pain management Flashcards

1
Q

what is pain

A

Unpleasant sensory/emotional experience

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2
Q

what can pain do

A

Can have destructive effects
Can warn of potential injury
A multidimensional experience

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3
Q

how do you classify pain

A
By origin
Superficial
Visceral
Somatic
Radiating/referred
Phantom
Psychogenic
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4
Q

classifying by cause

A

By cause
Nociceptive
Neuropathic

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5
Q

classifying by duration

A

By duration
Acute
Chronic
Intractable

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6
Q

what is transduction of pain

A

: activation of nociceptors by stimuli

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7
Q

what is transmission of pain

A

conduction of pain message to spinal cord

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8
Q

what is pain perception

A

: recognizing and defining pain in cortex

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9
Q

what is pain modulation

A

: changing pain perception

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10
Q

what are some factors that influence pain

A
Past experience with pain
Emotions
Developmental stage
Sociocultural factors
Communication skills
Cognitive impairments
Other illnesses contributingto pain
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11
Q

some ways that you can assess pain

A
Includes
 Obtaining a complete pain history
(e.g., onset, location, aggravating/alleviating factors)
 Nonverbal signs of pain
Elevated pulse/blood pressure
Crying, moaning
Grimacing
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12
Q

what are the different pain scales

A

Visual Analogue Scale (VAS)
Numeric Rating Scale (NRS)
Simple descriptor scale
Wong-Baker Faces Pain Rating Scale

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13
Q

steps for a pain assessment

A

Client’s expression of pain
Characteristics of pain
Onset and duration-When did the pain begin? How long has it lasted?
Location- Where is your pain? (don’t always assume that the pain will be in the same place).
Intensity- Is the pain mild? Severe? Unbearable?
Quality- Tell me what your discomfort feels like?
Pattern- What makes your pain worse? Does anything make it feel better?

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14
Q

nursing diagnosis of pain

A
Anxiety
Ineffective coping
Fatigue
Acute pain
Chronic pain
Ineffective role performance
Disturbed sleep pattern
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15
Q

what are some goals and outcomes of pain

A
  • Client is using pain relief measures safely

Setting priorities—pain rating 7 out of 10 requires immediate action.

Continuity of care—need variety of resources for pain control.

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16
Q

what are some nonpharmalogical measures

A
Cutaneous stimulation
Based on “gate control” theory
TENS
PENS
Acupuncture
Acupressure
Massage
Use of heat and cold
Contralateral stimulation
17
Q

other nonpharmalogical measures

A
Immobilization and rest
 Cognitive-behavioral interventions
Distraction
Progressive muscle relaxation
Guided imagery
Hypnosis
Therapeutic touch
Humor
Journaling
18
Q

pharmalogical measures

A
Nonopioid analgesics
NSAIDs
Acetaminophen
Opioid analgesics
Includes IV, IM, transdermal, and epidural forms
Client-controlled analgesia pumps
19
Q

patient controlled analgesia

A

Safe method for delivery of post-op and cancer pain management.

Allows client to self-administer opioids with minimal risk of overdose.

Goal is to maintain a constant plasma level of analgesic so that the problems of prn dosages can be avoided

20
Q

topical pain meds

A

Good example is EMLA cream (Eutectic mixture of local anesthetics).

Used mostly in Ped’s for premedicating for IV insertion.

Lidoderm-patches (3) containing lidocaine that are placed on and around a site of pain using an on 12 hr, off 12-hour schedule to avoid toxic effects of lidocai

21
Q

special nursing considerations

A

Managing pain in the elderly

Managing pain in clients with addictions

Use of placebos

22
Q

what is addiction?

A

primary, chronic, neurobiological disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following:
Impaired control over drug use
Compulsive use
Continued use despite harm
Craving.
Pseudo-addiction
Drug seeking behaviors that may appear when pain is under treated.

23
Q

pseudo-tolerance

A
Need to increase opioid dosage for reasons other than opioid tolerance:
Progression of disease
Onset of new disorder
Increased physical activity
Lack of adherence
Change in opioid formulations
Drug-drug interactions
Drug-food interactions
24
Q

somatic pain

A

pain emanating from muscles, skeleton, skin

25
radiating
pain that starts in one area and spreads to a larger area
26
visceral pain
deep internal pain. pain that results from the activation of nociceptors of the thoracic, pelvic, or abdominal viscera. It is felt as a poorly localized aching or cramping sensation and is often referred to cutaneous sites
27
chronic pain
pain that has lasted longer than 6 months.
28
nociceptive
most common type of pain. Associated with visceral and somatic.
29
neuropathinc
chronic pain. Hard to identify. hard to isolate. very complex. usually develops into something else. sometimes related to a nerve injury
30
how is pain perceived
pain is perceived by the interplay between 2 different kinds of fibers. Those that produce and those that inhibit