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Therapeutics > Pain COPY > Flashcards

Pain COPY Flashcards

1
Q

What are some things that can cause people to be reluctant to report pain

A

fear of being viewed as weak or complainer
dont want to be bothersome
fear of administration methods for pain relievers
viewing pain as normal

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2
Q

What does a pain assessment consist of

A

history of the pain

observation of behaviors, injuries, and secondary physiological responses to it

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3
Q

What are some things the nurse needs to be aware of when assessing pain

A

previous treatments and their effectiveness
when and what analgesics were lsat taken
other meds being taken
allergies to meds

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4
Q

What data should be collected during an interview assessing pain

A 
location 
quality
intensity
pattern
onset precipitating factors 
alleviating factors 
effect on ADL's
associated symptoms
meaning
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5
Q

What is a question to ask for location

A

where is your discomfort

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6
Q

What is a question to ask for quality

A

tell me what it feels like

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7
Q

What is a question to ask for intensity

A

0-10 scale

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8
Q

What is a question to ask for pattern

A

do you have pain free periods, if so how long do they last

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9
Q

What is a question to ask for onset

A

when did it start

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10
Q

What is a question to ask for alleviating factors

A

have you found anything that helps with the pain

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11
Q

What is a question to ask for precipitating factors

A

Does anything trigger the pain

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12
Q

What is a question to ask for associated symptoms

A

Do you have any other symptoms before during or after the pain

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13
Q

What is a question to ask for effect on ADL’s

A

How does the pain affect your daily activities

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14
Q

What can the nurse do to ass pain for clients who cannot use a numerical scale

A

assess the level of pain based on the degree of interference with functioning

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15
Q

What is the scale for pain based on functioning interference

A 
0 = no pain
2 = pain only when paying attention to it 
4 = can ignore pain and do things 
6 = cannot ignore pain, interferes
8 = impairs ability to function or concentrate
10 = incapacitating
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16
Q

What are good pain tests for patients who cannot use a numerical scale for pain

A

wong-baker faces rating scale

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17
Q

What are some good pain tests for patients with chronic pain

A

Brief pain inventory (BPI)

short form McGill Pain Questionaire (SF-MPQ)

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18
Q

What is a good pain test for children 2mo to 7yrs

A

FLACC

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19
Q

What are some physiological responses to acute pain

A

increased BP, HR, RR, pallor, diaphoresis, and pupil dilation

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20
Q

Are you more or less likely to see physiological reponses in people with chronic pain

A

no, bx of adaptation to the pain

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21
Q

What is the framework for determinign pain in nonverbal patients

A

attempt to get a self-report
Consider potential causes
Observe behaviors
obtain info from fam members or cargivers if available
attempt an analgesic trial and observe changes in behavior

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22
Q

What can be given to someone with chronic pain to help identify pain patterns and factors that mediate/exacerbate pain

A

a daily pain diary

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23
Q

What are some things that need to be recorded in a pain diary

A 
onset time 
activity or situation
quality 
intensity
emotions
any interventions
intensity after interventions
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24
Q

What are some nursing diagnoses for pain

A

acute and chronic pain

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25
Q

What should the nurse include in the diagnostic statement for pain

A

the location and related factors (when available)

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26
Q

What else can pain be in the diagnosis

A

the etiology

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27
Q

What are some examples of pain as the etiology

A

Impaired physical mobility related to pain
Ineffective airway clearance related to weak cough secondary to postoperative incisional abdominal pain
Hopelessness related to feelings of continual pain

28
Q

Before discharge, what data needs to be assessed

A

client knowledge and self care abilities for pain management
Family/caregiver availability, skills, and willingness to help
the degree of family role changes and coping
resources available to the client

29
Q

What are some things that should be taught for client teachign

A

skills for administrating meds
non-pharmacologic techniques to reduce pain
how to access community resources

30
Q

Poor pain management can cause problem with

A

vitals like cardiac output and oxygen demand
endocrine and metabolic response like increased cortisol, ADH, and insulin resistance
Wound healing bx of decreased participation in therapy and immune system problems
sleep

31
Q

What are patient influences that can affect pain management

A

previous experiences- ask them if past pain meds worked
Ability to communicate- use FLACC scale or a translator
Gender and culture- ways of expression including differences between genders
Addiction- may cause them to need a higher dose

32
Q

What are some nurse influences that can affect pain management

A

Knowledge- of different types of meds and their properties
Attitude- like biases
Skill- judgement, observation/assessment skills, communication skills

33
Q

During intervention, what is used to determine whether nonpharm or pharm pain management is needed

A

the WHO 3 step analgesic ladder

34
Q

What is the first step in the 3 step ladder

A

For mild pain (1-3 on a 0-10 scale)

use nonopioid analgesics

35
Q

When do you move to step two of the 3 step ladder

A

if the mild pain doesnt go away when using a full dose of meds or pain is reported between 4-6 on a 0-10 scale

36
Q

What is done in the step two of the step ladder

A

use of an opioid like codeine or tramadol by themselves or in combination with a nonpharm intervention as well like oxycodone with acetaminophen

37
Q

When do you use the 3 step of the 3 step ladder

A

pain of 4-6 doesnt go away with full dose or pain reported 7-10 on a 0-10 scale

38
Q

What are some opioids that are used for step 3 on the 3 stap ladder

A

morphine
hydromorphone
fentanyl

39
Q

What is a scale that can be used to assess the sedation level of a client receiving opioids

A

the pasero opioid-induced sedation scale

40
Q

What are the rackings of the pasero opioid induced sedation scale

A

1- awake and alert
2- slightly drowsy and easily aroused
3- frequently drowsy, arousable, and drifts off to sleep during conversation
4- minimal or no response to physical stimulation

41
Q

What are the common sideeffects of opioids

A 
constipation 
sedation 
N/V
Respiratory depression
pruritus 
urinary retention
42
Q

What are the three types of non-pharm pain management areas

A

physical
cognitive-behavioral
lifestyle

43
Q

What are the physical non-pharm pain management modalities

A

heat/cold
TENS
acupuncture
cutaneous stimulation (massage)

44
Q

What are the cognitive-behavioral non-pharm pain management modalities

A

distraction
relaxation techniques
hypnosis
emotional counceling

45
Q

What are the lifestyle non-pharm pain management modalities

A

stress management
exercise
nutrition
symptom monitoring

46
Q

What is nociceptive pain

A

Pain directly from tissue damage

47
Q

Patients with visceral pain often have more problems with

A

N/V

48
Q

What is neuropathic pain

A

Pain that is related to damaged or malfunctioning nervous tissue in the peripheral and /or CNS

49
Q

What is intractable pain

A

Pain for which there is no cure - cancer

50
Q

What are some descriptor words for nociceptive pain

A 
cramping
crushing 
sharp
throbbing 
tender
pressing
51
Q

What are some descriptor words for neuropathic pain

A 
drilling 
numb
burning
shooting 
stabbing 
tingling
52
Q

What are behavioral indicators of pain

A 
Guarding
Impaired thought processes
Social withdrawal
Introspection
Altered time perception
Moaning
Crying
Pacing, restlessness
Mask of pain
Diaphoresis, change in vital signs
53
Q

What is visceral pain?

A

Pain arising from organs or hollow viscera and is often perceived in an area remote from the organ causing the pain

54
Q

What are some sympathetic nervous system responses to acute pain?

A 
Increased pulse rate
Increased Respiratory rate
Elevated blood pressure
Diaphoresis- sweating
Dilated pupils
55
Q

What are some parasympathetic nervous system responses to chronic pain?

A

Dry, warm skin
Pupils normal or dilated
Vital Signs are Normal

56
Q

What does Hyperalgesia/Hyperpathia mean? What’s one example?

A

Heightened responses to a painful stimuli.

Extreme pain response to paper cut

57
Q

What does allodynia mean? What’s one example?

A

Non-painful stimuli that produces pain.

Wind blowing on face produces pain.

58
Q

What is dysesthesia?

A

An unpleasant abnormal sensation.

59
Q

How is pain perceived through nociception?

A

Nociceptors are activated when signals are transduced and transmitted to the spine and brain where the signals are modified before they are processed and “felt.”

60
Q

African Americans: Beliefs about Pain and How They React to It?

A

Pain and Suffering is part of life and must be endured
Some may deny or avoid dealing with pain
Some believe prayer will free a person from pain

61
Q

Hispanic/Latino: Beliefs about Pain and How They React to It?

A

Enduring pain is a sign of strength

62
Q

Asian Americans: Beliefs about Pain and How They React to It?

A

Chinese culture values silence and may be quiet when in pain
Japanese may be stoic and may even refuse pain medication
Filipino clients may believe that pain must be endured and not expressed
Buddhist view pain as bringing oneself to a higher state of being

63
Q

Arab Americans: Beliefs about Pain and How They React to It?

A

Pain is regarded as unpleasant and they anticipate immediate relief
Expressive, Emotional and Vocal responses to pain

64
Q

What are some painful disorders that women get that we should consider?

A

HA, Fibromyalgia, Lupus, and Menstrual related disorders

65
Q

What are some painful disorders that men get that we should consider?

A

Pain related to occupation, burns, post trauma pain

66
Q

What groups are frequently under treated for pain compared to adult males?

A

Very young, very old, women, and ethnic minorities

Therapeutics (41 decks)

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