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NSG 300 > Topic 9 > Flashcards

Topic 9 Flashcards

1
Q

transduction

A

conversion of one form of energy into another. In sensation, the transforming of stimulus energies, such as sights, sounds, and smells, into neural impulses our brains can interpret.

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2
Q

transmission

A

Sending of impulse across a sensory pain nerve fiber (nociceptor)

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3
Q

nerve impulses

A

Excitatory neurotransmitters send electrical impulses across the synaptic cleft between two nerve fibers, enhancing transmission of the pain impulse.

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4
Q

pain impulses

A

These pain-sensitizing substances surround the pain fibers in the extracellular fluid, spreading the pain message and causing an inflammatory response.

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5
Q

A fibers

A

fast, myelinated
-Send sharp, localized, and distinct sensations that specify the source of the pain and detect its intensity

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6
Q

C fibers

A

the very small, slow, unmyelinated
-Relay impulses that are poorly localized, visceral, and persistent

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7
Q

perception

A

the point at which a person is aware of pain

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8
Q

modulation

A

Inhibits pain impulse
-Once the brain perceives pain, there is a release of inhibitory neurotransmitters such as endorphins (endogenous opioids), serotonin, norepinephrine, and gamma-aminobutyric acid (GABA), which hinder the transmission of pain and help produce an analgesic effect.

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9
Q

gate-control theory

A

the theory that the spinal cord contains a neurological “gate” that blocks pain signals or allows them to pass on to the brain. The “gate” is opened by the activity of pain signals traveling up small nerve fibers and is closed by activity in larger fibers or by information coming from the brain.

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10
Q

pain threshold

A

the point at which a person feels pain

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11
Q

the stress respond of pain stimulates the…

A

autonomic nervous system

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12
Q

Continuous, severe, or deep pain typically involving the visceral organs activates the

A

parasympathetic nervous system

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13
Q

what are common behavior al responses of acute pain?

A

Clenching the teeth, facial grimacing, holding or guarding the painful part, and bent posture

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14
Q

chronic pain can affect a patients…

A

-activity (eating, sleeping, socialization)
-thinking (confusion, forgetfulness)
-emotions (anger, depression, irritability)
-quality of life and productivity.

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15
Q

pain tolerance

A

level of pain a person is willing to accept

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16
Q

Acute/transient pain

A

Protective, identifiable, short duration; limited emotional response

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17
Q

what is a primary nursing goal for individuals with acute/transient pain?

A

to provide pain relief that allows patients to participate in their recovery, prevent complications, and improve functional status

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18
Q

Chronic/persistent noncancer pain

A

Is not protective, has no purpose, may or may not have an identifiable cause

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19
Q

what are some things that are considered chronic noncancerous pain?

A

arthritis, headache, low back pain, or peripheral neuropathy

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20
Q

chronic episodic pain

A

Occurs sporadically over an extended duration

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21
Q

cancer pain

A

is normal (nociceptive), resulting from stimulus of an undamaged nerve and/or neuropathic, arising from abnormal or damaged pain nerves. Can be acute or chronic.

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22
Q

referred pain

A

pain that is felt in a location other than where the pain originates

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23
Q

idiopathic pain

A

Chronic pain without identifiable physical or psychological cause

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24
Q

factors influencing pain

A

-physiological (age, fatigue, genes, neurological functions)
-social factors
-spiritual factors
-psychological factors (anxiety/coping style)
-cultural factors

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25
Q

how does fatigue affect pain

A

Fatigue increases the perception of pain and can cause problems with sleep and rest

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26
Q

how does anxiety affect pain

A

Anxiety often increases the perception of pain, and pain causes feelings of anxiety. It is difficult to separate the two sensations.

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27
Q

ABCDEs of pain management: A

A

A: Ask about pain regularly. Assess pain systematically.

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28
Q

ABCDEs of pain management: B

A

B: Believe the patient and family in their report of pain and what relieves it.

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29
Q

ABCDEs of pain management: C

A

C: Choose pain control options appropriate for the patient, family, and setting

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30
Q

ABCDEs of pain management: D

A

D: Deliver interventions in a timely, logical, and coordinated fashion.

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31
Q

ABCDEs of pain management: E

A

E: Empower patients and their families. Enable them to control their course to the greatest extent possible

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32
Q

PQRSTU of Pain

A

P: Palliative or Provocative factors
Q: Quality:
R: Region/Relief measure
S: Severity
T: Timing
U: Effect of Pain

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33
Q

P: Palliative or Provocative factors questions

A

What makes pain better/worse?

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34
Q

Q: Quality questions

A

Describe your pain

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35
Q

R: Region/Relief measure questions

A

Show me where, what gives you relief?

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36
Q

S: Severity questions

A

on a scale from 1-10

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37
Q

T: Timing questions

A

Do you have pain all the time or only at certain times.

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38
Q

U: Effect of Pain questions

A

What are you not able to do because of pain?

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39
Q

what is the single most reliable report for pain

A

patients self report

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40
Q

if a patients is unable to communicate pain; what should the nurse pay attention to during the assessment

A

Vocal response, facial movements (e.g. grimacing, clenched teeth) and body movements (e.g., restlessness, pacing). Social interaction, does the patient avoid conversation?

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41
Q

characteristics of pain

A

Timing
Location
Severity
Quality
Aggravating and precipitating factors
Relief measures

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42
Q

what is the nurses job related to pain relief?

A

Administering and monitoring therapies ordered by health care providers for pain relief and independently providing pain-relief measures that complement those prescribed.

43
Q

what are the common holistic health approaches

A

wellness education, regular exercise, rest, attention to good hygiene practices and nutrition, and management of interpersonal relationships.

44
Q

when should nonpharmacologic measures never be used in place of pharmacologic therapies

A

in the ace of acute pain

45
Q

Nonpharmacological pain-relief interventions

A

-Cognitive and behavioral approach
-Relaxation and guided imagery
-Distraction
-Music
-Cutaneous stimulation
-Cold and heat application
-Transcutaneous electrical nerve stimulator (TENS)
-Herbals
-Reducing pain perception and reception

46
Q

guided imagery allows

A

patients to alter affective-motivational and cognitive pain perception

47
Q

relaxation

A

mental and physical freedom from tension or stress that provides individuals a sense of self-control.

48
Q

Distraction

A

directs a patient’s attention to something other than pain and thus reduces awareness of it

49
Q

Cutaneous stimulation

A

Stimulation of the skin through a massage, warm bath, cold application, and TENS may be helpful in reducing pain perception.

50
Q

Transcutaneous electrical nerve stimulator (TENS)

A

Involving stimulation of the skin with a mild electrical current passed through external electrodes.

51
Q

Herbals for Pain

A

echinacea, ginseng, ginkgo biloba, and garlic despite conflicting research evidence supporting their use in pain relief.

52
Q

Nonopioid analgesics

A

analgesics that are not classified as opioids, these include acetaminophen, and NSAIDS

53
Q

Opioids (narcotics)

A

are prescribed for moderate to severe pain. They are associated with respiratory depression and adverse effects of nausea, vomiting, constipation, itching, urinary retention, and altered mental processes. Sedation is an adverse effect of opioids that always precedes respiratory depression.

54
Q

physical dependence

A

A state of adaptation that is manifested by a drug class-specific withdrawal syndrome produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist

55
Q

addiction

A

A physiological or psychological dependence on a drug Þ primary, chronic, neurobiological disease with genetic, psychosocial, and environmental factors influencing its development and manifestations

56
Q

drug tolerance

A

A state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more effects of the drug over time

57
Q

placebos

A

are pharmacologically inactive preparations or procedures that produce no beneficial or therapeutic effect.

58
Q

Adjuvants/co-analgesics

A

drugs used to treat other conditions, but they also have analgesic qualities (tricyclic antidepressants and anticonvulsants).

59
Q

Patient-controlled analgesia (PCA)

A

a drug delivery system that uses a computerized pump with a button the patient can press to deliver a dose of an analgesic keeping constant plasma level (minimal risk of overdose)

60
Q

what are the safety guidelines for the PCA

A

-The patient is the only person who should press the button to administer the pain medication
-Monitor the patient for signs and symptoms of oversedation and respiratory depression.
-Monitor for potential side effects of opioid analgesics.

61
Q

Topical analgesics

A

Creams, ointments, patches

62
Q

Local anesthesia

A

Local infiltration of an anesthetic medication to induce loss of sensation to a small area, like an inscison site for example

63
Q

Regional anesthesia

A

the injection or infusion of local anesthetics to block a group of sensory nerve fibers.
*for a whole body part

64
Q

Perineural local anesthetic infusion

A

a surgeon places the tip of an unsutured catheter near a nerve or groups of nerves and the catheter exits from the surgical wound.

65
Q

Nursing implications for local and regional anesthesia

A

Provide emotional support
Protect patient from injury

66
Q

providing emotional support: local and regional anesthesia

A

Explaining the insertion technique and warning patients that they will temporarily lose sensory function within minutes of injection.

67
Q

protect patient from injury: local and regional anesthesia

A

-Protect the patient from injury until full sensory and motor function return. Patients are at risk for injuring an anesthetized body part without knowing it.
-When patients receive epidural analgesia, initially monitor them as often as every 15 minutes, including assessment of vital signs, respiratory effort, and skin color.
-Once stabilized, monitoring occurs every hour in the first 12 to 24 hours and then with less frequency if the patient is stable.

68
Q

WHO analgesic ladder

A

Recommended guidelines for prescribing, based on pain level (0-10, 10 = severe pain)

Level 1 (1-3 rating)—Use non-opioids
Level 2 (4-6 rating)—Use weak opioids alone or with adjuvant drug
Level 3 (7-10 rating)—Use strong opioids
Level 4- nerve block, epidural, PCA pump

69
Q

pain centers

A

treat patients on an inpatient or outpatient basis

70
Q

What is the goal of palliative care?

A

to learn how to live life fully with an incurable condition

71
Q

what kind of program is hospice

A

end of life care; helps terminally ill patients continue to live at home or in a health care setting in comfort and privacy.

72
Q

olfactory

A

smell

73
Q

gustatory

A

taste

74
Q

kinesthetic

A

position and motion

75
Q

Stereognosis

A

a sense that allows a person to recognize the size, shape, and texture of an object.

76
Q

Reception

A

stimulation of a receptor such as light, touch, or sound

77
Q

Perception

A

integration and interpretation of stimuli

78
Q

Reaction

A

only the most important stimuli will elicit a reaction

79
Q

what can losing visual and hearing acuity cause…

A

the person to withdraw by avoiding communication or socialization with others in an attempt to cope with the sensory loss

80
Q

what are the three types of sensory deprivation

A

-reduced sensory input
-elimination of patterns or meaning from input
-restrictive environments that produce monotony and boredom

81
Q

Reduced sensory input

A

sensory deficit from visual or hearing loss

82
Q

Elimination of patterns or meaning from input

A

e.g., exposure to strange environments

83
Q

Restrictive environments that produce monotony and boredom.

A

e.g., bed rest

84
Q

sensory deprivation

A

Inadequate quality or quantity of stimulation

85
Q

sensory deficits

A

Deficit in the normal function of sensory reception and perception

86
Q

Sensory overload

A

Reception of multiple sensory stimuli

87
Q

factors affecting sensory function

A

Age
Meaningful Stimuli
Amount of Stimuli
Social Interaction
Environmental Factors
Cultural Factors

88
Q

Visual changes occur during adulthood that result in the need for glasses around what age

A

40 to 50 years old

89
Q

Glaucoma

A

increased intraocular pressure results in damage to the retina and optic nerve with loss of vision

90
Q

Hearing loss usually begins around…

A

30 years of age

91
Q

Smell and taste changes usually begin around…

A

around 50 years

92
Q

meaningful stimuli

A

Reduce the incidence of sensory deprivation

93
Q

Meaningful stimuli include those activities and people who have…

A

a positive influence on the patient, such as pets, music, TV, movies, family, clock, and calendar.

94
Q

amount of stimuli

A

Can cause sensory overload

95
Q

Social interaction

A

The amount and quality of social contact with supportive family members and significant others influence sensory function. The absence of visitors during hospitalization or residency in an extended care facility influences the degree of isolation a patient feels.

96
Q

Environmental factors

A

Occupation, recreation, and sports activities

97
Q

audiologist or otolaryngologist

A

specialist in the ear and throat

98
Q

expressive aphasia

A

A motor type of aphasia, is the inability to name common objects or express simple ideas in words or writing. For example, a patient understands a question but is unable to express an answer.

99
Q

receptive aphasia

A

Is the inability to understand written or spoken language. A patient is able to express words but is unable to understand questions or comments of others.

100
Q

global aphasia

A

The inability to understand language or communicate orally.

101
Q

when do individuals need to have hearing screenings

A

at least every decade through age 50 and every 3 years thereafter

102
Q

what is important to remember in patients using assistive devices

A

Patients who wear corrective contact lenses, eyeglasses, or hearing aids need to make sure that they are clean, accessible, and functional.

103
Q

what are some ways to promote meaningful stimuli

A

Take measures to improve lighting, hearing, and tactile, taste, and smell sensations. If a patient is overly sensitive to tactile stimuli (hyperesthesia), minimize irritating stimuli.

104
Q

what are ways a nurse can control sensory stimuli

A

Combining activities such as dressing changes, bathing, and vital sign measurement in one visit prevents the patient from becoming overly fatigued. Try to control extraneous noise in and around a patient’s room.

NSG 300 (13 decks)

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