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NUR111 POWERPOINT Note Cards > Unit Two: The Concept Of Comfort > Flashcards

Unit Two: The Concept Of Comfort Flashcards

1
Q

Katharine Kolcaba’s Comfort theory

A

The immediate state of being strengthened by having the needs of relief, ease, and transcendence addressed in the four contexts of holistic human experience: physical, psycho spiritual, sociocultural, and environmental.

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2
Q

Domains of comfort

A

Physical, sociocultural, psychospirital, enviormental

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3
Q

Physical comfort

A

Homeostasis

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4
Q

Sociocultural

A

Culture, family, finances

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5
Q

Psychospiritual comfort

A

Sexuality, spirituality

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6
Q

Environmental comfort

A

Room temp, back ground noise

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7
Q

Comfort is _____________.

A

Subjective

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8
Q

A client indicates an intensity for 8 on the 0-10 pain scale. The best action for the nurse to take is which of the following?
A. Check back in 30 mins to see wether the pain has changed
B. Give pain medication
C. Further assess pain to determine the best intervention
D. Do nothing because pain is at a tolerable level

A

C

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9
Q 
When describing pain, the client states the pain is a dull aching pain. The nurse determines that this description tends to indicate that the client’s pain is most likely:
A. Neuropathic pain
B. Visceral Pain
C. Referred pain
D. Phantom Pain
A

B.

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10
Q

Neuropathic pain

A

Stabbing, burning; usually from fibromyalgia. Chronic pain. Sending incorrect pain signals. Tissue injury.

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11
Q

Visceral pain

A

Deep pain from organs

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12
Q

Referred pain

A

Coming from a site other than its point of origin

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13
Q

Phantom Pain

A

Usually coming from a site of amputation. Shooting, burning, stabbing pain.

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14
Q 
The nurse is evaluating a client’s pain. The client states that the pain is at level 2. The client is indicating which of the following about the pain?
A. Duration
B. Quality
C. Intensity 
D. Onset
A

C

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15
Q

Pain management is important because:
A. Determines whether the pt and family give good evaluations to the hospital and caregivers
B. It determines when the patient can be discharged from the hospital
C. It is defined as a pt right by the Joint Commission on the Accreditation of Healthcare Organization
D. It is the fifth vital sign

A

C.

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16
Q

Risk factors effecting comfort

A 
Poor nutrition
Smoking
Excessive alcohol intake
Illicit drug use
Poor hygiene
Occupational hazards including heavy lifting, long hours, or repetitive movements
Participation in team or extreme sports
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17
Q

________ is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.

A

Pain

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18
Q

Pain is always ______________.

A

Subjective

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19
Q

Pain is the ______________.

A

Fifth vital sign

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20
Q

_________ is the most common reason for seeking healthcare.

A

Pain

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21
Q

Pain experiences

A

Pain perception, Pain threshold, pain tolerance

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22
Q

Acute pain is:

A

Temporary(Less than 6 months)
Protective
Sudden onset
Identifiable cause

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23
Q

Examples of Acute pain:

A

Muscle spasms, toothaches

24
Q

Three types of acute pain:

A

Somatic, visceral, referred

25
Q

Chronic pain is:

A

Prolonged (longer than 6 months)
Non protective
May not be identifiable cause
Can be malignant or non-malignant

26
Q

Examples of chronic pain:

A

Back pain, arthritis, Crohn’s disease

27
Q

Factors that effect clients response to pain:

A 
Age
Developmental stage
Sociocultural Factors
Emotional Status
Past experiences 
Meaning of pain
Knowledge deficit
28
Q

Somatic pain

A

Acute; comes from skin or surface of body. Like an overstretched muscle.

29
Q

Physical response to Acute pain

A

Increased HR, Increased pulse, Increased BP, Increased muscle tension, dry mouth, Nausea, and vomiting. (fight or flight)

30
Q

Physical response to chronic pain

A

No autonomic nervous system response, usually because their body has gotten used to the pain.

31
Q

Breakthrough pain

A

Pain caused by some kind of trigger. Can be Incident pain or Ideopathic pain

32
Q

Breakthrough, Incident pain

A

Pain caused by doing something i.e. wound care or walking after surgery

33
Q

Breakthrough, Idiopathic pain

A

Has an unsure cause

34
Q

End of dose medication failure

A

Pain that happens right before it is time to give them their next dose of medication. Can be fixed by recommending to provider to change med schedule.

35
Q

Questions you need to ask when assessing pain:

A 
Location
Intensity
Quality
Duration
Aggravating and Relieving Factors
Signs and Symptoms
36
Q

Pain Assessment tools

A 
Visual analog scale
0-10 Numeric Pain Intensity Scale
Simple descriptive Pain Intensity Scale
FACES pain Scale
CNPI Scale
FLACC
37
Q

FLACC pain scale

A 
Face
Legs
Activity
Cry
Consolability
Used fo infants
38
Q

CNPI

A

Checklist of Nonverbal Pain Indicators

ICU patients, unconscious patients

39
Q

Nonpharmacologic Nursing interventions for pain

A 
Relaxation
Guided Imagery
Distraction
Massage
Heat/cold Therapy
Therapeutic touch
TENS Unit
40
Q

Pharmacological Therapies for pain

A 
Non-opioid analgesics/NSAIDS
Weak/partial opioid analgesics
Mixed opioid analgesics
Strong opioid analgesics
Co-analgesics
41
Q

Nonopioids

A

Used to treat mild to moderate pain. Many are over the Counter and have a ceiling effect narrow therapeutic index

42
Q

Examples of nonopioids used to treat pain

A

NSAIDS
Acetaminophen
Aspirin

43
Q

Nonopioids Salicylates—ASA

A 
Used to treat mild to moderate pain
Used as:
-Analgesic (reduces plain)
-Anti-inflammatory 
-Antipyresis 
-Antiplatelet
44
Q

Nonopioid Acetaminophen

A

Similar properties as ASA. More people are allergic to this ASA than to Acetaminophen. TYLENOL when used in high doses or long term use may cause liver damage. Do not take on empty stomach
Antidote is Acetylcystine.

45
Q

Nonopioid NSAIDs

A

Nonsteroidal Anti-Inflammatory Drugs.
Ibuprofen, Aspirin, Naproxen.
Common S/E: gastric ulcers, increased bleeding
Take with full glass of water
DO NOT give with antacids; reduces absorption of drug.

46
Q

Opioids

A

Formerly called narcotic analgesics
Controlled substances
Capable of controlling any type of pain
Most common S/E: sedation, nausea, and constipation AND RESPIRATORY DEPRESSION

47
Q

POSS

A

Palermo Opioid-induced Sedation Scale
S-sleep; easy to arouse
1. Awake and Alert
2. Slightly drowsy, easily aroused
3. Frequently drowsy, arousable, drifts off to sleep during conversation
4. Somnolent, minimal or no response to verbal of physical stimulation

INCLUDE RESPIRATORY RATE AND QUALITY INITAL AND 30 MINS AFTER

48
Q

Narcan

A

Opioid antagonist; reverses the respiratory depressant effect of an opioid.
Typically .4mg

49
Q

S/E: of opioids

A 
Respiratory depression
Nausea and Vomiting
Urinary retention
Constipation
Pinpoint pain
Light-headedness/dizziness
Confusion and disorientation 
Orthostatic Hypotension
50
Q

Adjuvant or Co-analgesics

A

Used to enhance the effects of opioids but also have other purposes.
Can help reduce S/E of the opioid or lessen anxiety about pain

51
Q

Commonly used adjuvant drugs:

A

Corticosteroids, anticonvulsants, and antidepressants

52
Q

Methods to distribute Pain Meds

A 
PCA pumps
Local
Nerve block
Oral
IM
IV
Pain Pump
Spinal Chord Stimulator
Epidural/spinal block
Transdermal
Transmuscousa
53
Q

When assessing pain while using pain meds

A

Evaluate continually; 30-90 mins after admin
Assess for increased drug tolerance
Identify need for route of admin change, dosage change, or S/E
Ongoing assessment is imperative as long as pain persists
Timing is important
PRN drug regimen has not been proven effective for acute pain

54
Q

Opioid use with children

A
  • Assessment is crucial (use appropriate scale; face scale)
  • Good communication with family
  • Children need a routine postoperative analgesics or by continuous infusion b/c they do not speak up
55
Q

Opioid use with the elderly

A
  • Chronic pain is most common in the elderly

- Pain is not a natural occurrence in the elderly so pain is sometimes underrated

56
Q

With the elderly avoid the use of ______________, _____________, ___________, and _______________ due to increased risk of toxicity.

A

Demerol, Davonte products, Talwin, Indocin

57
Q

Avoid ________________ whenever possible for the elderly because of diminished muscle, fat stores, and circulation.

A

IM injections

NUR111 POWERPOINT Note Cards (8 decks)

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