U2.2 Pain Medication Therapy Flashcards

1
Q

Describe the nursing process in the care of the patient having pain & receiving pharmacotherapy for pain.

A
  • Assess pain or migraine
  • Analyze patient’s needs
  • Prioritize nursing diagnosis and goals of care
  • Implementation of care to achieve pain management
  • Compare actual outcome with expected outcome
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2
Q

acute pain

A

Abrupt onset, but brief duration.

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3
Q

chronic pain

A

> 6 months, can interfere with daily activities, is sometimes associated with feelings of helplessness or hopelessness.

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4
Q

chronic nonmalignant pain

A

Not life-threatening and usually responds favorably to a consistent, stable dose of pain medication as a part of the treatment regimen.

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5
Q

chronic malignant pain

A

Associated with cancer - ends with control of the disease or death.

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6
Q

nociceptor pain

A

Nociceptors are sensory nerve receptors strategically located throughout the body that initiate pain transmission when stimulated.
further subdivided –> somatic or visceral

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7
Q

somatic pain

A

Sharp, localized sensations usually experienced in muscles and joints.

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8
Q

visceral pain

A

A generalized dull, throbbing, or aching pain usually located in internal organs.

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9
Q

neuropathic pain

A

Injury or irritation to nerve tissue. Typically described as burning, shooting, or numbing pain.

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10
Q

How is pain classified?

A

By its duration (acute or chronic) and source (nociceptor or neuropathic.)

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11
Q

What is the purpose of classifying pain?

A

To guide appropriate treatment rationales based on the type of pain reported by the client.

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12
Q

What are the phases of pain physiology?

A
  1. Pain transduction
  2. Pain transmission
  3. Pain perception
  4. Pain modulation
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13
Q

pain transduction

A

1st phase of pain physiology. Trauma stimulates nociceptor.

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14
Q

pain transmission

A

2nd phase of pain physiology. Pain impulse travels along peripheral nerves to spinal cord along A and C fibers

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15
Q

pain perception

A

3rd phase of pain physiology. Cerebral cortex recognizes the pain stimulus.

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16
Q

pain modulation

A

4th phase of pain physiology. Limbic system reacts to pain. Modulating signals sent along descending tracts of the spinal cord. Neurotransmitters can inhibit pain transmission.

17
Q

opiod agonist

A
  • Relieves moderate to severe pain
  • Causes CNS depression
  • GI side effects
  • Sedation, urinary retention, pruritus
  • Respiratory depression (decreased respiratory rate)
  • Dizziness, hallucinations, anxiety
  • Risk of dependency
18
Q

What is the action of an opioid agonist?

A

activates mu and kappa receptors

19
Q

What is the action of a mixed opioid agonist-antagonist?

A

Works on one receptor, but blocks or has no effect on another.

20
Q

mixed opioid agonist-antagonist

A
  • Treats moderate pain with less risk – narcotic analgesics developed for strong analgesia with fewer adverse effects
    o Less respiratory depression
    o Lower potential for dependence
21
Q

What is the action of an opioid antagonist?

A

Blocks mu and kappa receptors.

22
Q

opioid antagonist

A
  • Therapeutic use for opioid overdose or reversal of opioid effects
  • Reversal of constipation cause by opioids
23
Q

non-opioid analgesic

A
  • Includes NSAIDs, acetaminophen, and a few centrally acting agents
  • NSAIDs (aspirin, ibuprofen) drugs of choice
    o Have antipyretic and anti-inflammatory properties
    o Act as peripheral sites, inhibiting pain mediators at nociceptor level
  • Do not produce severe adverse effects of narcotics
24
Q

adjuvant analgesics

A

Diverse group of drugs used to enhance analgesia for specific indications, all have other primary classifications.

25
Q

Primary indications for adjuvant analgesics:

A
  • Pain refractory (resistant) to opiods (e.g. intractable cancer pain)
  • Neuropathic pain
26
Q

Type of adjuvant analgesics

A
  • Antidepressants (particularly SSRIs)
  • Antiseizure drugs
  • Corticosteroids
  • Local anesthetics
  • Muscle relaxants
27
Q

mild migraine

A

Occasional headaches; no other functional impairment.

28
Q

mild migraine treatment

A

o NSAIDs
o Acetaminophen combined with NSAID and caffeine
o Oral serotonin 5-HT1 agonists (e.g. tripatnas/ergot alkaloids)

29
Q

moderate migraine

A

Moderate headaches, nausea, some functional impairment.

30
Q

moderate migraine treatment

A

o Oral, intranasal, subQ serotonin (5-HT) agonists

- If contraindicated or ineffective, then dopamine agonists prescribed

31
Q

severe migraine

A

Severe headaches > three time/month; marked nausea or vomiting, functional impairment.

32
Q

severe migraine treatment

A

o SubQ, IM or IV serotonin agonists
o 2nd choice parenteral dopamine agonist
o Narcotic analgesics for refractory pain