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N201 > Pain I > Flashcards

Pain I Flashcards

1
Q

What is nociception?

A

the method of feeling pain

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2
Q

What is a neuromodulator?

A

a substance that alters nerve impulse transmission.

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3
Q

What is pain threshold?

A

the point beyond which a stimulus causes pain

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4
Q

what is an adjunct or adjuvant?

A

something that is added as a supplementary rather than an essential part

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5
Q

How long must you experience pain for it to be classified as chronic?

A

> 3 months

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6
Q

Describe what deep somatic pain or visceral pain is.

A

It is pain that is initiated in the ligaments, tendons, bones, blood vessels, and muscles.

described as dull, aching, poorly localized pain. Ex broken bone or sprain

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7
Q

What is neuropathic pain?

A

chronic pain resulting from injury to the nervous system.

Can be to the CNS or PNS

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8
Q

What are endogenous chemicals?

A

chemicals that originate within the body

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9
Q

What is pain tolerance?

A

it is the maximum level of pain that a person is able to tolerate

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10
Q

explain the difference between pain threshold and pain tolerance.

A

Pain threshold is the point where pain can be detected

pain tolerance is the maximum pain that one can endure

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11
Q

What is cutaneous/superficial pain?

A

pain that is detected just below the skin.

This area has a high amount of nociceptors resulting in a well defined, localized pain of short duration

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12
Q

What is referred pain?

A

It is pain that is felt in a part of the body other than its actual source.

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13
Q

Define pain.

A

Pain is whatever the experiencing person says it is, existing wherever the person says it is.

PAIN IS WHAT THE PATIENT SAYS IT IS

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14
Q

Who introduced the gate control theory and in what year?

A

Melzack and Wall in 1965

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15
Q

Explain the gate control theory. What does it emphasize?

A

Pain = physiological process + psychological variables

emphasized the holistic nature of pain.

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16
Q

What did the gate control theory develop into?

A

the neuromatrix theory that includes a genetic component

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17
Q

What are the five dimensions of pain? explain each.

A

1) PHYSIOLOGICAL and SENSORY: the physical sensation/experience
2) AFFECTIVE: emotional aspect
3) BEHAVIOURAL: wincing, crying, irritable, not wanting to move
4) COGNITIVE: perception and coping strategies
5) SOCIOCULTURAL: influence how pain is expressed

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18
Q

What are the four phases of nociception?

A

TRANSDUCTION
TRANSMISSION
PERCEPTION
MODULATION

19
Q

Describe the phase of transduction

A

1) noxious stimuli cause tissue damage
2) sensitizing chemicals released by damaged cells (ex bradykinins and prostaglandins)
3) chemicals stimulate nociceptors
4) AP generated and travels from periphery to spinal cord

20
Q

What do NSAIDs target to relieve pain?

A

NSAIDs target the sensitizing substances released by damaged cells such as bradykinins and prostaglandins

21
Q

Describe the transmission phase of nociception.

A

Has three parts
1) injury site to spinal cord

2) spinal cord to dorsal horn for processing
3) to thalamus (basic pain sensation) and cortex (interprets pain)

22
Q

Describe what perception of pain is

A

the conscious experience of pain

recognition and definition of pain

23
Q

Describe what perception of pain is

A

the conscious experience of pain

when pain is recognized, defined and responded to by the individual

24
Q

List 3 substances that are involved in the modulation of pain.

A

1) endogenous opioids such as enkephalins and endorphins
2) serotonin
3) norepinephrine

25
Q

List 3 substances that are involved in the modulation of pain.

A

1) endogenous opioids such as enkephalins and endorphins
2) serotonin
3) norepinephrine

26
Q

List the 8 types of pain

A

ACUTE

CHRONIC

CUTANEOUS / SUPERFICIAL

DEEP SOMATIC

VISCERAL

REFERRED

NEUROPATHIC

PHANTOM

27
Q

Describe acute pain

A

Sudden onset with limited duration

has purpose

expect elevated HR and BP, will be able to observe signs

28
Q

Describe chronic pain.

A

more gradual pain

becomes chronic after 3-6 months

can show no signs

Want to limit opioids within 90 days

29
Q

Describe cutaneous / superficial pain

A

pain on your skin

30
Q

Describe deep somatic pain

A

muscles, tendons and organs

31
Q

Describe visceral pain

A

inside the body

ex gallstones, chest pain

32
Q

Describe neuropathic pain.

A

due to damage to the nervous system

tingling, electrical

ex slipped disk, shingles, diabetic neuropathy

33
Q

What is phantom pain?

A

feeling in a limb that is no longer there

34
Q

What are some predisposing factors that contribute to acute pain progressing to chronic pain?

A

Hx of anxiety, depression

type A personality

Pre-existing chronic pain

hx of childhood abuse

hx of substance abuse

35
Q

List some factors affecting response to pain.

A

Pain tolerance

Pain threshold

Fear and fatigue

Developmental factors

Sociocultural influences

Physchological and physiological factors

Nurse’s interpretations or biases

36
Q

What are some developmental factors that might influence pain?

A

older adults do not want to admit pain

children can’t explain or verbalize pain

37
Q

Describe the three ways that sleep disturbances are associated with pain.

A

Sleep deprivation inc pain perception and neg affects mood

90 percent of patients with chronic pain also experience sleep disturbances

Medications:
NSAIDs dec melatonin production
OPIOIDS dec REM cycles

38
Q

What should you be sure you are assessing when someone has pain?

A

sleep disturbances

39
Q

What are the principles to remember when assessing pain?

A

1) Sensation of pain is completely subjective
2) Pain can’t be proven or disproved
3) Pain is whatever the experiencing person says it is
4) The gold standard for assessing existence of pain is the pt’s self report of pain
5) People’s responses to pain will vary

40
Q

What are some appropriate assessment tools for pain?

A

OPQRSTA (med-surg)

Descriptive scale (mild, mod, severe)

Numerical scale (initial assessment tool

age relevant factors such as faces

41
Q

List things that can be affected by pain.

A

Sleep

Activity level

Concentration

Appetite

Social activities

42
Q

List things that can be affected by pain.

A

Sleep

Activity level

Concentration

Appetite

Social activities

43
Q

What is the mnemonic OPQRSTA stand for and what is it used for?

A

it outlines the questions to be asked when assessing pain.

Origin
Provocation or palliation
Quality
Region and radiation
Severity
Time
Associated symptoms

N201 (5 decks)

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