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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
What is the Q in PQRSTU?
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
What is the R in PQRSTU?
Radiates or Region (location) Does the pain go anywhere else? Does it radiate?
27
What is the S in PQRSTU?
Severity 0-10 scale, faces scale
28
What is the T in PQRSTU?
Time When did the pain start? How long did it last? Constant or intermittent?
29
What is the U in PQRSTU?
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
Name some physiologic and behavioral indicators of pain.
``` 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
What is the MOST RELIABLE indicator of pain?
Subjective data from the patient
32
What are concomitant symptoms?
Occur with pain and usually increase with the severity of pain.
33
Name some concomitant symptoms.
``` Nausea Headache Depression Restlessness Dizziness ```
34
Name some factors that can influence pain.
``` Fatigue Genes Neurological Function Previous experience with pain Family and social support Spiritual Anxiety Culture ```
35
What age group handles pain the best?
None. All age groups handle pain differently.
36
Older adults commonly underestimate ______.
Pain
37
Is pain inevitable with aging?
No.
38
What are some treatments for pain?
Non-pharmacologic pain interventions | Pharmacologic pain interventions
39
Name psychological modalities for non-pharmacologic pain interventions.
``` Distraction Guided/Controlled Breathing Mindfulness Active Listening Education Decrease Stimulation Psychotherapy Biofeedback ```
40
Name some physical modalities for non-pharmacologic pain interventions.
``` Massage Heat Cold Repositioning Pet Therapy Hydrotherapy Ultrasound Exercise Programs ```
41
Name some types of pharmacologic pain interventions.
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
Thinning of the skin and loss of elasticity can affect the absorption rate of ______ medications.
Topical
43
A reduction in metabolism and excretion of drugs due to natural declines in liver and renal function that occur with age can cause what?
Greater peak and longer duration of analgesics
44
Definition: Drug delivery system used often after surgery. Typically administered IV. Patient is in control of pushing pain button to self administer pain medication.
PCA- Patient Controlled Analgesia
45
Definition: Creams, ointments, patches. Education important on placement, use, disposal, things that could increase absorption- hyperthermic.
Topical Anesthesia
46
Definition: Local infiltration of anesthetic medication to induce a loss of sensation. Brief surgical procedures- removing a mole/lesion, suturing a wound.
Local Anesthesia
47
Definition: Injection or infusion of local anesthetics to block a group of sensory nerve fibers. Also block motor and autonomic functions.
Regional Anesthesia
48
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.
Perineural Local Anesthetic
49
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.
Epidural Analgesia
50
What are the concerns in pain management? (4)
Addiction Physical Dependence Pseudo-addiction Drug Tolerance
51
What are some common symptoms of opioid withdrawal?
Shaking, chills, excessive yawning, joint pain
52
As a nurse, do we treat a patient's pain if they have physical dependence?
Yes
53
Who do we include in the management of pain?
Patient and family (if appropriate)
54
What does heat do for pain?
Increases blood flow
55
What does cold do for pain?
Decreases inflammation
56
What is the first line pharmacologic medication for pain?
Non-Opioid Analgesics | NSAIDS's, Cox-2 Inhibitors, Acetaminophen, Muscle Relaxants
57
If a non-opioid analgesic does not control a patients pain, what is the next type used?
An opioid analgesic
58
Approach that combines drugs with different mechanisms of action to optimize pain control.
Multi-modal
59
What type of pain is this?.... Burn, cut, or muscle strain
Acute pain
60
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?
To obtain a baseline pain level and track pain medication efficacy

Fundamentals- Cohort A-5 (6 decks)

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