Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing 1 > Pain, Comfort, and Sleep > Flashcards

Pain, Comfort, and Sleep Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

Standards relative to direct pt care state the following. 4 things

A

1) pts have the right to appropriate assessment and management of pain.
2) pain is assessed in all patients
3) Patients are educated about pain and managing pain as part of treatment, as appropriate
4) the discharge process provides for continuing pain care based on the pts assessed needs at the time of discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

These machines allow pts to self administer medications within safe boundaries based on their perception of pain.

A

PCA (patient controlled analgesia) machines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some nonpharmacologic methods of pain relief

A

biofeedback, distraction, guided imagery, massage, and relaxation techniques.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

often a warning of potential or actual tissue damage and allows the sufferer to withdraw from the source or to seek help in relieving symptoms

A

acute pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pain is transmitted to the brain through the ?

A

nervous system. This is done through afferent (sensory) neurons leading to the spinal nerves and then to the brain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

endogenous naturally occurring opiatelike peptides that reduce or block the perception of pain.

A

Endorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

attach to nerve endings in opioid receptors and block pain t

A

Endorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

treatment for pain should be bases on assessment that considers what factors? 3

A

1) pts verbal description of pain
2) nonverbal signs of pain
3) physiologic indicators of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

this pain involves injury to tissue in which receptors called nociceptors are located

A

Nociceptive pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

this phase of nociceptive pain begins when tissue damage causes the release of substances that stimulate the nociceptors and start the sensation of pain

A

Transduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

this phase of nociceptive pain involves movement of the pain sensation to the spinal cord

A

transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

this phase of nociceptive pain occurs when pain impulses reach the brain and the pain is recognized

A

perception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

this phase of nociceptive pain occurs when neurons in the brain send signals back down the spinal cord by release of neurotransmitters

A

modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

assists the patient in focusing on something other than the pain

A

Distraction technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

places a fine catheter in the epidural space near the base of the spine and then connects the catheter to a small battery operated programmable pump to relieve pain

A

epidural analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

verbally guiding the patient to imagine something as it is used for pain control, patients are assisted in forming mental images of a plesant envioronment where they are comfortable and happy. (vacation place)

A

guided imagery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

also called therapeutic suggestion. Involves inducing a trance like state using focusing and relaxation techniques and giving the pt suggestions that may be helpful after the return to an alert state of consciousness.

A

hypnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

(focusing on an image, thought, the breath, or awareness) can provide the same relief from a painful situation, but it relies on the use of a focus point rather than the mental creation of an alternate environment.

A

Meditation technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

(analgesia doses controlled by the patient) this method uses one of a variety of programmable pumps

A

Patient controlled analgesia (PCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

is helpful in reducing pain and allows the pts to obtain greater relief from pain medications.

A

relaxation technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

uses a small electrical stimulator attached to electrodes to block pain. available in high frequency and low frequency stimulation.

A

Transcutaneous electrical nerve stimulation (TENS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

use of fine needles along meridians of the body to relieve pain or other symptoms and restore balance

A

acupuncture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

feeling of distress or suffering

A

pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

naturally occurring opiate like peptides

A

endorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

manipulation of the joints and adjacent tissues of the body

A

chiropractic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

method of learning muscle relaxation using a machine that measures muscle tension

A

biofeedback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

line or passageway of energy that passes through the body

A

meridian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Nonopioid pain medications that have no steroidal effect

A

nonsteroidal anti inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

drug that relieves pain

A

analgesic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

difficulty in getting to sleep or staying asleep

A

insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

condition where breathing stops for a brief period during sleep

A

sleep apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

focusing on an image or thought for relaxation

A

meditation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

concentrated dose given in a short period

A

bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

specialized relaxation technique using a machine that measures the degree of muscle tension with skin electrodes

A

biofeedback technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

engaging in interesting activity reduces pain perception by…

A

diverting the attention elsewhere for a time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

anxiety increases pain perception causing?

A

acute pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what are the three basic categories of medications for pain relief?

A

NSAIDS- nonopioid analgesics
COX-2 inhibitors
Narcotics or opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

injectable pain medication is used for severe pain. when administering such an injection IM, it is very important to be careful not to?

A

damage the nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

the infant sleeps about ? hours per day in divided segments.

A

?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

A large portion of infant sleep is spent in the REM stage and it is thought that this is necessary for what

A

brain maturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

sleep and rest affect pain. a person who is rested shows both increased ? and a greater response to ?

A

pain tolerance; analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

school age children should get ? hours of sleep each night

A

10-11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

in which stage does the body receive the most rest?

A

NREM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Transition stage, person falls into a light sleep, muscles relax, lasts a few minutes

A

stage 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

person falls into a deeper sleep, brain wave activity become larger with bursts of electrical activity, last about 10-20 minutes

A

stage 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

person enters delta sleep, slow wave sleep, respirations and heart rate slow, body becomes immobile, lasts 20-40 minutes, dreaming is common, deepest stage of sleep, difficult to arouse the sleeping person

A

stage 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

obstructive sleep apnea can be successfully treated by

A

continuous positive airway pressure (CPAP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what are two things that snoring is caused by

A

vibration and or obstruction of the air passage at the back of mouth and nose
and obstructed airways related to colds or allergies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

narcolepsy is characterized by

A

..

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

a diagnosis of narcolepsy is achieved by

A

clinical evaluation, sleep logs or diaries, and results of sleep laboratory tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

three uses of cold for pain or discomfort are?

A

reducing swelling, calming muscle spasms, reducing the pain in joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

two precautions when using ice packs are?

A

should only be in contact with the skin for a few mins, and applied with a towel or other barrier between pack and skin not left in place for more than 15-20 mins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

in instructing a pt how to apply heat safely, the nurse would caution a pt not to…

A

go to sleep lying on a heating pad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

there are many types of pain scales. for a preverbal or non-communicative child, the ? scale would be a good choice

A

FLACC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

signs of fentanyl patch overdose are?

A

confusion and inability to walk normally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

a pt comes to the clinic complaining of insomnia. she has had difficulty sleeping for past 2 months is tired all the time, and her work is suffering in assessing the problem the nurse would ask her about

A

pattern of caffeine intake, stresses and problems in her life, (what medications she takes and when??)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

one thing the nurse would ask the pt to do to try to locate the reason for her insomnia is to

A

keep a diary related to sleep and problems encountered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

The nurse would advise the pt with insomnia to

A

get up at the same time each day and avoid naps, eliminate alcohol and nicotine for are least 2 hours before bedtime

59
Q

whatever the experiencing person says it is

A

pain

60
Q

endogenous chemicals that act like opioids

A

endorphins

61
Q

larger dose of analgesic required to relieve same pain

A

Tolerance

62
Q

psychological dependence

A

addiction

63
Q

self administered analgesics

A

patient controlled anesthesia PCA

64
Q

dose of analgesic limited by side effects

A

ceiling effect

65
Q

medications that relieve pain

A

analgesics

66
Q

drugs that are used to potentiate analgesics

A

adjuvants

67
Q

neurotransmitter released during pain

A

prostaglandin

68
Q

a morphine like drug

A

opioid

69
Q

which of the following definitions of pain is most appropriate to use when planning nursing care?

A

whatever the experiencing person says it is, occurring whenever the experiencing person says it does

70
Q

which of the following terms describes a feeling of threat to ones self image or life that may accompany pain?

A

suffering

71
Q

which of the following is a common side effect of opioid administration?

A

constipation

72
Q

which is the most accurate way to assess the severity of a pts pain?

A

have the pt rate pain on a standard pain scale

73
Q

which of the following statements best explains why a pt can be laughing and talking and yet still be in pain?

A

distraction can help relieve pain when used in combination with analgesics

74
Q

which type of pain may be accompanied by changes in vital signs?

A

acute pain

75
Q

an 82 yr old male pt has been receiving meperidine (demerol) IM for chronic back pain. after several weeks he becomes very irritable which is unlike him. which response by the nurse is best

A

consult with the registered nurse or physician about changing to a different analgesic

76
Q

A nurse is caring for a pt who reports being in severe pain. the pt has an order for percocet 2 tabs every 6 hours for pain. prior to providing the medication which of the following actions should the nurse take?

A

assess the pts pain level and respiratory rate

77
Q

a pt with severe pain is receiving narcotic pain medication through the use of a pt controlled analgesia intravenous pump. the LPN notes that the pt is lethargic and difficult to arous with a respiratory rate of 7 breaths per minute. after informing the RN which of the following drugs does the nurse anticipate will be ordered?

A

naloxone (narcan)

78
Q

a pt with a known history of cocaine abuse is admitted following a motorcycle accident he calls you into his room and says I need something for this pain now. which assumption by the nurse is the best?

A

the pt is in pain and needs an analgesic (you can not assume that the pt isn’t in pain and only seeking drugs)

79
Q

the nurse is providing care for a pt in the emergency department who is experiencing a migraine heardache the pt reports taking two extra strength acetaminophen every 6 hours for the fast few days the nurse would be most concerned by which of the following statements by the pt?

A

i usually drink three or four beers a day

80
Q

how pain is transmitted and perceived is called

A

nociception

81
Q

what is the gate control theory

A

describes the dorsal horn of the spinal cord as a gate, allowing impulses to go through when there is a pain stimulus and closing the gate when those impulses are inhibited.

82
Q

represents the initiation of the stimulus and conversion of that stimulus into an electoral impulse at the time of the injury. chemical substances called neurotransmitters are released from damaged tissue. these substances include prostaglandins bradykinin serotonin and substance p

A

Transduction

83
Q

the process of moving a painful message from the peripheral nerve endings though the dorsal root ganglion and the ascending tract of the spinal cord to the brain

A

transmission

84
Q

actually feeling the pain. during this processes the hypothalamus activates and controls emotional input and also generates purposeful goal directed behavior while the cerebral cortex receives the pain message

A

perception

85
Q

the body’s attempt to interrupt pain impulses by releasing endogenous (naturally occurring)opioids

A

modulation

86
Q

endogenous chemicals that act like opioids inhibiting pain impulses in the spinal cord and brain

A

endorphins

87
Q

one type of endorphin

A

enkephalin

88
Q

refers to the bodes normal reaction to noxious stimuli such as tissue damage with the release of pain producing substances.

A

nociception

89
Q

pain associated with injury to either the peripheral or central nervous system. not usually localized and it may spread to involve other areas along the nerve pathway

A

neuropathic pain

90
Q

malingerer

A

pretending to be in pain

91
Q

categories of drugs that were originally developed for a different purpose but have been found to have pain relieving properties in certain painful conditions

A

adjuvants

92
Q

limited in their use because they have a ceiling effect to analgesia

A

nonopioid analgesic

93
Q

level 1 on the WHO ladder

A

mild pain, pt can usually sleep perform activities of daily living and even work Non opioid pain persisting or increasing

94
Q

level 2 on the WHO ladder

A

mild to moderate pain may not be able to sleep and may have trouble working and staying focused adds an opioid analgesic

95
Q

level 3 on the WHO ladder

A

Opioid for moderate to severe pain affecting the quality of the pts life.

96
Q

can help pts understand and cope with pain and take an active part in its assessment and control. include interventions such as educational information relaxation exercises guided imagery distraction and biofeedback

A

cognitive behavioral interventions

97
Q

may include providing comfort correcting physical dysfunction altering physiological responses and reducing fear that might be associated with immobility . include application of heat or cold massage exercise immobilization, and transcutaneous electrical nerve stimulation

A

physical agents

98
Q

Meperidine should be avoided in?

A

elderly patients

99
Q

the pt will experience the best pain relief with the combination of?

A

an opioid and nonopiod

100
Q

nociceptive pain occurs with

A

tissue injury

101
Q

chronic sleep loss can increase the risk of? (7)

A

obesity, depression, hypertension, diabetes, heart attack, and stroke

102
Q

very light sleep, only a few mins long, vital signs and metabolism beginning to diminish, can be awakened easily, feels relaxed and drowsy

A

Stage 1 NREM

103
Q

deeper sleep, 10-20 min in length, vital signs and metabolism continuing to diminish, requires slightly more stimulation to be awakened, increased relaxation

A

Stage 2 NREM

104
Q

deep sleep, 15-30 min in length, vital signs continuing to decrease, difficult to awaken, relaxation such that the person seldom moves

A

Stage 3 NREM

105
Q

called delta sleep, deepest sleep, 15-30 min in length, vital signs very low as compared to when awake, very difficult to awaken, stage at which the body achieves physical rest and restoration, stage at which enuresis and talking and walking in ones sleep occurs, repair and renewal of tissue.

A

Stage 4 NREM

106
Q

Occurrence of dreams, usually begins about 90 min after falling asleep, length increases with each sleep cycle, average length is 20 mins, varying vital signs, very difficult to awaken, stage at which mental rest and restoration occur.

A

REM

107
Q

birth to 3 months

A

16 hr a day

108
Q

infants (3 months to 1 year)

A

8-10 hours plus with two to three naps

109
Q

toddlers

A

12 hour with some sleep during a daytime nap

110
Q

preschooolers

A

12 hour with less napping during the day

111
Q

school age

A

11-12 hour for younger children with 9 to 10 hour for older ones

112
Q

adolescents

A

7.5 hours

113
Q

young adults

A

6-8.5 hours

114
Q

middle adults

A

6-8.5 hours

115
Q

older adults

A

6-8.5 with daytime naps possibly accounting for some of the hours

116
Q

most common sleep disorder, is defined as the inability to get an adequate amount of sleep and to feel rested.

A

insomnia

117
Q

a disorder of the sleep and wake mechanism. the person may lose the ability to stay awake. often happens at inappropriate times and can put the person at risk for injury

A

narcolepsy

118
Q

medications of choice for insomnia are?

A

benzodiazepine like medications which include the sedative hypnotics zolpidem(ambient) eszopiclone(luniesta), and zaleplon (sonata)

119
Q

Transduction

A

is the conversion of painful stimuli to an electrical impulse through peripheral nerve fibers (nocieptors)

120
Q

Transmission

A

Occurs as the electrical impulse travels along the nerve fibers and is regulated by neurotransmitters

121
Q

the pain threshold is?

A

the point at which a person feels pain

122
Q

Substances that Increase pain transmission and cause an inflammatory response (4)

A

substance P, prostaglandins, bradykinin, histamine

123
Q

substances that Decrease pain transmission and produce analgesia

A

serotonin, endorphins

124
Q

occurs in various areas of the brain and is influenced by thought and emotional processes

A

perception or awareness of pain

125
Q

occurs in the spinal cord, causing muscles to contract reflexively, moving the body away from painful stimuli

A

modulation

126
Q

this pain arises from damage to or inflammation of tissue other than that of the peripheral and central nervous systems. usually throbbing aching and localized. this pain typically resounds to opioids and nonioioid meds.

A

Nociceptive pain

127
Q

arises from abnormal or damaged pain nerves. includes phantom limb pain, diabetic neuropathy. This pain is usually intense, shooting burring or described as pins and needles. This pain typically responds to adjuvant meds, (antidepressants, antispasmodic agents, skeletal muscle relaxants)

A

Neuropathic Pain

128
Q

risk factors for under treatment of pain include (4)

A

cultural and societal attitudes, lack of knowledge, fear of addiction, exaggerated fear of respiratory depression

129
Q

causes of acute and chronic pain include (7)

A

trauma, surgery, cancer, arthritis, fibromyalgia, neuropathy, diagnostic or treatment procedures (injection, intubation, radiation)

130
Q

(acetaminophen, nonsteroidal anti inflammatory drugs(NSAIDs) including salicylates) are appropriate for treating mild to moderate pain

A

nonopioid analgesics

131
Q

morphine sulfate, fentanyl (sublimaze) and codeine are appropriate for treating moderate to severe pain (post operative pain myocardial infraction pain, cancer pain)

A

opioid analgesics

132
Q

enhance the effects of nonopioids, help alleviate other symptoms that aggravate pain (depression, seizures, inflammation) and are useful for treating neuropathic pain

A

adjuvant analgesics

133
Q

Adjuvant medications include? (6)

A

anticonvulsants; carbamazepine(tegretol)
antianxiety agents; diazepam (valium)
tricyclic antidepressants; amitriptyline (elavil)
antihistamine; hydroxyzine (visatril)
glucocorticoids; dexamethasone (decadron)
antiemetics; ondansetron hydrochloride (zofran)

134
Q

4 types of Neuropathic pain

A

Diabetes, HIV/AIDS, Guillain-Barre syndrome, Caner

135
Q

3 types of Nociceptive pain

A

Trauma, burns, surgery

136
Q

6 types of acute pain

A

surgery, injury, cholecystitis, appendicitis, infection, renal colic

137
Q

this type of pain is usually not relieved by analgesics and opioids alone. Is managed with common analgesics such as those in the NSAID family, but also increasingly with adjuvant medications such as tricyclic antidepressants, anticonvulsants, and corticosteroids.

A

Neuropathic pain

138
Q

what does the mnemonic device for pain assessment stand for PQRST

A 
precipitating events,
quality of pain or discomfort
radiation of pain
severity of pain 
timing
139
Q

FLACC

A

face, legs, activity, cry, and consolability scale is used for preverbal or non communicative children.

140
Q

NIPS

A

Neonatal infant pain scale

141
Q

CRIES

A

crying, requires oxygen to maintain saturations, increased vital signs, expression, and sleeplessness

142
Q

PIPP

A

premature infant pain profile

143
Q

acute pain may be treated with? whereas; chronic pain may be treated with?

A

conventional high frequency TENS therapy; low frequent TENS therapy

144
Q

PENS

A

Percutaneous electrical nerve stimulation is used for relief of some severe headaches and lower back pain

Nursing 1 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions