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Nursing 337 > these are even painful to make > Flashcards

these are even painful to make Flashcards

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1
Q

what is pain

A

anything the patient says it is, wherever the patient says it is, whenever the patient says it is

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2
Q

harmful effects of unrelieved acute pain on the endocrine and metabolic system

A 
wt loss
^ HR
^ RR
shock
glucose intolerance
hyperglycemia
fluid overload
hypertension
urinary retension
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3
Q

harmful effects of unrelieved acute pain on the cardiovascular system

A

HTN
unstable angina
MI
DVT

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4
Q

harmful effects of unrelieved acute pain on the on respiratory system

A

atelectasis

pneumonia

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5
Q

harmful effects of unrelieved acute pain on the renal and urologic system

A

constipation
anorexia
paralytic ileus

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6
Q

harmful effects of unrelieved acute pain on the musculoskeletal system

A

immobility

weakness and fatigue

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7
Q

harmful effects of unrelieved acute pain on the neurologic system

A

confusion

impaired ability to think, reason, and make decisons

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8
Q

harmful effects of unrelieved acute pain on the immune system

A

infection

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9
Q

what is the physiologic dimension of pain

A

genetic, anatomic and physical determinants of pain influence how painful stimuli are processed, recognized and described

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10
Q

what is the affective dimension of pain

A

emotional responses to pain include anger, fear, depression and anxiety
negative symptoms may interfere with quality of life

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11
Q

what is the cognitive dimension of pain

A

beliefs, attitudes, memories, and meaining attributed to pain influence the ways in which a person responds to pain

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12
Q

behavioral dimensions of pain

A

observable actions

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13
Q

sociocultural dimension of pain

A

age and gender influence
families
culture affects pain expression, medication use, coping methods

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14
Q

what is suffering

A

suffering is a state of distress associated with loss and a profound sense of insecurity

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15
Q

what is nociception

A

the physiologic process by which information about tissue damage is communicated to the CNS

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16
Q

what is the main idea of transduction

A

involves the conversion of a noxious mechanical, thermal. or chemical stimulus into a an electrical signal called an action potential

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17
Q

what chemicals are released from noxious stimuli and cell damage

A

prostaglandins, bradykinin, serotonin, substance p, histamine

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18
Q

what cells are involved in transduction

A

mast cells and macrophages

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19
Q

what types of neurons is the action potential sent from in transduction

A

from myelinated A fibers and unmyelinated C fibers

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20
Q

what is peripheral sensitization

A

the increased sensibility to nociception following an initial wound or noxious stimuli

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21
Q

what enzyme plays an important role in peripheral sensitization

A

cyclooxygenase

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22
Q

how do you stop pain at the transduction level

A

drugs that stabilize the neuronal membrane and inactive peripheral sodium channels inhibit production of the nerve impulse

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23
Q

Why did the cookie cry

A

because his mom was a wafer soo long!

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24
Q

what is transmission

A

is the process by which pain signals are relayed from the periphery to the spinal cord and then to the brain

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25
Q

where do the primary afferent fibers terminated when transmitting

A

in the dorsal horns

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26
Q

what does the dorsal horn do

A

it integrates and modulates the periphery

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27
Q

what are the three segments of transmission

A

1- transmission along the peripheral nerve fibers to spinal cord
2- dorsal horn processing
3- transmission to the thalamus and the cerebral cortex

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28
Q

what are dermatones

A

are areas on the skin that are innervated primarily by a single spinal cord segment

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29
Q

what is central sensitization

A

is increased sensitization and hyperexcitability of neurons in the CNS

30
Q

what is allodynia

A

the epxerience of significant pain from touch or tactile stimulation in and around the area of tissue or nureve injury

31
Q

what can untreated acute pain lead to

A

acute pain can lead to chronic pain through the process of central sensitization

32
Q

what is neuroplasticity

A

the process that allow neurons in the brain to compensate for injury and adjust their responses to new situations or changes in their environment

33
Q

what does central sensitization of the dorsal horn result in

A

1 hyperalgesia
2 painful responses to normally innocuous stimuli
3 prolonged pain after the original noxious stimuli ends
4 the extension of tenderness or increased pain sensitivity outside of an area of injury to include uninjured tissue

34
Q

what is referred pain

A

location of pain reported by the person with an injury or a disease involving visceral organs

35
Q

how do fibers from the dorsal horn enter the brain

A

through the spinothalamic tract and the spinoreticular tract

36
Q

what are some ways to target pain in the transmission stage

A

opioid analgesics

37
Q

what is perception

A

occurs when pain is recognized, defined, and assigned meaning by the individual experiencing the pain

38
Q

what is the reticular activating system responsible for in the perception stage of pain

A

for warning the individual to attend to the pain stimulus

39
Q

what is the somatosensory system responsible for

A

responsible for localization and characterization of pain

40
Q

what is the limbic system responsible for in the perception stage of pain

A

for emotional and behavior responses to pain

41
Q

what is the cortical structure responsible for in the perception stage of pain

A

crucial to constructing the meaning of pain

42
Q

what is modulation

A

involves the activation of descending pathways that exert inhibitory or facilitatory effects on the transmission of pain

43
Q

what type of drugs exert their effects on modulation of pain

A

antidepressants

44
Q

what is nociceptive pain

A

normal processing of stimulus that damages normal tissue or has the potential to do so if prolonged

45
Q

what is neuropathic pain

A

abnormal processing of sensory input by the peripheral or central nervous system

46
Q

what is the treatment of nociceptive pain

A

typically a nonopioid or an opioid

47
Q

what is the treatment of neuropathic pain

A

typically includes adjuvant analgesic

48
Q

what causes nocicpetive pain

A

damage to the somatic or visceral tissue

49
Q

characteristics of superficial pain

A

sharp burning prickly

50
Q

characteristics of deep pain

A

deep aching throbbing

51
Q

what causes viceral nociceptive pain

A

activation of nociceptors in the internal organs and body cavities- respond to inflammation, stretching, and ischemia

52
Q

what are the signs and symptoms of neuropathic pain

A

described as numbing, hot, burning, shooting, stabbing, sharp, or electric shock-like
it is sudden intense, short lived or lingering

53
Q

what are common causes of neuropathic pain

A

trauma, inflammation, metabolic disease, alcoholism, infections of the nervous system, tumors, toxins, and neurologic diseases

54
Q

what is differentation pain

A

pain that results from loss of afferent input secondary to either peripheral nerve injury or CNS injury

55
Q

what is sympathetically maintained pain

A

pain that is associated with dysregulation of the autonomic nervous system

56
Q

what cause central neuropathic pain

A

is caused by CNS lesions or dysfunction

57
Q

onset of acute pain

A

sudden

58
Q

onset of chronic pain

A

gradual or sudden

59
Q

duration of acute pain

A

less than 3 months or as long as natural healing to occur

60
Q

what is the duration of chronic pain

A

longer than 3 months- may start as an acute injury but continues past normal time for recovery

61
Q

cause of acute pain

A

generally can identify a precipitating event- surgery or illness or trauma

62
Q

cause of chronic pain

A

may not be known, original cause of pain may differ from mechanisms that maintain pain

63
Q

course of acute pain

A

decrease over time and goes away as recovery occurs

64
Q

course of chronic pain

A

typically pain does not go away

periods of remission and exacerbation

65
Q

typical physical and behavioral manifestations of acute pain

A 
may vary but can reflect sympathetic nervous system activation
- ^ HR, RR, BP
- diaphoresis
- pallor
anxiety
agitation confusion
urinary retention
66
Q

typical physical and behavior manifestations of chronic pain

A 
predominantly behavioral manifestations
- flat affect
decreased physical activity
fatigue
withdrawal from social interaction
67
Q

what is breakthrough pain

A

pain in patients who have a baseline of pain that is mild to moderate but fairly controlled

68
Q

what is end- of - dose failure

A

pain that occurs before the expected duration of specific analgesic

69
Q

why did the bicycle fall over

A

because it was two tired

70
Q

what is sciatica

A

pain that follows the course of the sciatic nerve- it may originate from muscles or joints around the back or from compression or damage to the sciatic nerve

Nursing 337 (9 decks)

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