Week 6 Flashcards
What is an example of acute pain?
sprained ankle
What is an example of chronic pain?
arthritis
What does it mean when pain is classified according to its etiology?
classified according to its cause
What is nociceptive pain?
Initiated by nociceptors that are activated by actual or threatened damage to the peripheral tissue and is representative of the normal pain process
What is cutaneous pain?
Superficial pain usually involving the skin or subcutaneous tissue
An example is a paper cut
What is somatic pain?
Diffuse or scattered
originates in tendons, ligaments, bones, blood, vessels, and nerves
Strong pressure on a bone or damage to tissue that occurs with a sprain causes somatic pain
What is visceral pain?
AKA splanchnic pain
poorly localized
originates in body organs in the thorax, cranium, and abdomen
One of the most common types of pain produced by disease
occurs as organs stretch abnormally and become distended, ischemic, or inflamed
What is neuropathic pain?
Pain caused by a lesion or disease of the peripheral or central nerves
Described as burning, electric, tingling, or stabbing
What is transduction?
the activation of pain receptors
What is transmission?
conduction along pathways (A-delta and C-delta fibers)
What is perception of pain?
awareness of the characteristics of pain
What is modulation?
inhibition or modification of pain
What is bradykinin?
a powerful vasodilator that increases capillary permeability and constricts smooth muscle
What are prostaglandins?
important hormone-like substances that send additional pain stimuli to the CNS
What is Substance P?
sensitizes receptors on nerves to feel pain and also increases the rate of firing nerves
What is the gate control theory of pain?
describes the transmission of painful stimuli and recognizes a relationship between pain and emotions
small and large diameter nerve fibers conduct and inhibit pain stimuli toward the brain
Gating mechanism determines the impulses that reach the brain
What are physiologic responses to pain?
Decreased BP
muscle tension and rigidity
increased RR
What are behavioral responses to pain?
moving away from painful stimuli
grimacing, moaning, and crying
restlessness
protecting the painful area and refusing to move
What are affective (psychological) responses to pain?
withdrawal
stoicism
anger
depression
fatigue
hopelessness
What affects modulation of pain
Neuromodulators- opioid chemical regulators that appear to have analgesic activity and alter pain perception
Endorphins, dynorphins, and enkephalins
What are endorphins and dynorphins?
Pain blocking chemicals that have prolonged analgesic effects and produce euphoria
May be released when certain measures are used to relieve pain, such as skin stimulation and relaxation techniques, and when certain pain-relieving drugs are used
What are enkephalins?
thought to reduce pain sensation by inhibiting the release of substance P from the terminals of afferent neurons
What are nociceptors?
peripheral nerve fibers that transmit pain
What is the pathway of pain sensation and relief?
nerve endings in burned finger
pain reaches dorsal horn
travels to thalamus then to cerebral cortex then to spinal cord
endorphins block pain
What are general assessments of pain?
-pt’s verbalization and description of pain
-duration of pain
-location of pain
-quantity and intensity of pain
-quality of pain
-chronology of pain
-aggravating and alleviating factors
-physiologic indicators of pain
-behavioral responses
-effect of pain on activities and lifestyle
What is the WONG-Baker FACES tool?
pain scale that uses a series of faces to rate pain
used on children above 3 years old
What is the Beyer Oucher pain scale?
0-100 scale with 6 photographic images of children in pain
useful for older children
What is the CRIES pain scale?
-Used on patients 0 to 6 months
Crying
Requires oxygen
increased vital signs
expression
sleepless
What is the FLACC scale?
Face
Legs
Activity
Cry
Consolability
Scale used from 2 months to 7 years in children who are nonverbal and don’t have expressive communication
How to diagnose pain?
-type of pain
-etiologic factors
-behavioral, physiologic, affective response
-other factors affecting pain process
How do you manipulate pain experience factors?
remove or alter cause of pain
alter factors affecting pain tolerance
initiate nonpharmacologic relief measures
What are examples of adjuvant drugs?
antidepressants
anticonvulsants
What is the WHO 3-step analgesic ladder?
1st step- nonopioid, adjuvant
2nd step- opioid for mild to moderate pain, nonopioid, adjuvant
3rd step- opioid for moderate to severe pain, nonopioid, adjuvant
What are pain management regimens for cancer or chronic pain?
give meds orally if possible
administer meds ATC rather than PRN
adjust the dose to achieve max benefit with minimal side effects
allow pts as much control as possible over the regimen
