Pain Flashcards
1
Q
What is pain
A
Physical or emotional, what the PT says it is, SUBJECTIVE
2
Q
What are the two types of pains
A
Prevent injury )hot stove) or resulr from injury (fracture)
3
Q
What does unrelieved pain result from
A
Failure to ASSESS, ACCEPT, or INITIATE
4
Q
How does age affect pain
A
Infants can’t VERBALIZE, older people have lots of PROBLEMS
5
Q
How does fatige affect pain
A
Increases sensitivity
6
Q
How does genetic sensitivity affect pain
A
In/decrease tolerance
7
Q
How does cognitive function effect pain
A
Reporting pain
8
Q
How does prior experiences effect pain
A
in/decrease sensitivity, positive/negative experience
9
Q
How does anxiety and fear affect pain
A
Increase sensitivity to pain
10
Q
How does a support system affect pain
A
Can help cope
11
Q
How does the culture affect pain
A
Can make people more/less likely to show pain
12
Q
What must nurses be aware of regarding pain
A
Their own attitudes and expectations
13
Q
What do all pts have the right to
A
Effective pain management
14
Q
What must nurses do related to caring for pain
A
Assess, advocate, monitor, evaluate, educate, document
15
Q
What does the ANA say about pain
A
We have the ethical RESPONSIBILITY, INDICIDUALIED, MULTIMODAL
16
Q
What is nociception
A
The sensation of tissue injust is conducted from pain RECEPTORS to the brain
17
Q
What are the 4 steps of nociception
A
Transduction, transmission, perception, modulation
18
Q
What is transduction
A
At the TISSUE, they convert pain into ELCETRICAL impulse
19
Q
What is transmission
A
The impulse TRAVELS, regulated by NEUROTRANSMITTERS
20
Q
What can increase pain tranmission lead to
A
inflammatory response
21
Q
What can decrease pain transmission
A
analgesias
22
Q
What are the inflammatory neurotransmitters
A
Substace P, prostagladins, bradykinin, histamine
23
Q
What are the analgesia neurotransmitters
A
Serotonin and endorphins
24
Q
What is perception
A
Recognition of pain in the brain
25
What influences perception of pain
thoughts and emotions
26
What is the pain threshold
Point in which someone FEELS pain
27
What is pain tolerance
Amount of pain the pt will BEAR
28
What is modulation
The brain changes the perception by sending INHIBITORY input
29
What are inhibitory inputs
Endogenous endorphins
30
Why are there pain theories
Because it's not completely understood
31
What is the specificity theory of pain
Understanded that pain receptors existed
32
What is the sensory interaction theory
large vs. small nerve fibers
33
What is the gate control theory
Thoughts and emotions influence pain, wheither the pain goes up to the brain or not
34
What substances close the gate
Opioids, massage, nonpainful stimuli, topical analgesics
35
What is the neuromatrix theory
Each person has a unique network of neurons and that's why pain is different for each person
36
What type of pain is protective
Acute
37
How does acute pain resolve
With tissue healing, 3-6 months
38
What type of pain is associated with trauma, surgery, acute, disease, and labor
Acute
39
What is the physiological response of acute pain
Fight or flight response
40
What is the behavioral response of acute pain
Grimacing, moaning, guarding
41
What is the intervention of acute pain
Treat the underlying cause
42
What type of pain is not protective
chronic
43
What is chronic pain
ongoing or repeated pain, interfers with ADLs
44
What are the causes of chronic pain
May not have a know cause: arthritis, fibromyalgia, neuropathy
45
What is the physiological response with chronic pain
Does NOT alter vitals, depression, decreased level of functioning
46
What can chronic pain lead to
disability
47
What are the interventions of chronic pain
Symptomatic releif
48
What is nociceptive pain
most COMMON, physical pain that is caused by tissue DAMAGE
49
What is the type of physcial pain with nociceptive pain
Throbbing, aching, sharp, burning
50
What can cause nociceptive pain
Surgery, inflammation, injurt, trauma
51
What are the two types of nociceptive pain
Somativ, visceral
52
What is somatic pain
INjury to the skin, muscles, bones, and joints
53
What is visceral pain
From the internal organs
54
What type of pain is caused from sunburns, lacerations, fractures, sprains, arthritis, bone cancer
Somatic
55
What type of pain is caused from appendicitis, pancreatitis, IBS, bladder distention, cancer
Visceral
56
What type of pain can cause reffered pain in other body locations
visceral
57
What are the interventions for nociceptive pain
non/opioid meds
58
What are the two types of symtpoms to nociceptive pain
Reffered and radiating
59
What is referred pain
Originates in one area but hurts in another
60
What is radiating pain
Extends from source ot an adjacent area
61
What type of symptom is heart attack
Reffered
62
What type of symptom is sciatica
Radiating
63
What is neuropathic pain
Results from nerve injury but continue after stimuli are gone
64
What are the symptoms of neuropathic pain
Intense, shootin, burning, pins and needles
65
Is neuropathic chronic
Usally
66
What type of pain can neuropathies, tumors, infection, and chemotherapy cause
Neuropathic
67
What type of pain can CVA, viral infections, phantom limbs, DM lead to
Neuropathic
68
what are the interventions of neuropathic pain
Adjucant meds: antidepressants, antispasmodics, muscle relaxers
69
What is psychogenic pain
Perceived pain with no physical cuase
70
What can effect psychogenic pain
Mental, emotional, or behavioral factors
71
What typ eof pain are headaches, backache, stomachaches
Psychogenic
72
What can peripheral neuropathy from DM cause
alterations in pain pathways which can alter perception of apin
73
What are the physiologic alterations caused by pain
The body reacts and over time that can cause issues, Ex. increase RR can lead to pneumonia
74
What are some factors that influence pain
Age, gender, diasbilities, culture, wthnicity, religion
75
What is pain
SUBJECTIVE
76
How does the nurse assess pain
Asking quesiotions. SOCRATES, OLDCARTS, OPQRSTU
77
What does OPQRSTU stand for
Onset, precipitating/palliative, quality, region, severity, timing, understanding
78
What is the most reliable indicator of pain
Pts self report
79
What is the numeric scale
0-10, with a verbal and acitivty tolerance scale
80
What is the wong-baker faces sclae
Used for people who have a hard time communicating, use for kids <3
81
What is the FLACC scale
OBservational, kids 2 months- 7 years old, or pts with cognitive disabilities
82
What are the scores for the FLACC tool
0: relaxed
1-3: mild
4-6: moderate
7-10 Severe
83
What objective data can you collect to complement the pts self report
Vital signs, behaviors, psychological response
84
When should you assess pain
When getting vitals
85
What can an elevated HR and BP indicate
Acute pain, need for med
86
What can a decreased HR and CP indicate
chronic pain
87
Are vitals accurate over a long period of time
No
88
What type of pain is related to burns, MI, amputation as evidence by tissue damage, EKG changes, incision
Acute
89
What type of pain is related to cancer, arthritis, DM as evidence by burning feeling, malignacny
Chronic
90
What can indicate a difficulty of coping with pain
Prolonged pain, poor concentration, inability ot ask for help
91
How do you know if your goal statement works
If your goal was meat with a YES or NO
92
When can you use just nonpharmacologica pain management
Mild pain but use is concurrently with meds for severe or chronic pain
93
What are the nonpharmacologica pain management things you can do
Repositioning, skin stimulation, distraction, relaxation, imagery, acupuncture, reduction of painful stimuli, elevation of swollen limbs, naurolgic and neurosurgical pain therapies
94
What does skin stimualtion do
interrupt pain pathways, heat increases blood flow, cold helps inflammtion
95
Me are somethings you can do to distract your pt
ambulation, deep breahting, TV, vistors, conversation
96
What are some relaxation tecniques
meditation, yoga, prayer
97
What are the neurologic and neurosurgicla pain therapies
Spinal cord stim, TENS
98
What is the spinal cord stim
Device implanted to treat chronic neuroligc pain, tingling sensations alters pain perception
99
What are the three classes of pharmacologic pain management
Nonopioids, opioids, adjuvants
100
What are the mainstay for relieving pain
Analgesics
101
What class is appropriate for mild to moderate pain
Nonopioids
102
What class is appropriate for moderate to severe pain
Opioids
103
What class enhances the effects of nonopioids
Adjuvants
104
What are the two therapeutic stategies to manage pain
Mulitimodal analegesia and preemptive analgesia
105
What is mulimodal anagesia
Using more than one type of agent
106
What are the benefits of mulimodal analgesia
More effective, lower dosese, less side effecrts
107
What is preemptive analgesia
Giving meds before a painful event
108
What are some nonopioids drugs
Acetaminophen, NSAIDs, aspirin
109
What should you know about acetaminophen
Hepatotoxicity, max 4g/day
110
What should you know about NSAIDs
Renal function, bleeding, w/ food
111
What should you know about aspirin
Monitor for salicylism+ tinnits, vertigo
112
What drugss are used for pain post-op, MI, or cancer
Opioids
113
What drugs are opioids
Morphine, fentabyl, codeine
114
How should you manage giving opioids
Short-term sceduled meds rather than PRN
115
What are the adverse effects of opiods
Constipation, orthostatic hypoteneion, urinary retention, sedation, RESPIRATORY DEPRESSION
116
What must you check before giving opioids
Vitals
117
What are the risks of opioid use
Tolerance, dependence, addiction, accidental ingestion
118
What is drug tolerance and what should you do about it
Body gets use to meds and is less effective, use a difference drug
119
What is physicla dependence
Body can not function and will have withdrawal symptoms
120
What is addiction
Psycholoigcal or emotion dependence, compulsively takes the drug
121
What can substance use disorders lead to
Disability, health issues, interfers with life
122
What is the leading cause of accidental death in the US
drug overdose
123
How can you prevent accidental ingestion
Educate pts to keep opioids secure and out of reach of hcildren
124
What is patient-controlled analgesia (PCA)
pt controls small frequent dosing to improve pain control with less lag time
125
What is important with PCAs
2 RNs must set it up, monitor for respiratory depression, and only the PT can push the button
126
What do adjuvant drugs do
Enhavne the effects of nonopiods to alleviate other symptoms
127
What are adjuvants useful for
neuropathic pain
128
What are SNRIS
duloxetine+ cymbalta
129
What are the type of meds in adjuvant care
anticonvulsants, anxiety, depressatns, histamines, metics
130
What is medical marifuana used for
neuropathic pain, spams, cancer, HIV pain
131
What should the nurse try frist for mild pain
nonpharmacologic measures
132
What type of approach should a nurse have when giving pain meds
proactive, around the clock, follow up and reassess
133
When should you reassess after giving pain meds
30 mins- 1 hour
134
What are some pt barriers to good pain management
Fear, cost, no access
135
What are the health care provider barriers to good pain management
Bad assessment, beliefs, attitude, sterotyping, lack of education
136
What are the health care system barriers to good pain management
Not a high priority, not good resources, or reimbursement
137
What is undertreatment of pain
SERIOUS health care problem
138
What can acute and chronic pain lead to
Anxiety, fear, depression
139
What can poorly managed acute pain lead to
Chronic pain syndrome
140
What are the risk factors of undertreatment of pain
attitudes, lack of knowledge, fear od addiction, respiratory depression
141
In what case are we not as worried about respiratory depression
Chronic use
142
Who are the populations at risk for undertreatment of pain
yound, old, pain with substance use issues
143
What are some detrimental outsomes of inadequate pain management
Impaired revocery, chronic pain, ADLs, sleep, suffering, work loss, increased costs, relationships
144
What must you document
Time given, post assessment, duration, score, education at discharge
145
When do you need to assess the pain score
Every shift
146
What do you need to do if goals are unmet
Collaborate
