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Med-Surg > Pain > Flashcards

Pain Flashcards

1
Q

What is somatic pain ?

A

arises from bone, joint, muscle, skin or connective tissue
- usually aching or throbbing in quality
- well localized pain

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2
Q

What is visceral pain ?

A

arises from visceral organs, such as the GI tract and bladder
- vague, harder to pinpoint pain

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3
Q

What is neuropathic pain ?

A

abnormal processing of sensory input by the peripheral or central nervous system

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4
Q

How is neuropathic pain described as ?

A

numbing, hot, burning, shooting, stabbing, sharp or electric shock-like

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5
Q

What are the causes of neuropathic pain ?

A

trauma, inflammation, metabolic disease (DM), alcoholism, infections of the nervous system, tumors

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6
Q

What is acute pain ?

A
  • <3 months duration
  • increased HR, RR, BP
  • diaphoresis/pallor
  • anxiety, agitation, confusion
  • urine retention
  • Goal: pain control w/ eventual elimination
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7
Q

What is chronic pain ?

A
  • > 3 months duration
  • decreased physical movement/activity
  • fatigue
  • withdrawal from others and social interaction
  • Goal: control pain to the extent possible focusing on quality of life & function
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8
Q

What is OLDCARTS ?

A
  • Onset
  • Location
  • Characteristics
  • Aggravating
  • Relieving
  • Treatment
  • Severity
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9
Q

What is the pain scale for babies ?

A

FLACC

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10
Q

Who is the FACES pain scale used for ?

A
  • self report
  • 4+ year olds
  • can be used as young as 3 yrs old
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11
Q

Who is the numeric pain scale used for ?

A
  • 8 yrs or older
  • developmentally able
  • can be used as young as 5 yrs old if they can count
  • if a pt can self-report, do not change to an observational scale while asleep
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12
Q

What are some physiological reactions to pain ?

A
  • skin flushing/diaphoresis
  • vital sign changes: BP, HR, RR
  • O2 saturation, restlessness
  • pupil changes
  • chronic pain may result in physiological changes
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13
Q

What are some physical non-medicated pain relief strategies ?

A
  • massage
  • exercise
  • transcutaneous electrical nerve stimulation (TENS)
  • percutaneous electrical nerve stimulation (PENS)
  • acupuncture
  • heat/cold therapy
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14
Q

What are some non-pharmacological pain management for pediatrics ?

A
  • distraction
  • nonnutritive sucking (pacifer)
  • kangaroo care
  • containment and swaddling (sleep sacks)
  • relaxation
  • guided imagery
  • cutaneous stimulation
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15
Q

What are some characteristics of Acetaminophen/Tylenol ?

A

can harm the liver in large doses

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16
Q

What is a characteristics of toradol/ketorolac ?

A

may cause bleeding & kidney damage

17
Q

What are some common side effects of opioids ?

A

drowsiness, respiratory depression, constipation, nausea

18
Q

What drug category is Nalbuphine (Nubain) & Butorphanol ?

A

mixed agonst-antagonist
- less respiratory depression
- may cause withdrawal to occur

19
Q

What is Tramadol ?

A

weak mu agonist
- inhibits reuptake or norepinephrine and serotonin
- may cause seizures

20
Q

What are some meds for opioid addiction ?

A
  • Methadone: opioid agonist, more mild and long acting
  • Suboxone: Buprenorphine + Naloxone
21
Q

How may we manage pain in those with opioid addiction ?

A
  • assess for substance abuse or possible diversion of opioids
  • consider referral to pain clinic/specialist
  • right to receive effective pain management
  • consider complications of withdrawal
22
Q

What type of pain med schedule is effective for those with chronic & predictable pain ?

A

around the clock (ATC)

23
Q

What is the goal of med titration ?

A

use the smallest dose of analgesic that provides effective pain control with the fewest side effect

24
Q

When is the oral route for medication good for ?

A

with pt’s that has functioning GI system
- immediate release q4 hrs
- sustained release q12-24 hrs (takes 2 hrs for onset)

25
Q

When is the sublingual and buccan route for med good for ?

A

for pt’s who can’t swallow
- faster relief (5-7 mins) and lasts about 2-5 hrs

26
Q

When is the rectal med route good for ?

A

for pt’s who can’t swallow
- absorption may vary

27
Q

How long does it take for the transdermal med route to work ?

A

12-17 hrs for full effect
- report use of this med/assess for it
- remove previous patch before applying new

28
Q

When is the parenteral med route good ?

A
  • SQ: slow absorption, not used to acute pain
  • IM: painful, unreliable absorption
  • IV: best route for immediate analgesia
29
Q

How does a patient controlled analgesia (PCA) pump work ?

A

programmed to give a dose of med every time the patient hits the button
- can only hit the button a certain amount of times
- only the patient should press the button
- occasionally a basal rate is added where a certain amount of med is being given constantly, no matter if the button is pressed
- high risk & end-tidal CO2 monitoring

30
Q

What are some signs of opioid overdose ?

A
  • slow or shallow respirations
  • oversedation
  • confusion
31
Q

What is the treatment for opioid overdose ?

A
  • if running a PCA, put it on hold and shut it off
  • if receiving opioids, give Narcan (Nalaxone) is respirations < 8 (usually)
32
Q

What are some special considerations about pain management with older adults ?

A

start low, and go slow
- they metabolize drugs more slowly
- NSAIDS cause GI bleeding
- drug interactions
- cognitive impairment
- incorporate exercise and other nonpharmacologic interventions

33
Q

What are some consequences of untreated pain ?

A
  • suffering
  • immunosuppression
  • sleep disturbances
  • impaired recovery from acute illness and surgery
  • physical and psychosocial dysfunction
34
Q

What are some harmful effects of unrelieved pain ?

A
  • tachycardia
  • increased clotting
  • shallow breathing/decreased tidal volume (can cause pneumonia)
  • urinary and bowel retention
  • anorexia
  • weakness/fatigue
  • impaired muscle coordination
  • disorganized thought processes

Med-Surg (23 decks)

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