Pain, Health Promo, Nutrition Flashcards by Erin Nolan

Nociception

How noxious stimuli are typically perceived as pain

How well did you know this?

Not at all

Perfectly

Phases of Nociception (4)

1) Transduction

2) Transmission

3) Perception of Pain

4) Modulation

How well did you know this?

Not at all

Perfectly

Transduction

noxious stimuli

chemicals released that propagate pain message

action potential moves up afferent nerves to dorsal spinal cord

How well did you know this?

Not at all

Perfectly

Transmission

pain impulse moves from spinal cord to brain

How well did you know this?

Not at all

Perfectly

Pain Perception

in da brain

pain perception not just impacted by synapse

e.g. antidepressant will affect how pain is perceived

How well did you know this?

Not at all

Perfectly

Modulation

neurons from brain stem release neurotransmitters to block pain impulse

How well did you know this?

Not at all

Perfectly

Main Types of Pain (2)

1) Nociceptive
2) Neuropathic

How well did you know this?

Not at all

Perfectly

Nociceptive Pain Description and Subtypes (2)

caused by tissue injury; well localized

described as “aching” or “throbbing”

1) Somatic

2) Visceral

How well did you know this?

Not at all

Perfectly

Somatic Pain

Superficial from skin and subcutaneous tissue
(cutaneous pain)

Deep from joints, tendons, muscles, or bone

How well did you know this?

Not at all

Perfectly

Visceral Pain

from direct injury or stretching of large interior
organs

result of tumor, ischemia, distension, or contraction

constant OR intermittent

may be poorly localized/referred from another part of the body

How well did you know this?

Not at all

Perfectly

Neuropathic Pain

“Caused by lesion or disease affecting somatosensory nervous system”

results from damage to nerve pathway

e.g. nerve cut during surgery, stroke, chemo, HIV, diabetes, herpes zoster

caused by direct nerve trauma, infections, metabolic problems; may be drug induced

“burning” or “shooting”

manifestations vary among patients

referred pain

How well did you know this?

Not at all

Perfectly

You step on a lego. What type of pain is this?
a) nociceptive, visceral
b) nociceptive, somatic
c) neuropathic

b) nociceptive, somatic

How well did you know this?

Not at all

Perfectly

Which type of pain would cholecystitis (gallbladder disease) cause?
a) somatic
b) visceral
c) cutaneous
d) persistent

b) visceral

How well did you know this?

Not at all

Perfectly

Types of Pain by Duration (2)

1) Acute
2) Chronic/Persistent

How well did you know this?

Not at all

Perfectly

Acute Pain

short-term

self-limiting

follows a predictable trajectory

dissipates after injury heals

How well did you know this?

Not at all

Perfectly

Chronic Pain

continues for 6 months or longer

malignant (cancer-related) OR nonmalignant

does not stop even after tissue has healed

How well did you know this?

Not at all

Perfectly

T or F: Pain is a normal part of the aging process.

FALSE

How well did you know this?

Not at all

Perfectly

PQRSTU Pain Assessment

P - provocative or palliative

Q - quality of pain, words to describe

R - region of body, radiating

S - severity, 0 to 10

T - timing and onset

U - understanding of pain

How well did you know this?

Not at all

Perfectly

Pain Assessments Tools (3)

1) Brief Pain Inventory

2) Short-Form McGill Pain Questionnaire

3) Pain Rating Scales

How well did you know this?

Not at all

Perfectly

Brief Pain Inventory

pain in previous 24 hours

graduated scale (0–10)

how much relief

how it interferes with activities

How well did you know this?

Not at all

Perfectly

Short-Form McGill Pain Questionnaire

Study These Flashcards

patient ranks a list of descriptors in terms of their intensity

rates the overall intensity of the pain

mental health - e.g. fear

Pain Rating Scales

Study These Flashcards

Visual Analogue or Numeric Rating Scale
-0 to 10

Faces Pain Scale
-patients 4 to 5 years of age

Descriptor Scale
-no pain, mild pain, moderate pain, and severe pain
-older adults

Nonverbal/Behavioural Pain Assessment

Study These Flashcards

Acute pain behaviours
-use scale, have them point

Persistent (chronic) pain behaviours
-ask patient how they behave when in pain

Unconscious patient
-grimacing, wincing, moaning, rigidity, arching, restlessness, shaking
-Critical-Care Pain Observation Tool

Facial Expressions

Vitals - HR, resp, BP

Developmental considerations for pain in neonates

Study These Flashcards

behavioural and physiological cues

more than one assessment approach needed

include contextual factors (gestational age or
sleep/wake state behaviours - e.g. sleeping too much, can’t settle)

Neonatal Pain, Agitation, and Sedation Scale

Premature Infant Pain Profile – developed at University of Toronto and McGill University

Developmental considerations for pain with intellectual/cognitive disability

sensory ability to perceive pain not diminished Scales: PAINAD scale, PACSLAC-II discussion with family or other health care team members to identify patterns comprehensive health assessment needed to confirm or rule out sources of pain

Which anticipated persistent pain finding should guide a nurse’s care planning? a) Patients with persistent pain having trouble sleeping b) Patients with persistent pain showing elevated BP c) Patients with persistent pain needing less medication d) Patients with persistent pain showing few or no outward signs of pain

all

A crying patient says, “Please, get me something to relieve this pain.” What should the nurse do next? a) Verify that the patient has an order for pain medication and administer the order, as directed. b) Assess the level of pain and ask the patient what usually works for his or her pain; administer pain medication as needed, and then reassess pain level. c) Assess the level of pain, give medication according to the pain level, and then reassess the pain. d) Reposition the patient and then reassess the pain after intervention.

The nurse is reassessing a patient’s pain level after pain medication administration, following a pain level of 9/10. The patient states that his pain level is now a 3/10. What should the nurse do next? a) Verify orders for medication and offer more pain medication, if appropriate. b) Continue to assess patient’s pain level. c) Document the patient’s pain level in the chart. d) There is no need for further action because the patient’s pain is manageable.

Nutritional Status

degree of balance between nutrient intake and nutrient requirements

Optimal Nutritional Status

consumption of nutrients in amounts that support daily growth and any increased metabolic demands

Undernutrition

depletion of nutritional reserves or inadequate intake to meet daily requirements

Overnutrition

consumption of nutrients in excess of requirements

Developmental considerations for nutrition in infants and children

birth to 4 months --> most rapid period of growth in life cycle* Recommendations -exclusive breastfeeding for first 6 months -daily vitamin D supplements until diet includes at least 10 mcg (400 IU) per day from dietary sources -introduction of solid food (iron-fortified cereal) ~6 months -avoid whole cow’s milk until 9 to 12 months of age

Developmental considerations for nutrition in adolescents

rapid physical growth and endocrine and hormonal changes increased energy demands increased calcium and iron requirements related to bone, muscle mass increase, and menarche impact of societal importance placed on physical appearance preoccupation with body image and disordered eating influence of gender

Developmental considerations for nutrition during pregnancy and breastfeeding

HC recommendations for gestational weight gain for singleton pregnancies increased nutritional risk in pregnancy -teens) multiple pregnancies, short intervals between pregnancies, tobacco/alcohol/drugs, restrictive diets, inadequate or excessive weight gain folic acid

Developmental considerations for nutrition in adulthood

influence of lifestyle factors importance of nutritional counselling to prevent weight gain and obesity

Developmental considerations for nutrition in older adults

risk for undernutrition and overnutrition energy requirements DECREASE by 5% per decade impact of poor dentition, visual acuity, slowed GI, and diminished taste/smell SES polypharmaceutical challenges Vitamin D supplementation

What is a key determinant of nutritional health?

food security

BMI Interpretation: <18.5

underweight

BMI Interpretation: 18.5–24.9

normal weight

BMI Interpretation: 25.0–29.9

overweight

BMI Interpretation: 30.0–34.9

Obesity (Class 1)

BMI Interpretation: 35–39.9

Obesity (Class 2)

BMI Interpretation: ≥40

Extreme obesity (Class 3)

Which of the following body measurements would indicate higher risk for coronary artery disease? a) Weight 72 kg, height 175 cm b) BMI 23 c) Gynoid obesity (waist–hip ratio) (pear) d) Android obesity (waist–hip ratio) (apple)

d) Android obesity (waist–hip ratio) (apple)

Which of the following patients is at highest risk for nutritional deficits? a) 5-month-old infant who is only being breastfed b) 2-year-old toddler who is in the 50th percentile c) 13-year-old female who is 1.6 m tall, weighs 50 kg, and thinks she is “fat” d) 65-year-old female with Parkinson’s disease

d) 65-year-old female with Parkinson’s disease metabolic demands of having a chronic disease

Health Promotion Concepts

changing conceptualization of meaning of health changing patterns of disease and mortality shift from infectious diseases to chronic conditions WHO declaration: health is “not merely the absence of disease” foundational concepts of disease prevention and health promotion in Canada

Primary Prevention

people and populations are prevented from becoming ill, sick, or injured e.g. sanitation and immunization

Secondary Prevention

early detection of disease before symptoms emerge e.g., Pap test, mammography, lipid profiles

Tertiary Prevention

prevention of complications when disease is present e.g., teaching to avoid complications of diabetes

SDOH (12)

Income & Social Status Employment/Working Conditions Education & Literacy Childhood Experiences Physical Environments Social Supports and Coping Skills Healthy Behaviours Access to Health Services Biology and Genetic Endowment Gender Culture Race/Racism

Pain, Health Promo, Nutrition Flashcards

(51 cards)