Pain and Pain Management Flashcards
What is the 5th vital sign?
pain
What is pain?
an unpleasant sensory and emotional experience associated with actual or potential tissue damage
What are the pain-related goals for clinicians?
- eliminate source of pain
- teach patient to function within pain limitations
- improve pain control through physical and psychological methods
- relieve drug dependency
- treat overall well-being
- improve family and community support systems
What does optimal pain management do for patients?
- helps patients understand their symptoms, adhere to their treatment plan, and return to their normal lives
What is a passive medicine for pain?
opioids
What are the three phases/types of pain ?
- acute: < 30 days, well localized and defined
- chronic: longer than 3-6 months duration; nociceptive, neuropathic (CNS,PNS, SNS)
- Referred: perceived as coming from site different from source (visceral pain)
What is the most reliable indicator for pain?
self - report of pain = subjective
What is a quantitative rating of intensity of pain?
- pain scales
= objectify the measure
What are some objective measures of pain?
- verbal rating scales
- numeric rating scales
- visual analog scales
- picture or face scales
What do we need to consider when selecting a method of pain measurement?
- consider symptom duration, pt’s abilities, and time needed
- complexity of measure to be sensitive to change
What are nonverbal pain indicators?
- sighs, gasps, moans, groans, cries
- facial grimaces, winces
- bracing or guarding against movement
- restlessness’
- rubbing the area
- vital sign response: increased HR, RR, BP
Which sensory pathway or tract does crude touch and pain follow in the spinal column as the signal courses toward the cortex?
anterolateral spinothalmic pathway
What is the anterolateral spinothalmic pathway the primary sensation for?
- primary sensation for nondescrimative/crude touch, pain, temp
What does the anterolateral spinothalmic pathway receive signals from?
mechanoreceptors, nociceptors, thermoceptors
What are C-fibers?
small, unmyelinated peripherial nerve
What is nociception?
neural process of encoding a noxious stimuli
Is pain nociception?
NO
What can happen to nociception on its way to the brain?
can be facilitated or inhibited along the way
- MODALITIES CAN INHIBIT
What is pain triggered by?
the action potential of a nociceptor and converted to conscious understanding of that stimulus
What is the perception of nociception by the cerebrum?
pain
What are the three dimensions of the experience of pain?
Sensory-discrimative
motivationsal-affective
cognative-evaluative
What is sensory-discriminative?
where the pain is felt and what it feels like
What is motivational-affective?
how the patient feels about the pain emotionally
What is cognative-evaluative?
what the patient thinks about the pain intellectually and what they expect
What are nociceptors?
type of sensory receptor that responds to noxious stimuli and result in the perception of pain
Where are sensory receptors located?
At the distal ends of an afferent nerve
Sensory receptors are __________ and __________ to the type of stimulus for which they were designed “sense”
specific and sensitive
What are free nerve endings ?
Type of nociceptor/mechanoreceptor that “senses” pain
What are nociceptors triggered by?
- intense thermal, mechanical or chemical stimuli
- exogenous source: brick, acid, bleach, fire
- endogenous source: fx, inflammatory response (chemicals bradykinin, histamine, arachidonic acid)
Nocicpetors are nerve endings for afferent neurons:
C fibers and A-delta fibers
What are 80% pain transmitting fibers?
C- fibers
- 20% a-delta
