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Nursing > Pain And Nutrition > Flashcards

Pain And Nutrition Flashcards

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1
Q

Referred pain

A

Appears in a different area of the body

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2
Q

Visceral pain

A

Pain arising from organs or hollow viscera

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3
Q

Duration

A

Acute and chronic

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4
Q

Acute pain

A

Pain lasts only through the expected recovery period

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5
Q

Chronic pain

A

Persistent or prolonged

Usually reoccurring and lasting longer than 3 months

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6
Q

Nociceptive pain

A

When intact properly functioning nervous system sends signals that tissues are damaged, requiring attention and proper care

Transient or persistent

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7
Q

Nociceptive

Somatic pain

A

Originates in the skin, muscles, bone, or connective tissue.

Paper cut or sprained ankle

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8
Q

Nociceptive

Visceral pain

A

Activation of pain receptors in the organs and/or hollow viscera.
Cramping, throbbing, pressing, or aching

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9
Q

Neuropathic pain

A

Associated with damage or malfunctioning nerves due to illness, injury, or undetermined reasons.

Burning, electric shock, tingling

Tends to be chronic and difficult to treat

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10
Q

Peripheral neuropathic pain

A

Eg- phantom limb pain
Carpel tunnel

Follows damage or sensitization of peripheral nerves

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11
Q

Central neuropathic pain

A

Spinal chord injury, post stroke, ms

Resulting from malfunctioning nerves in the central nervous system

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12
Q

Sympathetically maintained pain

A

Temp regulation, blood flow regulation, edema

Occurs occasionally when abnormal connections between pain fibers and the sympathetic nervous system perpetuate problems with both the pain and sympathetically controlled functions

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13
Q

Hyperalgesia and hyperpathia

A

Heightened response to a painful stimuli

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14
Q

Allodynia

A

Non painful stimuli that produces pain. Light touch, contact with wind, linen

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15
Q

Dysesthesia

A

An unpleasant abnormal sensation

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16
Q

Nociception

A

The physiological process related to pain perception

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17
Q

Four physiological process in nociception

A

Transduction
Transmission
Perception
Modulation

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18
Q

Transduction

A

Nociceptors can be excited by mechanical, chemical, or thermal stimuli

Harmful stimuli trigger the release of biochemical mediators such as prostaglandins

Pain meds can work during this phase by blocking the production of prostaglandins

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19
Q

Transmission

A

First segment the pain impulses travel from the peripheral nerve fibers to the spinal chord.

Second segment is transmission of the pain signal through an ascending pathway in the spinal chord to the brain

Third segment transmission of info to the brain where pain perception occurs. Sensory Cortex

Pain control can take place in the second process with opioids that block the release of substance p and stops the pain at the spinal level

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20
Q

Perception

A

When the client becomes conscious of the pain

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21
Q

Modulation

A

Neurons in the brain send signals back down to the dorsal horn of the spinal chord. These descending fibers release substances such as endogenous opioids, serotonin, and norepinephrine. Which can inhibit or reduce the ascending painful impulses in the dorsal horn

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22
Q

Factors that affect the pain experience

A 
Cultural
Developmental stage 
Support people
Previous pain experience
Meaning of pain
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23
Q

Assessment interview

A 
Location 
Quality
Intensity 
Pattern
Precipitating factors
Alleviating factors
Associated symptoms
Effects on adl's 
Past pain experience
Meaning of pain
Coping resources 
Affective response
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24
Q

Pain history

A

Subjective and objective data

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25
Q

Pain scales

A

11 point scale
Flacc scale
Painad for dementia- breathing, vovalization, facial expression, body language, and consolability
The faces scale

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26
Q

Signs of pain

A

Increase in Blood pressure, pulse rate, respiratory rate, pallor, diaphoresis, and pupil dilation.

Can be absent in people with chronic pain

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27
Q

Pain may be the etiology of other nursing diagnosis

A 
Hopelessness. 
Ineffective airway clearing
Anxiety
Ineffective coping 
Impaired physical mobility
28
Q

Management of pain

A

Consists of both independent and collaborative nursing actions

29
Q

Misconceptions about pain management

A

Lack of knowledge
Client thinks nothing can be done
They think pain is not severe enough
They think they will become addicted

30
Q

Tolerance

A

Using opioids over time an increases dose is needed to provide the same level of pain

31
Q

Physical dependence

A

Expected physical response when a client who has used opioids long term reduces or stops meds
Nausea, vomiting, diarrhea, chills and change in vitals

32
Q

Addiction

A

Chronic relapsing treatable disease influenced by psychosocial and environment factors

Craving for substance
Lack of control over the substance
Compulsive use
Continue despite harm

33
Q

Pseudo addiction

A

Under treatment of pain that the patient watches clock for next dose and can seem drug seeking

34
Q

Non opioids / NSAIDs

A

Management for acute and chronic pain

Moderate pain

35
Q

24 hour max

A

Tylenol 3000mg affects liver

Ibuprofen 3200mg kidneys, thins
blood, stomach ulcer

Aspirin 4000mg thins blood irritates gastric lining

36
Q

Ceiling effect

A

Once the maximum analgesic benefit is reached taking additional amounts will not produce more analgesics

37
Q

Narrow therapeutic index

A

There is not much margin for safety between the dose that produces a desired effect and the dose that produces a toxic, even lethal effect

38
Q

Opioids

Full antagonist

A 
There is no ceiling
Morphine the gold standard 
Oxycodone
Fentanyl
Hydromorphone

Severe pain

39
Q

Mixed agonists antagonist

A

Can act like opioids to relieve pain
When given to a client whom hasn’t had opioids
Can block or inactivate other opioids
No ceiling

40
Q

Partial agonists

A

Have a ceiling

Buprenorphine alternative to methadone

41
Q

Coanelgesics

A

Not classified as a pin medication

Antidepressants
Anticonvulsants
Local anesthetic a
Sedatives

Have properties that may reduce pain alone or in combination with other analgesics

42
Q

Non pharmacological pain management

A 
Ice or heat
Tens ( transcutaneous electrical nerve stimulation) 
Immobilization
Therapeutic exercise 
Acupuncture 
Distracting activities 
Relaxation techniques 
Spiritually 
Acupressure
43
Q

Nonpharmacologic invasive therapy

A

A nerve block is a chemical interruption of a nerve pathway caused by injecting a local anesthetic into the nerve

Used in dental work

Used to treat whiplash, lower back disorders,
Bursitis and cancer

44
Q

Pain may be described in terms as

A

Location duration intensity and etiology

45
Q

Macronutrients

A

We need these in large amounts

Carbohydrates, fats, proteins, minerals, vitamins, and water

46
Q

Micronutrients

A

Are those vitamins and minerals We need in small amounts

47
Q

Carbohydrates

A

Simple carbs high calories low nutrients

Complex carbs lower calories higher nutrients

48
Q

Proteins are

A

Tissue building

49
Q

Essential amino acids

A

They can not be manufactured in the body and must be supplied by being injested

50
Q

Nonessential amino acids

A

Are those that the body can manufacture

51
Q

Complete proteins

A

Contain all essential amino acids and many nonessential

Eg- poultry, fish, dairy, eggs

52
Q

Incomplete proteins

A

Lack one or more essential amino acid and are usually derived from a vegetable

53
Q

Vitamins

A

Are organic compounds that cannot be manufactured by the body and is needed in small quantities to catalyze metabolic processes

54
Q

Minerals

A

Found in organic and compounds, inorganic compounds, and free ions
Most common deficiencies are iron and calcium

55
Q

Basal metabolic rate

A

The rate at which the body metabolizes food to maintain the energy requirements of a person who is awake and at rest

56
Q

Resting energy expenditure

A

The amount of energy required to maintain the basic body functions in other words the calories required to maintain life

57
Q

Body mass index

A

Underweight

58
Q

Factors that affect nutrition

A 
Age
Culture
Belief
Personal preference
Religious practice
Lifestyle 
Economics
Medications and therapy 
Health
Alcohol consumption 
Advertising
Psychological factors
59
Q

Assessing nutrition

A

NSI for older adults
PG-SGA
History: age, sex,activity level, difficulty eating, condition of the mouth and teeth, changes in appetite, changes in weight, physical disabilities that affect purchasing preparingand eating, cultural and religious believes that affect food choices, living arrangement such as living alone and economic status, general health status,medical condition, medication history

60
Q

Serum albumin

A

A low level indicates prolonged protein depletion

61
Q

Serum Transferrin

A

Binds and carries iron from the intestine through the serum. Shorter half life so it shows resent protein depletion

62
Q

Total iron binding capacity TIBC

A

Indicates the amount of iron in the blood which the transferrin can bind

63
Q

Pre albumin

A

Shortest half life
Most responsive serum protein to rapid changes in nutritional status
15-30mg/dl normal

64
Q

Creatinine

A

Reflects A person’s total muscle mass
The chief and product of the creatinine produced when energy is released during skeletal muscle metabolism

As skeletal muscle atrophies the creatinine excretion goes down

65
Q

Total parenteral nutrition (TPN)

A

Long term

Dextrose, water, fat, proteins, electrolytes, vitamins, and trace elements

To prevent malnutrition or severe malnutrition

10-50% dextrose

66
Q

Precautions with TPN

A

Start slow to prevent hyperglycemia

Decrease slowly to prevent hypoglycemia
And hyperinsulinema

67
Q

Peripheral parenteral nutrition (ppn)

A

Through peripheral veins

10-20% dextrose

Short time higher rate for phlebitis

Nursing (9 decks)

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