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Fundamentals- Cohort A-5 > Pain Management > Flashcards

Pain Management Flashcards

1
Q

First step in physiologic mechanism of noxious pain?

A

Transduction

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2
Q

Second step in physiologic mechanism of noxious pain?

A

Transmission

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3
Q

Third step in physiologic mechanism of noxious pain?

A

Perception

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4
Q

Final step of physiologic mechanism of noxious pain?

A

Modulation

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5
Q

4 steps in physiologic mechanism of noxious pain?

A
  1. Transduction
  2. Transmission
  3. Perception
  4. Modulation
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6
Q

What is the most common reason that people seek healthcare?

A

Pain

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7
Q

Is pain subjective or objective?

A

Subjective

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8
Q

What are the complex components of pain?

A

Physical, emotional, cognitive

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9
Q

Name some benefits of effective pain management?

A
  • Improves quality of life
  • Reduces physical discomfort
  • Promotes earlier mobilization and return to previous baseline functional activity
  • Results in fewer hospital and clinic visits
  • Decreases hospital length of stay
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10
Q

What are the 7 types of pain?

A
  1. Acute
  2. Chronic
  3. Chronic Episodic
  4. Cancer
  5. Idiopathic
  6. Somatic
  7. Visceral
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11
Q

Pain Classifications:

A

Nociceptive Pain

Neuropathic Pain

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12
Q

Definition: Normal stimulation of special peripheral nerve endings (nociceptors). Pain results from activity in neural pathways secondary to actual tissue damage, or potentially tissue-damaging stimuli.

A

Nociceptive Pain

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13
Q

Definition: Abnormal processing of sensory input by the peripheral or CNS. Pain initiated by nervous system lesion or dysfunction.

A

Neuropathic Pain

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14
Q

Explain somatic pain:

A

musculoskeletal- comes from bone, joint, muscle tissue, connective tissue, usually well localized

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15
Q

Explain visceral pain:

A

arises from internal organs- can be well localized or poorly localized, depending on the organ and what is occurring.

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16
Q

Explain idiopathic pain:

A

Chronic pain without an identifiable physical or psychological cause or pain perceived as excessive for pathological condition.

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17
Q

Describe chronic episodic pain:

A

Pain that occurs sporadically over an extended period of time. Pain episodes can last for hours, days, or weeks

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18
Q

Name some examples of descriptions of subjective pain.

A 
Sharp pain
Throbbing
Burning
Stabbing
Weakness
Tingling
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19
Q

Name some objective data of pain.

A

Guarding a body part
Facial expression (crying, moaning)
Profuse sweating
Alteration in BP, HR, RR

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20
Q

Name some non-pharmacological methods to help with pain.

A

Heat/ice
Massage
Relaxation Techniques
Distraction

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21
Q

What are some of the ways to perform an assessment for pain?

A

Ask the patient to use a numeric pain scale of 0-10
Simple Descriptive Pain Intensity Scale
Visual Analogue Scale (Thermometer Scale)
FLACC (Face, Legs, Activity, Cry, Consolability)
FACES (Wong-Baker Faces Scale

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22
Q

What is the FLACC pain scale used for?

A

Patients that can’t tell you when they are in pain.

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23
Q

What demographic would be most appropriate to use a Wong-Baker Faces Scale to assess pain?

A

Young children

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24
Q

What is the P in PQRSTU?

A

Provocative/Palliative

What causes your pain? What makes it better/worse?

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25
Q

What is the Q in PQRSTU?

A

Quality

What does it feel like? Is it sharp/dull/stabbing/crushing/aching…etc. Always try to let the patient describe first, only give suggestions if they struggle.

26
Q

What is the R in PQRSTU?

A

Radiates or Region (location)

Does the pain go anywhere else? Does it radiate?

27
Q

What is the S in PQRSTU?

A

Severity

0-10 scale, faces scale

28
Q

What is the T in PQRSTU?

A

Time

When did the pain start? How long did it last? Constant or intermittent?

29
Q

What is the U in PQRSTU?

A

Understanding

How does this pain affect you? Does it make it difficult to: move, breathe, eat, sleep, etc.? Do you know what is causing this pain, have you had pain like this before?

30
Q

Name some physiologic and behavioral indicators of pain.

A 
Increased HR
Change in Respiratory pattern and/or rate
Increase in BP
Decrease in SpO2
Moaning, crying
Grimacing
Restlessness
Reduced attention span
Protective movements of body parts
31
Q

What is the MOST RELIABLE indicator of pain?

A

Subjective data from the patient

32
Q

What are concomitant symptoms?

A

Occur with pain and usually increase with the severity of pain.

33
Q

Name some concomitant symptoms.

A 
Nausea
Headache
Depression
Restlessness
Dizziness
34
Q

Name some factors that can influence pain.

A 
Fatigue
Genes
Neurological Function
Previous experience with pain
Family and social support
Spiritual
Anxiety
Culture
35
Q

What age group handles pain the best?

A

None. All age groups handle pain differently.

36
Q

Older adults commonly underestimate ______.

A

Pain

37
Q

Is pain inevitable with aging?

A

No.

38
Q

What are some treatments for pain?

A

Non-pharmacologic pain interventions

Pharmacologic pain interventions

39
Q

Name psychological modalities for non-pharmacologic pain interventions.

A 
Distraction
Guided/Controlled Breathing
Mindfulness
Active Listening
Education
Decrease Stimulation
Psychotherapy
Biofeedback
40
Q

Name some physical modalities for non-pharmacologic pain interventions.

A 
Massage
Heat
Cold
Repositioning
Pet Therapy
Hydrotherapy
Ultrasound
Exercise Programs
41
Q

Name some types of pharmacologic pain interventions.

A

Non-opioid Analgesics (Acetaminophen, NSAID’s)
Opioid Analgesics
Adjuvants-medications that enhance analgesics or have analgesic properties
Anti-depressants (neuropathic pain)
Anti-convulsants (neuropathic pain)
Steroids (adjuvant use for pain from inflammation or bone metastasis)
Bisphosphonates (adjuvant use for bone pain)
Local Anesthetics (acute localized pain, some neuropathic pain)
Benzodiazepines

42
Q

Thinning of the skin and loss of elasticity can affect the absorption rate of ______ medications.

A

Topical

43
Q

A reduction in metabolism and excretion of drugs due to natural declines in liver and renal function that occur with age can cause what?

A

Greater peak and longer duration of analgesics

44
Q

Definition: Drug delivery system used often after surgery. Typically administered IV. Patient is in control of pushing pain button to self administer pain medication.

A

PCA- Patient Controlled Analgesia

45
Q

Definition: Creams, ointments, patches. Education important on placement, use, disposal, things that could increase absorption- hyperthermic.

A

Topical Anesthesia

46
Q

Definition: Local infiltration of anesthetic medication to induce a loss of sensation. Brief surgical procedures- removing a mole/lesion, suturing a wound.

A

Local Anesthesia

47
Q

Definition: Injection or infusion of local anesthetics to block a group of sensory nerve fibers. Also block motor and autonomic functions.

A

Regional Anesthesia

48
Q

Definition: Type of regional anesthesia- infusion of local anesthetics infused through an unsutured catheter that is inserted near a nerve or group of nerves. Usually left in place for 48 hours. Continuous or intermittent infusion. On-Q pump.

A

Perineural Local Anesthetic

49
Q

Definition: Type of Regional Anesthesia- Opioids or combination of anesthetics are administered into epidural space. Inserted by anesthesiologist or Nurse Anesthetists. Patients can self administer demand doses.

A

Epidural Analgesia

50
Q

What are the concerns in pain management? (4)

A

Addiction
Physical Dependence
Pseudo-addiction
Drug Tolerance

51
Q

What are some common symptoms of opioid withdrawal?

A

Shaking, chills, excessive yawning, joint pain

52
Q

As a nurse, do we treat a patient’s pain if they have physical dependence?

A

Yes

53
Q

Who do we include in the management of pain?

A

Patient and family (if appropriate)

54
Q

What does heat do for pain?

A

Increases blood flow

55
Q

What does cold do for pain?

A

Decreases inflammation

56
Q

What is the first line pharmacologic medication for pain?

A

Non-Opioid Analgesics

NSAIDS’s, Cox-2 Inhibitors, Acetaminophen, Muscle Relaxants

57
Q

If a non-opioid analgesic does not control a patients pain, what is the next type used?

A

An opioid analgesic

58
Q

Approach that combines drugs with different mechanisms of action to optimize pain control.

A

Multi-modal

59
Q

What type of pain is this?…. Burn, cut, or muscle strain

A

Acute pain

60
Q

When a nurse receives a client in the ED who is complaining of abdominal pain, the nurse assesses the client’s pain and charts the pain level in the client’s chart, why?

A

To obtain a baseline pain level and track pain medication efficacy

Fundamentals- Cohort A-5 (6 decks)

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