Unit 2: Pain Management Flashcards
Pain threshold is the maximum amount of pain a person can tolerate.
False
Pain threshold is the minimum amount of pain for a person to feel
Pain from ischemia gradually increases and becomes intense over a longer time
True
It is important to monitor the therapeutic serum level of opioids
False
it is important to maintain the therapeutic level
The lower the serum opioid level, the more difficult it is to achieve the therapeutic level with the next dose
True
Respiratory depression gradually peaks 6 to 12 hours after epidural opioids are administered
True
_________ are free nerve endings found in the skin.
Nociceptors
Prostaglandins are chemical substances that are believed to increase the sensitivity of pain receptors by enhancing the pain-provoking effect of _________
Brandykinin
_________ is the need for increasing doses of opioids to achieve the same therapeutic effect
Tolerance
________ is a behavioral pattern of substance use characterized by a compulsion to take the substance primarily to experience its psychic effects
Addiction
A ______ ______ occurs when a person responds to the medication of other treatment because of a reaction that the treatment will work rather than because it actually does so
Placebo effect
What is pain?
An unpleasant sensory & emotional experience resulting from actual or potential tissue damage
Why is pain the fifth vital sign?
Increases the awareness among healthcare professionals of the relationship between pain and health
What are the types of pain?
Nociceptive pain
Neuropathic pain
What is nocicpetive pain?
Pain from injury
What is neuropathic pain?
The abnormal processing of sensory input by the PNS and CNS; occurs after injury is healed
What are factors that influence the pain experience?
Past experience Anxiety Depression Culture Age Gender
What is acute pain?
Recent onset; specific injury; indicates that damage or injury has occurred; typically decreases as injury heals
What is non-malignant chronic pain?
Abnormal processing of sensory input by the CNS and PNS; unclear/no cause or origin
What are commonly used non-pharmacologic pain relief interventions?
Cutaneous stimulation Massage Thermal therapies TENS Distraction Relaxation Guided imagery Hypnosis Music therapy
What are common pharmacologic remedies for pain?
Non-opioid analgesics
Opioids
Adjuvant analgesic therapy
Identify components of a pain assessment
Onset Location Quality Intensity Timing Personal meaning Aggravating & Alleviating factors
OPQRST
Onset Provoking factors Quality Region/Radiating Severity Timing
Addiction
Medical diagnosis; a behavioral pattern of substance use characterized by characterized by a compulsion to take the substance primarily for the psychic effects
Tolerance
Occurs when a person using opioids becomes less sensitive to their analgesic properties; need for increasing doses to maintain same level of pain relief
Physical dependence
Body cannot function normally without drug in system; without drug person will experience withdrawal symptoms
Pseudoaddiction
Person displays characteristics of addict; however, their behaviors are caused by inadequate pain relief; once desired level of pain relief id met, behaviors subside
Pain is subjective
True
Purpose of pain management
Alleviate pain & suffering
COMFORT
Somatic pain
Pain that originates in the skin, bone, or muscles and is conducted by sensory fibers
Superficial somatic pain
pain that arises from stimulation of receptors in the skin and mucous membranes
Visceral pain
a poorly localized, dull, or diffuse pain that arises from the abdominal organs
Nociceptors
Sensitive to pain-causing stimuli
NSAIDs
Block the enzyme needed for prostaglandin synthesis which results in pain control
Myelinated A delta fibers
Transmit the inital pain sensation rapidly to the brain
Acute pain
Unmyelinated C fibers
Associated with chronic pain; has dull, aching, and burning qualities
Patients require less medication and experience more effective pain relief if analgesia is administered _______ they become sensitized to the pain.
Before
What is the systemthat sends information from the spinal cord to the brain?
Ascending system
After tissue injury is occurring, nociception continues, and relays the impulses to the ___________ of the spinal cord. The painimpulse then travels to the brain by the anterolateral pathway to the thalamus.
Dorsal horn
Endorphins
Natural analgesics that decrease pain perception
What the pt waits too long to report pain and it becomes difficult to relieve
Sensitization
Metabolized by the liver, excreted by the kidneys; contraindicated in pt with renal or liver disease
Opioid analgesic agents
Opioids have no maximum safe dose, both the maximum safe dosage and therapeutic serum levels are individual to the pt
True
NSAIDs may displace and increase the effect of _______
warfarin
What are the most effective ways to safely and effectively give pain medication?
Asking the pt to rate the pain
Observing the response to the pain medication
Multimodal / balanced analgesia
The most effective pharmacologic intervention
Itching
Pruritis
What is the nursing role in pain?
Advocating for people with pain
Do vitals change when a patient is experiencing pain?
Yes; but acute pain only
What objective data can we observe if a patient is experiencing pain?
Appearance
Movements
Affect
Vitals
Opioid narcotics have a ceiling effect after constant use.
False; therapeutic level continues to increase
What are common side effects to opioid analgesics and what are their interventions?
Nausea/vomiting: antiemetic
Constipation: laxative
Pruritus: antihistamine
Respiratory depression: stimulate pt, administer naloxone
What is the best route for opioid administration?
Intravenous
What are common side effects from drug therapy?
Constipation Sedation & confusion Nausea & vomiting Pruritus Urinary retention respiratory depression
How would you relieve pain for an addict?
Try non-narcotics first; non-pharmacologic remedies; local anesthetics
