Pain Management

Question 1

pain influenced by many factors (4)

Answer 1

1) affective
ex/ fatigue
2) behavioral
ex/ age
3) cognitive
ex/ alert, not alert
4) physiological sensory
ex/ neuro function, genes

Question 2

pains serves as what

Answer 2

an injury prevention mechanism

Question 3

what is nociception

Answer 3

how pain is transferred/processed

-processing painful stimuli

Question 4

transduction

Answer 4

impulses travel along afferent (sensory) nerve fibers

Question 5

a-delta

Answer 5

sharp, localized pain after injury

Question 6

c-fibers

Answer 6

• slow conducting
• dull, poorly localized pain after injury
• first vs. second

Question 7

impulses travel via the ____

Answer 7

spinothalmic tract

Question 8

what is the most important pathway for pain sensation

Answer 8

spinal dorsal horn

Question 9

impulse route

Answer 9

A-delta & c-fibers -> dorsal root -> spinal dorsal horn -> spinothalmic tract -> brain stem -> thalamus

Question 10

neurotransmitters:

-all cellular damage results in release of (3)

Answer 10

1) prostaglandins (increase feeling of pain)
2) substance P (causes increase pain too)
3) serotonin (decrease pain)

Question 11

neurotransmitters produce a ____ _____ inflammatory response

Answer 11

pain-sensitizing

Question 12

perception: once the impulse reaches the cerebral cortex, the brain interprets the quality of pain based on what 3 things

Answer 12

1) past experiences
2) knowledge
3) culture

Question 13

perception is?

Answer 13

personal awareness

Question 14

modulation

Answer 14

to control / regulate it

Question 15

once the brain perceives pain, it releases endogenous opioids to produce ____

Answer 15

analgesia

• serotonin
• norepinephrine

Question 16

gate control theory: _____ acts as a gate

Answer 16

dorsal horn

Question 17

how does dorsal horn acts as a gate for pain?

Answer 17

• CLOSE to prevent nociceptive impulses from reaching the brain
• OPEN to allow impulses to be transmitted to the brain

Question 18

what fibers open the gate?

Answer 18

a-delta & c-fibers

Question 19

what fibers close the gate?

Answer 19

alpha & beta fibers

Question 20

whats the significance of the gate theory

Answer 20

provides ideas for pain relief emphasizing multiple dimensions of pain

• sensory
• emotional
• behavioral
• cognitive

Question 21

5 types of pain

Answer 21

1) acute
2) persistant (chronic)
3) cancer
4) nociceptive
5) neuropathic

Question 22

acute pain

Answer 22

usually less than 6 months
-with injury or disease
-associated w/ anxiety / fear
-typically increases with:
wound care
ambulation
coughing
deep breathing

Question 23

persistant (chronic) pain

Answer 23

• longer than 6 months
• assoc. w/ depression, frustration, fear
• cause may be unidentifiable (idiopathic)

Question 24

nociceptive pain

Answer 24

somatic, visceral

Question 25

neuropathic pain

Answer 25

nerve damage

-sharp, shooting pain

Question 26

malignant pain

Answer 26

“all consuming”

• progressive pattern of: recurrent, acute pain or persistent chronic pain
• resistant to treatment or cure
• intractable (doesn’t go away)
• interferes with quality of life

Question 27

lifespan considerations

• newborn/infant
• toddler/preschooler
• school age/adolescent
• adult/older adult
• cultural

Answer 27

• newborn: under treatment of pain
• toddler: cannot ID pain
• school age: can rationalize pain
• adult/older adult: muscle skeletal pain
• cultural: communication / devalued

Question 28

verbal factors of pain are what

Answer 28

• subjective
• the most dependable indicator of pain
• suffering

Question 29

nonverbal factors of pain are what

Answer 29

-gives clues to location of pain

Question 30

manifestations of pain (indications)

Answer 30

• increase BP
• increase HR
• increase respiratory rate

Question 31

metabolic changes when in pain

Answer 31

• increase metabolism
• increase O2
• increase blood glucose
• increase free fatty acids
• increase blood lactate
• increase ketones

Question 32

pain threshold

Answer 32

-amount of pain stimulation a person requires before feeling it

Question 33

pain tolerance

Answer 33

-highest intensity of pain that the person is willing to tolerate

Question 34

opiod concerns (2)

Answer 34

1) addiction (psychological)

2) dependence (physiological)

Question 35

tolerance treatment to pain meds

Answer 35

titration

-adjusting drug dosage to clients response

Question 36

opiod antagonist

Answer 36

narcan (when overdosing on opiods)

Question 37

always give ____ with opiods

Answer 37

bowel regime

laxative/stool softener

Question 38

heat is vaso___

Answer 38

vasodilation

Question 39

cold is vaso____

Answer 39

vasoconstriction