

What is the leading cause of accidental death in the US

A

drug overdose

123
Q

How can you prevent accidental ingestion

A

Educate pts to keep opioids secure and out of reach of hcildren

124
Q

What is patient-controlled analgesia (PCA)

A

pt controls small frequent dosing to improve pain control with less lag time

125
Q

What is important with PCAs

A

2 RNs must set it up, monitor for respiratory depression, and only the PT can push the button

126
Q

What do adjuvant drugs do

A

Enhavne the effects of nonopiods to alleviate other symptoms

127
Q

What are adjuvants useful for

A

neuropathic pain

128
Q

What are SNRIS

A

duloxetine+ cymbalta

129
Q

What are the type of meds in adjuvant care

A

anticonvulsants, anxiety, depressatns, histamines, metics

130
Q

What is medical marifuana used for

A

neuropathic pain, spams, cancer, HIV pain

131
Q

What should the nurse try frist for mild pain

A

nonpharmacologic measures

132
Q

What type of approach should a nurse have when giving pain meds

A

proactive, around the clock, follow up and reassess

133
Q

When should you reassess after giving pain meds

A

30 mins- 1 hour

134
Q

What are some pt barriers to good pain management

A

Fear, cost, no access

135
Q

What are the health care provider barriers to good pain management

A

Bad assessment, beliefs, attitude, sterotyping, lack of education

136
Q

What are the health care system barriers to good pain management

A

Not a high priority, not good resources, or reimbursement

137
Q

What is undertreatment of pain

A

SERIOUS health care problem

138
Q

What can acute and chronic pain lead to

A

Anxiety, fear, depression

139
Q

What can poorly managed acute pain lead to

A

Chronic pain syndrome

140
Q

What are the risk factors of undertreatment of pain

A

attitudes, lack of knowledge, fear od addiction, respiratory depression

141
Q

In what case are we not as worried about respiratory depression

A

Chronic use

142
Q

Who are the populations at risk for undertreatment of pain

A

yound, old, pain with substance use issues

143
Q

What are some detrimental outsomes of inadequate pain management

A

Impaired revocery, chronic pain, ADLs, sleep, suffering, work loss, increased costs, relationships

144
Q

What must you document

A

Time given, post assessment, duration, score, education at discharge

145
Q

When do you need to assess the pain score

A

Every shift

146
Q

What do you need to do if goals are unmet

A

Collaborate

Nursing Essentials (16 decks)

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