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NURS 202 > Pain, Health Promo, Nutrition > Flashcards

Pain, Health Promo, Nutrition Flashcards

1
Q

Nociception

A

How noxious stimuli are typically perceived as pain

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2
Q

Phases of Nociception (4)

A

1) Transduction

2) Transmission

3) Perception of Pain

4) Modulation

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3
Q

Transduction

A

noxious stimuli

chemicals released that propagate pain message

action potential moves up afferent nerves to dorsal spinal cord

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4
Q

Transmission

A

pain impulse moves from spinal cord to brain

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5
Q

Pain Perception

A

in da brain

pain perception not just impacted by synapse

e.g. antidepressant will affect how pain is perceived

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6
Q

Modulation

A

neurons from brain stem release neurotransmitters to block pain impulse

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7
Q

Main Types of Pain (2)

A

1) Nociceptive
2) Neuropathic

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8
Q

Nociceptive Pain Description and Subtypes (2)

A

caused by tissue injury; well localized

described as “aching” or “throbbing”

1) Somatic

2) Visceral

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9
Q

Somatic Pain

A

Superficial from skin and subcutaneous tissue
(cutaneous pain)

Deep from joints, tendons, muscles, or bone

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10
Q

Visceral Pain

A

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

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11
Q

Neuropathic Pain

A

“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

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12
Q

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

A

b) nociceptive, somatic

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13
Q

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

A

b) visceral

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14
Q

Types of Pain by Duration (2)

A

1) Acute
2) Chronic/Persistent

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15
Q

Acute Pain

A

short-term

self-limiting

follows a predictable trajectory

dissipates after injury heals

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16
Q

Chronic Pain

A

continues for 6 months or longer

malignant (cancer-related) OR nonmalignant

does not stop even after tissue has healed

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17
Q

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

A

FALSE

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18
Q

PQRSTU Pain Assessment

A

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

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19
Q

Pain Assessments Tools (3)

A

1) Brief Pain Inventory

2) Short-Form McGill Pain Questionnaire

3) Pain Rating Scales

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20
Q

Brief Pain Inventory

A

pain in previous 24 hours

graduated scale (0–10)

how much relief

how it interferes with activities

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21
Q

Short-Form McGill Pain Questionnaire

A

patient ranks a list of descriptors in terms of their intensity

rates the overall intensity of the pain

mental health - e.g. fear

22
Q

Pain Rating Scales

A

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

23
Q

Nonverbal/Behavioural Pain Assessment

A

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

24
Q

Developmental considerations for pain in neonates

A

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

25
Q

Developmental considerations for pain with intellectual/cognitive disability

A

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

26
Q

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

A

all

27
Q

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.

A

b)

28
Q

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.

A

b)

29
Q

Nutritional Status

A

degree of balance between nutrient intake and nutrient requirements

30
Q

Optimal Nutritional Status

A

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

31
Q

Undernutrition

A

depletion of nutritional reserves or inadequate intake to meet daily requirements

32
Q

Overnutrition

A

consumption of nutrients in excess of requirements

33
Q

Developmental considerations for nutrition in infants and children

A

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

34
Q

Developmental considerations for nutrition in adolescents

A

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

35
Q

Developmental considerations for nutrition during pregnancy and breastfeeding

A

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

36
Q

Developmental considerations for nutrition in adulthood

A

influence of lifestyle factors

importance of nutritional counselling to prevent weight gain and obesity

37
Q

Developmental considerations for nutrition in older adults

A

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

38
Q

What is a key determinant of nutritional health?

A

food security

39
Q

BMI Interpretation: <18.5

A

underweight

40
Q

BMI Interpretation: 18.5–24.9

A

normal weight

41
Q

BMI Interpretation: 25.0–29.9

A

overweight

42
Q

BMI Interpretation: 30.0–34.9

A

Obesity (Class 1)

43
Q

BMI Interpretation: 35–39.9

A

Obesity (Class 2)

44
Q

BMI Interpretation: ≥40

A

Extreme obesity (Class 3)

45
Q

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)

A

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

46
Q

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

A

d) 65-year-old female with Parkinson’s disease

metabolic demands of having a chronic disease

47
Q

Health Promotion Concepts

A

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

48
Q

Primary Prevention

A

people and populations are prevented from becoming ill, sick, or injured

e.g. sanitation and immunization

49
Q

Secondary Prevention

A

early detection of disease before symptoms emerge

e.g., Pap test, mammography, lipid profiles

50
Q

Tertiary Prevention

A

prevention of complications when disease is present

e.g., teaching to avoid complications of diabetes

51
Q

SDOH (12)

A

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

NURS 202 (6 decks)

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