Pain Flashcards
1
Q
Cellular damage by thermal, mechanical, or chemical stimuli causes pain, and results in the release of what neurotransmitters?
A
- Excitatory NT, that increase inflammatory response and increase sensitivity to pain such as:
- Prostaglandins
- Bradykinin
- Substance P
- Histamine
2
Q
What is transduction
A
- transduction converts energy produced by painful stimuli into electrical energy. Begins in periphery when the pain impulse meets a nociceptor (peripheral pain nerve fiber). This initiates an action potential
3
Q
What is transmission
A
- occurs after transduction. Sending of he nerve impulse. It travels along sensory afferent nerve fibers to the spinal cord. The pain stim enters spinal cord at dorsal horn, then up to the the thalamus. The thalamus transmits the pain stim to higher functioning parts of the brain
4
Q
What do myelinated A-delta fibers do?
A
- Peripheral nerve fibers that send sharp, localized pain and distinct sensations. They specify the source of the pain and detect its intensity
5
Q
What do C fibers do?
A
- Slow, small, unmyelinated. Relay impulses that are poorly localized such as burning or persistent pain. diffuse and widespread pain
6
Q
What is pain perception
A
- the patients experience of pain
7
Q
What is modulation
A
inhibitiion of pain or release of inhibitory NT (opioids, serotonin, GABA). Release after the brain perceives pain
8
Q
Describe the gate control theory
A
- pain has emotional and cognitive components as well as physical sensation
- gating mechanisms along peripheral nervous system regulate or block pain impulses
- pain passes through when gate is open, and is blocked when gates are closed. Closing gate is basis for non-pharmacological pain relief interventions.
- EX= stress and exercise release endorphins and raise pain threshold
9
Q
describe acute pain
A
- protective
- serves purpose and has identifiable cause
- short duration
- limited tissue damage and emotional response
- primary nursing goal is pain relief that allows patient to participate in their recovery
10
Q
describe chronic pain
A
- non protective, no purpose
- lasts longer than 6 months
- constant, reoccuring
- does not always have identifiable cause
- arthritis, low back pain, myofascial pain, headache, peripheral neuropathy
- usually non-life threatening
- can lead to depression
- doesnt usually show obvious symptoms
11
Q
What is chronic episodic pain
A
- occurs sporadically over an extended period of time. Lasts for hours, days, weeks. Example=migraine, pain related to sickle cell
12
Q
What is cancer pain
A
- can be acute or chronic
- nociceptive and/or neuropathic pain
- usually caused by tumor progression
- referred pain is common
13
Q
what is inferred pathological pain
A
- nociceptive pain (somatic/musculoskeletal)
- visceral (internal organ pain)
- neuropathic (abnormal or damaged pain nerves
14
Q
what is idiopathic pain
A
- chronic pain in the absence of an identifiable physical or psychological cause, or pain received in excess for the extent of an organic pathological condition. Example= complex regional pain syndrome
15
Q
Things to remember to avoid misconceptions of pain in older adults
A
- Pain is NOT a natural outcome of growing old (older adults are just at greater risk for many painful conditions)
- Pain perception or pain sensitivity does NOT increase with age. There is no evidence that they have dulled sense of pain
- Older patients commonly under-report pain but this does not mean they arent experiencing pain
- If they are sleeping, it does not mean they are not in pain. May be coping mechanism
- Opioids are safe for them
