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Med Surg > Week 2 > Flashcards

Week 2 Flashcards

1
Q

what is pain?

A

problem causing suffering and reduces the quality of life. effective pain relief is a basic human right

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2
Q

what is the nurses role related to pain?

A

to assess, document and communicate it with other healthcare staff, provide pain relief and monitor pain management strategies, provide education to patients and evaluate effectiveness of intervention

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3
Q

true or false. unrelieved persisten pain is not considered an epidemic in canada?

A

false. it is an epidemic. pain i often misunderstood due to its invisability. 1 in 4 canadians live with chronic pain

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4
Q

true or false. pain can have an impact on physical and mental health, family and community life as well as economy?

A

true.

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5
Q

true or false. pain effects 65% of older people in long term care.

A

false. it is actually 80%

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6
Q

true or false people with cancer often do not recieve adequate pain treatment

A

true.

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7
Q

what cultural group have the highest prevelance of persistance pain?

A

indigenous people

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8
Q

what are consiquences of untreated pain?

A

unnessacary suffering, physical dysfunction, impaired recovery from acute illness and surgery, immunosupression and sleep disturbances

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9
Q

defintions of pain

A

whatever and whenever the person expiriencing says it is. unpleasent sensoryand emotional expirience associated with actual or potential tissue damage. multidimensional and subjective, can be expirienced in the absence of indentifiable tissue damage. NOT synonymous with suffering

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10
Q

what is nociception in pain?

A

physiological process that sense and communicates tissue damage (pain signals) to the central nervous system

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11
Q

what are the mechanisms by which pain is recieved?

A

1) transduction: process of converting painful stimuli into electrical signals
2) transmission: the signals travel to the brain
3) perception: when the signal reaches the brain and person is consiously aware they are in pain.
4) modulation: the bodies response to the pain

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12
Q

What are the 5 dimensions of pain?

A

1) Sensory - discriminative: recognition of sensation that something is painful. sensory pain elements include pattern, area, intensity and nature
2) motivational-affective: emotional response to pain expiriance
3) Behavioural: observable actions used to express or control pain
4) Cognitive-evaluation: beliefs, attitudes, memories meaning of pain to you which can inidicate response to pain
5) Sociocultural: demographics, support systems, past history with pain, cultural beliefs, age, sex, economic status, education as well as families and caregivers as they influence patients response as well

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13
Q

How is pain classified?

A

1) by underlying pathology: nociceptive or neurological pain
2) by duration: acute or persistent

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14
Q

what is nocioceptive pain? what are the types?

A

pain related to damage to somaticorvisceral tissue. can be planned such as surgical incision, broken bone, medical condition such as athritis. usually responds well to opioid or non opioid medication. 2 types. 1) somatic 2) visceral

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15
Q

what is somatic nocioceptive pain?

A

aching, throbbing, localized, arises brobone, joint, muscle, skin or connective tissue

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16
Q

what is visceral nocioceptive pain?

A

usually has to do with cancer or tumour involvement, arises from internal organs such as intestine and bladder

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17
Q

what is neuropathic pain?

A

damage to the peripheral nerve or CNS. burning, shooting, stabbing pain or electrical. can be sudden, intense, short lived or lingered. difficult to treat. can be ceneral or peripheral in origin.

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18
Q

what is included in the initial pain assessment

A

O,P,Q,R,S,T,U,V. Onset, Provocative/palliative, Quality, Region, Severity, Treatment/timing, Understanding, Values

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19
Q

True or false. the nurse must document the words that the pt used to desciribe the pain.

A

true.

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20
Q

true or false. intensity of pain is measured using scales.

A

true. 0/10. can be adjusted to pt’s age and cognitive ability. eg. the faces scale

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21
Q

what must we keep in mind when it comes to indigenous people and pain?

A

high rates of persistant pain. awareness of discrimination related to the assumption of substance miss use and pain issues. acknowledge expirienced related to historical social issues to ensure culturally sensitive pain management.

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22
Q

pain treatment basic principals.

A

routine assessment is essential for effective managment. unrelieved acute pain complicate recovery. pt’s self report of pain should be used whenever possible. pt’s report of pain needs to be believed and taken seriously. need to assess pts for pain often and check in on them after pain relief provided to ensure it is effective and working. ALL pts should have adequate pain relief. treatment is based on pt’s goals for pain treatment. treatment of pain should include combination of pharmalogical and nonpharmalogical therapies. NEED TO FREQUENTLY ASSESS

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23
Q

Equianalgesic Dose (equal pain killing)

A

dose of one analgesic equivalent in pain-relieving effects with another analgesic. important when substituting an analgesic for another when changing the administration route of opioids (due to half life)

24
Q

schedualing analgesics

A

focus on prevention or ongoing control. do NOT wait for severe pain to control. constant pain requires around the clock admin (NOT PRN). fast acting medications for incident or break through. Long acting medications for constant pain

25
Q

Can you layer meds?

A

YES. eg, tylenol and advil at the same time. so tylenol at 10am, advil at 12pm, tylenol at 2pm, advil at 4pm.etc.

26
Q

what is titration?

A

dose adjustment is based on assessment of the analgesic effect vs adverse effects. use the smallest dose that provides effective pain control with the fewest adverse effects

27
Q

are ranges of doses prescribed for pain meds?

A

yes. eg. 2-4mg dependign on what pt rates pain.

28
Q

what is mild pain?

A

rated a 1-3 on a scale of 0-10. treated with step 1 medications (nonopioid analgesics) organs most worried about with these drugs are kidney and liver

29
Q

what is the cieling effect?

A

increasing the dose beyond an upper limit provides no greater analgesic effect.

30
Q

what is mild to moderate pain?

A

4 to 6 on a scale of 0-10 OR can be mild but persistent despite non opioid therapy. Step 2 meds used to treat. including morphine, oxycodone, hydromorphone and methadone.

31
Q

what is moderate to severe pain?

A

7-10 on a scale of 0-10 OR when step #2 meds do NOT produce effective pain relief. Step 3 meds used to treat: most are mu receptor agonists ex. morphine, hydromorph and fentynol. potent. no analgesic ceiling. can be delivered via many routes. these meds can cause respiratory supression

32
Q

What is adjuvant analgesic therapy?

A

used in conjunction with opioids and non opioids. sometimes called co-analgesics. what are the 3 ways that this can enhance pain therapy?
1) enhancing the effects of opioids and non opioids
2) posessing analgesic properties of their own
3) counteracting adverse effects of other analgesics

33
Q

antidepressants also help with what?

A

pain

34
Q

antiseizure agents also help with what?

A

neuropathic pain

35
Q

what else does muscle relaxants also help with?

A

muscle pain

36
Q

what does analgesthics also help with?

A

trauma or surgery as it freezes the nerves.

37
Q

what is special about ketamine?

A

provides analgesic effect with out the worry of respiration depression

38
Q

Benefits of sublingual route

A

works quickly, can still give if unconcious, avoids GI tract not causing stomach issues

39
Q

Benefits of intranasal route

A

avpid swallowing meds in kids, works very fast as a visceral area

40
Q

why would we give meds rectally?

A

slower release but lasts long over time

41
Q

what are nerve blocks?

A

the block ALL afferent and efferent transmission NOT only noiceptive input. used during and after surgery to reduce pain. block the nerve causing pain using ultrasound. not reversible.

42
Q

What are neuroblative techniques?

A

for severe pain unresponsive to other therapy. destroys nerves to stop transmission. Effects include loss of sensation in whatever location the nerve is destroyed. NOT reversible.

43
Q

what is neuroaugumentation?

A

electrical stimulation of brain and spinal cord (like at PT). commonly used for back pain secondary to nerve damage

44
Q

what are concerns of pain management?

A

tolerance. physical dependance and substance misue.

45
Q

In palliative care what is the main goal?

A

to keep the patient comfortable! we do not worry about drug dependance or tolerance. if giving pts meds for pain management and that causes death it is not as much what we are worried about as pt is comfortable.

46
Q

What are our concerns in elderly with analgesics?

A

they metabolze meds more slowly. greater risk of adverse effects. risk of GI bleeding with NSAIDs. multiple med use (interactions). cognitive impairment can be exacerbated.

47
Q

What is the Canadian Holistic Nurses Association? (CHNA)

A

established to foster holistic nursing as speciality

48
Q

What are natural products?

A

include herbal therapies, nutraceuticals, nutrition therapy, aromatherapy and probiotic therapy. Be sure to encourage use of only products that have been approved for sale through health canada

49
Q

What is herbal therapy?

A

AKA: botonical medicine OR phyotherapy. nurses must be aware of herbal therapies being used and potential interactions with pharmaceutical interventions.

50
Q

What are dietary supplements?

A

examples are fatty acids and omega 3. melatonin, glucosmain and probiotics. again be aware of interactions

51
Q

what is cannabis therapy?

A

effect on cell receptors in the brain and body that can change how these cells be have and communicate. what are the 3 types? THC, CBD and terpenes

52
Q

What are mind body practices?

A

behavioural, psychological, social and spiritual approaches of health. include message therapy, yoga, meditation, prayer, pressure point therapy and relaxation techniques.

53
Q

What is indigenous health?

A

balance of spiritual, emotional, physical, mental and social aspects of life. they use a medicine wheel. and 4 sacred medicines.

54
Q

What are the 4 sacred medicines of indigenous people?

A

1) cedar
2) sage
3) sweet grass
4) tabacco

55
Q

What is traditional chinese medicine?

A

involve manipulation of energy fields. examples include: therapeutic touch, heeling touch, reiki, bioelectomagnetic therapy, hot cups

Med Surg (4 decks)

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