test 5?pain..

Question 1

how is pain defined

Answer 1

is an unpleasant sensory and emotional experience and is the most common reason patients seek medical advice.. Pain is transmitted to the brain through the nervous system. this is done through afferent( sensory) neurons leading to the spinal nerves, and then to the brain.

Question 2

what are common myths and barriers to the effective management of pain?

Answer 2

-A person who is laughing and talking is not in pain.
( a person in pain is likely to use laughing as a distraction)
- If morphine is given too early to the patient with cancer pain, it will not work when the patient really need it, towards the end, when the pain gets worse.
(pg. 145)
- respiratory depression is common in patients receiving opiod pain medications. if patients are monitored carefuly whrn they are at risk, such as with the first dose of an opiod or when the dose is increased, respiratory depression is preventable. respiratory status should be routinely monitored using LOS scale.
- Pain medication is more effective when given by injection

Question 3

What are the differences between addiction, physical dependence, and tolerance?

Answer 3

Addiction: something many patients fear. drug seeking or craving for other usese besides what it is for.
Tolerance: normal biological adaption. Exposure to drug induces changes that result in a decrease of one or more of the drugs effects over the time.
Physical dependence: is a normal physiological phenomenon that most people experience after a few week of continuous opiod use. - if dc abrubtly then pt. may experience withdrawl syndrome

Question 4

What is the current knowledge about the basic physiology of the pain response?

Answer 4

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Question 5

What characteristics help to define acute, chronic nonmalignant, and cancer pain?

Answer 5

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Question 6

What shoul be included in a basic pain assessment?

Answer 6

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Question 7

How is the world health organization analgesic ladder used for the treatment of pain?

Answer 7

the WHO ladder is used. Level #1= mild pain pt. can sleep, perform activities, even work. ( nonopioids analgesica). Level #2= mild- moderate pain. & adds an opiod analgesic. Level #3 pain is moderate- severe pt. not able to work, daily activities Adjuvent analgesic may be appropriate.

Question 8

What are the three classes of analgesics and their uses?

Answer 8

Opioids, nonopioids, and adjuvents.

Question 9

What are commonly used pain medication treatment modalities and their appropriate use?

Answer 9

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Question 10

How and when are nondrug pain management techniques utilized?

Answer 10

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Question 11

How does ethical decision making play a role in the care of the patient in pain?

Answer 11

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Question 12

what is the gate control theory?

Answer 12

described in 1965. pain transmission is viewed as being controlled by gate mechanism in the central nervous system. [ opening the gate allows the transmission of pain sensation. closing the gate blocks the this transmission.]

Question 13

what are endorphins?

Answer 13

are endogenous, naturally occurring, opiate- like peptides that reduce or block the perception of pain like morphine they attach to nerve endings in opiod receptors and block pain transmission.

Question 14

what is acute pain?

Answer 14

is usually associated with an injury, medical condition, or surgical procedure. lasting from few hours to few days. ex. burns, fractures, strains. acute pain may worsen in the presence of anxiety or fear. ( high blood pressure, high heart rate, or high respiratory rate) PAIN MEDICATION CURES

Question 15

what is chronic pain?

Answer 15

chronic pain continues for months or possibly years . it is associated with ongoing condition such as arthritis or back problems. MEDICATION AND TREATMENTS

Question 16

what is nociceptive pain?

Answer 16

involves injury to tissue in which receptors called nociceptors are located. may be found in skin, joint, viscera.

Question 17

there are four phases of pain associated with nociceptive pain. what are they?

Answer 17

transduction, transmission,modulation and perception?

Question 18

what is transduction?

Answer 18

is the first phase and begins when tissue damage causes the realease of substances that release substances that stimulate the nociceptors and start the sensation of pain.

Question 19

what is transmission?

Answer 19

second stage that involves movement of the pain sensation to the spinal cord.

Question 20

what is perception?

Answer 20

third phase, when pain impulses reach the brain and the pain is recognized.

Question 21

modulation?

Answer 21

the fourth phase, occurs when neurons in the brain send signals back down the spinal cord by release of neurotransmitters.

Question 22

narcolepsy?

Answer 22

sudden onset uncontrol

Question 23

what is REM sleep?

Answer 23

REM sleep is the time in which you sleep It is a period of high level activity.

Question 24

NREM

Answer 24

when the body get the most rest. vitals decline

Question 25

what four stage is NREM divided into?

Answer 25

1. Transition stage, person falls into light sleep , the muscles relax. lasts a few minutes.
2. person falls into deeper sleep. brain wave activity becomes lager.last 10-20 minutes.
3. enteres delta sleep or slow brain sleep body becomes immobile.
4. deepest stage of sleep, 15-20 minutes. resembling coma.

Question 26

normal sleep requirements?

Answer 26

newborns- 16 hours, 80% in REM sleep. brain maturation 
AGE 1-         12-14 hours
preschool-      11-13 hours
school- age-   10-11 hours
adolescents-   9-10 hours
adults-             8 hours

Question 27

what are the 3 different types of insomnia? Pg.616

Answer 27

transient, chronic, depression

Question 28

what are the 3 types of sleep apnea? pg. 616

Answer 28

obstructive- most common type and caused by relaxation.
central- failure of the brain to communicate with resoiratory muscles. much less common
mixed- complex- combination of obstructive and central sleep apnea.

Question 29

what is a CPAP?

Answer 29

continuous positive arway. maintains airflow via mask or nasal pongs