Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 3510 Palliative > Week 4 pain > Flashcards

Week 4 pain Flashcards

1
Q

What are the 4 aspects of total pain?

A
  1. Emotional pain
  2. Physical Pain
  3. Social Pain
  4. Spiritual Pain

How these all interact with each other. Very individual and sometimes one can be way higher than another domain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is suffering?

A

When someone experiences pain in all the domains of “total pain”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do we provide “culturally comfortable” care ?

A

-Recognize the client as a unique individual
-Explore the client’s lived experience of pain
-Promote shared decision making

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are options If the patient cannot self-report?

A
  1. Observe behavior
  2. Talk with proxy, family member
  3. Think about: underlying diagnosis, impact of the illness
  4. Vitals- not really reliable for pain
  5. Trial treatment - does it seem to help?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 4 common side effects of Opioids?

A

Constipation!
Nausea
Sedation
Xerostomia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 2 less common side effects of Opioids?

A

Pruritus
Urinary retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 2 rare side effects Opioids?

A

Respiratory depression
Opioid- induced neurotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What can cause respiratory depression with Opioids?

A
  1. giving too much to someone opioid naive
  2. Someone chews their long acting meds accidentally
  3. too many opioids at once
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Metabolites are the result of the breakdown of opioids. When too many build up, what happens?

A

Opioid - induced neurotoxicity (OIN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What intervention makes OIN worse?

A

Adding more opioids cuz we’re just adding more metabolites in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the management of OIN?

A

Hydration - careful about fluid overload conditions - go slower
Decrease opioid dose
Opioid rotation more common
Calm reassurance - b/c person is confused
Educate the family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are 6 risk factors for OIN?

A

Frail/elderly
Impaired renal function
Impaired Kidney function
Rapid dose increase of opioids
Using the same opioid for a long time
Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the clinical manefestations of OIN?

A
  1. Delirium/confusion - tends to be subtle
  2. myoclonus - can lead to seizure
  3. Hyperalgesia - heightened response to pain
  4. Allodynia - not typically painful but is for the person (like a blanket on their legs is painful)
  5. hallucinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What differentiates total pain with OIN?

A

The clinical manifestations . If not there, it’s likely Total pain so assess the domains of total pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What main thing makes us stop and wonder if someone has OIN even before main clinical manifestations?

A

If we give opioids and the pain isn’t getting better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Tolerance when on opioids ?

A

Normal and expected
We need more drug to get the same effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is physical dependance?

A

The way our body responds physiologically to the opioids in our system. If they are suddenly withdrawn we get withdrawal symptoms : chills, N&V, insomnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Addiction?

A

Pscyhological dependends
people want to feel eurphoric
results in negative social and personal consequences. People will do anything to get the opioid and compromise other aspects of their life - that is where the problem is.
when used properly, addiction is rarely an issue for people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do we help with Emotional Pain?

A

Active listening
Being present
Relaxation interventions
Pharmacological management when appropriate
Mindfulness meditation/breathing
Use of humor (where appropriate)
Art therapy
Music therapy
Journaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do we help with social pain?

A

Encourage meaningful social connection
Include families in discussions
Reduce social isolation with the use of technology
Therapeutic touch
Pet therapy
Support for family caregiver
Encourage communication to heal damaged relationships

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do we help with spiritual pain?

A

A caring presence – from us and others
Facilitate connection to outdoors/nature
Give space for personal, spiritual and religious beliefs/rituals
Spiritual/pastoral care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a quick definition of emotional pain?

A

a subjective experience with negative thoughts and feelings because there are negative changes in the person’s self and their function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a quick definition of Physical pain?

A

it’s a sensory response to actual or potential tissue damage that is unpleasant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is a quick definition of social pain?

A

a subjective experience where person feels lack of social connection whether that be real or perceived.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is a quick definition of spiritual pain?

A

A threat of some kind - usually existential (purpose, meaning in life, relationships, higher power etc) . Closely tied to social pain

26
Q

What is the preferred route for physical pain management?

A

always PO (by mouth)

27
Q

What medication drug class is amitriptyline and what is one common side effect?

A

Antidepressant
Urinary retention

28
Q

What is the main side effect of morphine?

A

constipation

29
Q

What drug class is gabapentin and what is one main side effect?

A

Anticonvulsant
Dizziness

30
Q

What drug class is Ketamine and what is one common side effect?

A

NMDA antagonist
confusion

31
Q

What type of pain is Ketamine indicated in?

A

breakthrough pain

32
Q

What meds are used for Somatic pain?

A

NSAIDS
Opioids
Steroids

33
Q

What meds are used for Visceral pain?

A

NSAIDS
Opiods
steroids

34
Q

What meds are used for neuropathic pain?

A

Antidepressants
Anticonvulsants
Steroids
Local anethetics
Ketamine

35
Q

Do opioids work for neuropathic pain?

A

Only partially

36
Q

What is Acute pain ?

A
  1. well defined pattern and onset
  2. can be indentified usually
  3. activation of ANS (vitals)
  4. precipitating cause
  5. time limited

analgesics and treat the cause

37
Q

What is subacute pain?

A
  1. comes on over several days
  2. increases intensity

we can titrate appropriately

38
Q

What is episodic pain?

A
  1. occurs during defined periods of time & regular basis (called intermittent pain also)

usually movement/dressing changes

use analgesics prior to pain-provoking event

39
Q

What is chronic pain?

A
  1. persists more than 3 months
  2. ANS adapts - no signs in vitals

fatigue, depression, withdrawl, insomnia - all bad. want to die

40
Q

What is breakthrough pain?

A

Transient increase in pain to more than moderate intensity - based on their baseline

usually happens near end of dosing interval for reg. sched. meds

41
Q

What is incident pain?

A

Pain due to nurse or patient actions

changing/dressings

42
Q

What diseases are Acetaminophen (non-opioid) good for?

A

Renal disease
Stroke
CHF
Liver disease (low dose)

43
Q

What diseases are NSAIDS good for?

A

Stroke
ALS
Renal disease (time-limited use)

44
Q

What diseases is codeine good for (weak opioid) ?

A

HIV/AIDS (co-analgesics)
ALS
Moderate to severe pain W/Tylenol & Caffeine (T3)
Somatic pain

45
Q

What diseases is morphine good for?

A

Liver disease
HIV/AIDS
Somatic pain
Neuropathic (some)

46
Q

What diseases is hydromorphone good for?

A

CHF
HIV/AIDS
Liver disease
ESRD
Somatic pain
Neuropathic (some)

47
Q

What diseases does fentanyl help with?

A

HIV/AIDS
CHF
Liver disease
ESRD
Somatic pain
Neuropathic (some)

48
Q

What are the 4 adjuvant analgesics ?

A
  1. Tri-cyclic antidepressants
  2. anticonvulsants
  3. NMDA (excitatory receptor) antagonists
  4. Corticosteroids
49
Q

What is an example of a non-pharmacological intervention related to rehabilitative?

A

Physiotherapy

50
Q

What is an example of a non-pharmacological intervention related to Psychological?

A

Psychoeducational and CBT

51
Q

What is an example of a non-pharmacological intervention related to Integrative?

A

Massage

52
Q

For opioid side effects what is the managment of constipation?

A
  1. laxative
  2. disimpaction
53
Q

For opioid side effects what is the managment of sedation?

A

Keep patient safe from falls

54
Q

For opioid side effects what is the managment of confusion/delirium?

A

Keep patient safe
ensure delirium isn’t from another cause

55
Q

For opioid side effects what is the managment of N & V?

A

antiemetics

56
Q

For opioid side effects what is the managment of multifocal myoclonus?

A

seizure meds

57
Q

For opioid side effects what is the managment of Opioid-induced hyperalgesia?

A

Rest

58
Q

For opioid side effects what is the management of urinary retention?

A

Monitor I &O
encourage fluids

59
Q

For opioid side effects what is the management of pruritus?

A

benadryl
cold compress
slapping method
treat scabs

60
Q

For opioid side effects what is the management of Respiratory depression?

A

Watch RR and O2 sats
give naloxone if serious to reverse opioid effect

NURS 3510 Palliative (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions