Pain Mangement Part 2 Flashcards
Acute pain lasts how long?
Chronic pain lasts how long?
Less than 6 months
Over 6 months
Acute pain has a-
Predictable end
Name some examples of acute pain:
Incision Pain, Pain from Heat or Cold
Chronic pain is-
Constant, Recurring, & has No Predictable End
Examples of Chronic Pain are:
Arthritis, Back Pain, Headaches
Is chronic pain emotionally or physically debilitating?
Both
If acute pain is untreated/unaddressed it becomes-
Chronic
Pain caused by the damage or inflammation of tissue =
Nociceptive Pain
Pain Receptors =
Nociceptors
This is whenever noxious stimuli activates Nociceptors =
Nociception
Nociceptive pain is usually-
Localized and Throbbing or Aching
Nociceptive pain affects -
Tissues, Organs, Damaged Body Parts, Referred Pain
Back pain and broken ribs are both examples of-
Nociceptive Pain
This kind’ve pain comes from abnormal or damaged pain nerves, with no tissue damage =
Neuropathic Pain
This can be referred to as “Nerve Pain” =
Neuropathic Pain
Examples of Neuropathic Pain are-
Diabetic Neuropathy
Phantom Limb Pain
Pain associated with a Spinal Cord Injury
Sciatic Pain
Trigeminal Neuralgia
Neuropathic Pain can be described as-
Shooting or Burning + Accompanied with numbness or intense itching + Pins and needles
Pain after below the knee amputation =
Neuropathic Pain (Phantom Pain)
What does “Viscera” mean?
It means “Internal Organs”
What are the different types of Nociceptive Pain?
Somatic, Visceral, Cutaneous
Somatic pain is pain that involves the-
Joints, bones, muscles, or CT
Cutaneous pain may also be referred to as-
Somatic
What does Superficial Somatic Pain feel like?
Sharp, Burning, Localized
What is affected by superficial somatic pain?
Skin, Mucous Membranes, Subcutaneous Tissue
What does Deep Somatic Pain feel like?
Aching, Throbbing, Diffuse
What is affected by deep somatic pain?
Bones, joints, muscle, skin
What is affected by visceral pain?
Internal organs
What does visceral pain feel like?
Aching, Throbbing, Diffuse
What drugs do you use to treat Nociceptive Pain?
Opioid or Non-Opioid Drugs
Examples of visceral pain include:
Appendicitis, Cholecystitis, Cancer in the Internal Organs
What causes Visceral Pain?
Pain impulses respond to inflammation, stretching, and ischemia
Non-Opioids are-
Opioids are-
Non-Opioids are under the counter
Opioids are prescribed
What does Neuropathic Pain feel like?
Numbing, hot, burning, shooting, stabbing, sharp, or electric shock-like
What can cause damage to the Peripheral Nerves?
Infection, Illness, Injury
What illnesses can cause damage to the Peripheral Nerves?
Diabetic Neuropathy, Fibromyalgia, Multiple Sclerosis
What phantom pain cause damage to the Peripheral Nerves?
Phantom Limb, Spinal Cord
A Pharmacological treatment of a patient’s Neuropathic pain can include meds like-
Tricyclic Antidepressants (Amitriptyline) + Anti-seizure Meds (Pregabalin) + Transdermal Lidocaine (Topical Anesthetic)
Using CBT + Non-Irritation of Peripheral Endings to solve a pt’s Neuropathic Pain is an example of-
The Multi-Prong Approach
What causes Neuropathic Pain?
Damage to the Peripheral Nerves
The meds that you’d give for Neuropathic Pain are classified as-
Non-Opioid
The treatments of neuropathic pain are a-
Multi-Prong Approach (Using two separate methods of treatment to get the same goal)
Why use the Multi-Prong Approach to treat Neuropathic Pain?
Opioid Analgesics on their own aren’t enough to treat Neuropathic Pain
What kind’s of pain can be caused by Cancer?
Tumor Pain, Bone Pain, Treatment Associated Pain, Radiation-Induced Pain, Neuropathies related to Chemotherapy
Is cancer pain unique to cancer?
Yes
Children are at a high risk of what whenever it comes to pain?
Ignored Pain, pain may not be properly assessed
Children display what differently from adults?
Pain
What do you assess about a child whenever it comes to pain?
Assess Behavior.
Assess Physiological Symptoms (BP, Pulse).
Listen to parent/guardian reports.
What pain scales do you used for children?
Wong Baker FACES Scale
FLACC Scale
CRIES Scale
This scale is used for kids between 2 months old and 7 years old =
FLACC Scale
This scale is used for infants =
CRIES Scale
This scale is used for kids 3 and up and is not specifically limited to children =
Wong Baker FACES Scale
What are some examples of Subjective indicators of pain?
Pain scale scores
Descriptions of quality and quantity of pain
What are some examples of Objective indicators of pain?
Things observed by the nurse (grimacing, guarding, crying)
What does the mnemonic called OLD CARTES stand for?
Onset
Location
Duration
Characteristics
Associated Symptoms / Aggravating Factors
Relieving Factors / Radiating
Timing / Treatment
Effect
Severity (Intensity)
What does the mnemonic COLDSPA stand for?
Character
Onset
Location
Duration
Severity
Pattern
Associated Factors
What kind’ve questions would you ask to figure out the Onset of pain?
When did your pain start?
What’s causing your pain?
What kind’ve questions would you ask to figure out the Duration of pain?
How long does it last? Acute or Chronic? Around The Clock (ATC)? Intermittent?
What kind’ve questions would you ask regarding any Breakthrough Pain?
How often? How long?
Supplemental dose of pain med effective?
Pain regimen need to be modified?
What is Breakthrough Pain?
A sudden increase in pain when dealing with a chronic condition
What is Radiating Pain?
Pain that extends or spreads from one place to another
A kid gets a sore throat, but the pain spreads to their ears. What is this an example of?
Radiating Pain
What is Referred Pain?
Pain that is isolated from what is causing it in the first place
Visceral pain is often-
Referred Pain
One of your organs are messed up but you feel a lot of shoulder pain. This is an example of-
Referred Pain
With Referred Pain, you may not-
Know the source of the pain
If the origin of pain is the heart, then it could be referred to-
The left shoulder
Arm
Jaw
If the origin of pain is the esophagus, lungs, diaphragm, gallbladder, or pancreas, then it could be referred to-
The neck, shoulder, mid-back
If the origin of pain is the bladder, urethra, or ureters, then it could be referred to-
Perineum or Penis
What are the heart attack signs in women?
Pressure, squeezing, fullness or pain in the center of chest. It lasts more than a few minutes or goes away and comes back
SOB with or without chest discomfort
Break out in a cold sweat
Nausea or lightheadedness
Pain or discomfort in one or both arms, the back, neck, jaw or stomach
Like men, women’s most common heart attack symptom is-
However, women are more likely to have other symptoms, such as:
Chest Pain or Discomfort.
Other symptoms like SOB, Nausea & Vomiting, Back or Jaw Pain.
If you show manifestations of myocardial infarction, how long should you wait before calling for help?
No more than 5 minutes
What scale uses pictures and rates the pain on a scale of 0 to 5?
Wong-Baker FACES Scale
What scale measures pain on a scale of 0 to 10 and uses a combination of Adjectives and Numbers?
The Numerical Scale
What is considered to be mild pain on the numerical rating scale?
1-3
What is considered to be moderate pain on the numerical rating scale?
4-6
What is considered to be severe pain on the numerical rating scale?
7+
This scale is very useful for cognitive barriers, mental barriers, or language barriers =
The Wong-Baker FACES Scale
The FLACC Scale scores the Face, Legs, Activity, Cry, and Consolability as-
0, 1, or 2 (The higher the number, the worse the pain)
Anxiety, Fatigue, and Lack of Sleep are all-
Associated symptoms of pain
It is important to assess the impact of pain on-
Daily Life + the Beliefs, Meaning, and Expectations on Pain
When should you assess pain?
Prior to giving meds, then in 30 mins to an hour you should reassess
This is useful for chronic pain management and helps identify onset, duration, and any relieving factors =
Pain Diary
A nurse is caring for a group of patients. Which patient will the nurse see first to best manage patient needs?
A.) A patient writhing and moaning from abdominal pain after abdominal surgery.
B.) A patient lying very still in bed who reports no pain but is pale with warm, dry skin.
C.) A patient with severe pain who is nauseated and feels like he or she is about to vomit.
D.) A patient who received morphine and has a pulse of 62 beats/min, respirations 10 breaths/min, and blood pressure 110/60 mm Hg.
D, Morphine depresses respirations
Pain can be the Etiology to other problems such as-
Activity Intolerance
Anxiety / Hopelessness
Ineffective Coping / Ineffective Role Performance