pain assessment and management Flashcards
gate control
psychological factors play a role in perception of pain
transduction
activation of A and C nerve fibres by chemical mediators
nociceptor pain
“normal” pain
neuropathic pain
exaggerated response to pain
somatic pain
muscle, bones, soft tissue
- easily localized
visceral pain
internal pain with organs
acute pain
sudden onset associated with event or procedure
- easier to manage
chronic pain
lasts longer than 3 months,
assessment
onset, location, duration, character, aggravation, radiation, timing, severity
FACES pain scale
used for children as young as 3
mild pain
0-4/10
- cox inhibitor (tylenol)
- NSAIDs (aspirin, ibuprofen, naproxen)
moderate pain
4-6/10weak opioids
- codeine (15-30)
- tramadol (50-100)
severe pain
6-10/10; strong opioids
- morphine
- oxycodone
- fentanyl
- hydromorphone
breakthrough pain
pain exacerbation in a pt with adequately controlled baseline pain
Cervical dermatome
head to clavicle and arms
c1-c8
thoracic dermatome
just below clavicle to 3/4 down of back and front stomach
- t1-t12
lumbar dermatome
lower back and all of front leg
- l1-l5
sacral dermatome
buttocks and back of legs
s1-s5
stop of pain signal transmission at CNS treatment
- acetaminophen
- opioids
stop of pain signal transmission at peripheral level treatment
NSAID’s
opioids
inhibit release of substance P and are centrally acting
glucocorticoids
used for autoimmune; inhibits COX-2
- suppresses some WBC and histamine
- “one” suffix
complex regional pain syndrome
pain more severe than injury warrants (thought to be due to increased sensitization of A and C fibres)
NSAID contraindications
- kidney problems
- stomach ulcers
- heart failure
- older adults
- people on blood thinners
- pregnant women
