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
Q

radiating

A

pain that starts in one area and spreads to a larger area

26
Q

visceral pain

A

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
Q

chronic pain

A

pain that has lasted longer than 6 months.

28
Q

nociceptive

A

most common type of pain. Associated with visceral and somatic.

29
Q

neuropathinc

A

chronic pain. Hard to identify. hard to isolate. very complex. usually develops into something else. sometimes related to a nerve injury

30
Q

how is pain perceived

A

pain is perceived by the interplay between 2 different kinds of fibers. Those that produce and those that inhibit