Week 6 - Pain Flashcards
Define pain in healthcare.
Pain is a subjective experience influenced by physical and emotional factors.
Define ‘nociceptive pain’ and provide examples.
Nociceptive pain arises from tissue damage, such as muscle or joint pain.
What are the physiological dimensions of pain transmission?
Pain transmission involves stimuli activating sensory neurons, leading to pain perception.
Explain the role of bradykinin and histamines in pain response.
Bradykinin stimulates sensory neurons; histamines increase blood flow and inflammation.
How can nociceptive pain be categorized?
Nociceptive pain is categorized as somatic (localized) or visceral (poorly localized).
Describe characteristics of acute pain.
Acute pain has a sudden onset and varies in intensity.
How is pain intensity measured?
Pain intensity is measured using scales tailored to the patient’s age and understanding.
Define ‘referred pain’.
Referred pain is felt in a different location from its source.
What are the two main types of pain based on duration?
Acute pain and persistent (chronic) pain.
Explain the OPQRSTUV method in pain assessment.
It assesses pain through Onset, Palliate/Provoke, Quality, Region, Severity, Treatment, Understanding, and Values.
Identify qualities of neuropathic pain.
Neuropathic pain is described as burning, cold, or stabbing.
How to evaluate pain relief effectiveness?
Monitor the patient’s pain rating and their request for more analgesia.
Define safety evaluation in pain management.
Safety evaluation monitors complications like respiratory depression and checks SpO2 levels.
What education should be provided regarding pain management?
Educate about side effects, interactions, and the importance of managing pain with a doctor.
How to ensure effective pain relief delivery?
Ensure proper landmarking for absorption and appropriate needle sizes.
What follow-up action after pain relief medication?
Assess the patient’s pain level and document their response.
Describe neuroaugmentation and its use.
Neuroaugmentation uses electrical stimulation for chronic back pain.
How do nerve blocks function?
Nerve blocks interrupt transmission, providing pain relief.
Define neuroablation and its purpose.
Neuroablation destroys nerves to stop pain transmission.
What age-related considerations for pain management?
Older adults often have inadequate pain assessment and treatment.
Identify treatment cautions for advanced age.
Cautions include slower drug metabolism and increased risk of adverse effects.
Explain the nurse’s role as an advocate in pain management.
Nurses advocate for better pain relief management for patients.
Describe acute pain after surgery.
This is referred to as breakthrough pain.
How to administer analgesics post-surgery?
Administer analgesics around-the-clock to control pain.
Define equianalgesic dose.
An equianalgesic dose provides equivalent pain relief to another analgesic.
Importance of fast-acting analgesia.
Fast-acting analgesia controls pain before it starts.
Strategy for managing post-surgical pain.
Focus on prevention or control of pain rather than reactivity.
Potential issues with equianalgesic dosing.
Equianalgesic doses may be ineffective or cause intolerable effects.
Benefits of topical administration routes.
Topical routes provide localized treatment and minimize systemic side effects.
Define ‘analgesic ladder’.
The analgesic ladder is a stepwise approach to pain management.
Parenteral vs enteral routes of administration.
Parenteral routes allow faster absorption than enteral routes.
Goal of pain management.
Achieve the most effective route for pain relief.
Role of adjuvants in pain management.
Adjuvants enhance pain relief at any stage of the analgesic ladder.
Original purpose of the analgesic ladder.
Designed for managing cancer-related pain.
Role of adjuvants in pain management.
Adjuvants enhance pain therapy alongside opioids and nonopioids.
How do cognitive techniques help in pain management?
Cognitive techniques alter pain perception and reduce stress.
Define nonpharmacological therapy for pain.
Includes methods like massage and TENS to reduce pain without medications.
Examples of nonpharmacological pain management techniques.
Massage, TENS, heat, and cold application.
How do adjuvant medications enhance pain therapy?
They increase effectiveness or mitigate side effects of analgesics.
Types of medications considered adjuvants.
Antidepressants and anticonvulsants can help manage pain.
Describe drug tolerance in pain management.
Drug tolerance requires higher doses for the same pain control.
Response to physical dependence on medication.
Taper medication gradually to avoid withdrawal symptoms.
Define addiction in substance use.
Addiction is a chronic disease characterized by compulsive drug use.
Key characteristics of addiction.
Impaired control, compulsive use, and cravings.
Difference between drug tolerance and addiction.
Tolerance is needing higher doses; addiction is compulsive use.
Identify ethical issues in pain management.
Includes fears of hastening death and use of placebos.
Intervention for hospice patient with severe pain.
Administer prescribed morphine dose for pain relief.
Nurse’s response to post-operative patient with low respiratory rate.
Evaluate pain management needs before administering more morphine.
Define Principle of Double Effect in pain management.
Ethical justification for treatments with both positive and negative effects.
Role of NSAIDs in hospice pain management.
NSAIDs improve pain control but may not be first choice for severe pain.
Do deep breathing and coughing exercises help respiratory rates?
Yes, but may not be suitable for patients in severe pain.
Importance of monitoring respiratory rates with morphine.
Crucial due to risk of respiratory depression.
Therapeutic class of acetaminophen (Tylenol).
Non-opioid analgesic and antipyretic.
Pharmacologic class of ibuprofen (Advil).
Non-steroidal anti-inflammatory drug (NSAID).
How is naloxone (Narcan) used?
Naloxone is an opioid antagonist for reversing overdose effects.
Primary use of ondansetron (Zofran).
Antiemetic to prevent nausea and vomiting.
Caution with acetaminophen (Tylenol).
Risk of hepatotoxicity in liver disease or alcohol use.
Maximum daily dosage of ibuprofen (Advil) for adults.
Less than 4 grams per day.
Pharmacokinetics of morphine administration.
IV morphine has consistent absorption; IM/SQ varies.
Therapeutic class of naloxone.
Opioid antidote.
How does naloxone work?
Naloxone blocks opioid receptors without activating them.
Cautions with morphine use.
Includes respiratory depression and hypotension risks.
Effects of activating Mu receptor with opioids.
Leads to analgesia, sedation, and respiratory depression.
Potential effects of Kappa receptor activation.
Can cause dysphoria, sedation, and hallucinations.
Therapeutic class of ondansetron.
Antiemetics.
How does gabapentin function in epilepsy?
Reduces abnormal electrical activity in the brain.
Primary use of lidocaine.
Local anesthetic to block pain signals.
Significance of EMLA before a procedure.
EMLA numbs the area before venipuncture or incision.
Role of gabapentin in alcohol withdrawal.
Calms the brain, reducing anxiety and cravings.
Use of intravenous lidocaine in pain management.
For neuropathic and postoperative pain management.
Nurse’s response to patient on Tramacet with insufficient pain control.
Advise the doctor about inadequate pain control.
Nurse’s education for client prescribed Tylenol #3.
Avoid alcohol and operating machinery.
Monitor changes after hydromorphone IV administration.
Anticipate changes in pain rating and respiratory rate.
Recommended frequency for Tylenol #3.
Two tablets every 4 to 6 hours as needed.
Importance of monitoring INR for certain medications.
To prevent complications, monitor INR annually.
Key consideration for assessing a patient after pain medication.
Assess the patient’s respiratory rate.
Legal aspects of cannabis administration in hospitals.
Understand regulations for medical cannabis use.
Scope of practice for registered nurses and cannabis.
Includes administration of cannabis in compliance with regulations.
Role of CPNS nurses in cannabis administration.
Manage legal aspects and ensure patient safety.
Need for healthcare professionals to know cannabis regulations.
To ensure legal compliance and patient safety.
Dimensions of pain.
Pain includes sensory, emotional, cognitive, and behavioral aspects.
Acute vs chronic pain.
Acute pain is short-term; chronic pain persists.
Importance of pain assessment.
Guides treatment decisions and understanding patient experience.
Lifespan and intersectionality in pain management.
Age, gender, and culture affect pain experiences.
Drugs used in pain management.
Includes NSAIDs, opioids, acetaminophen, and adjuvants.
Consequences of untreated pain.
Leads to suffering, dysfunction, and impaired recovery.
Misconceptions about pain and treatment.
Can result in inadequate pain assessment and treatment.
Reasons patients may underreport pain.
Fear of addiction, belief pain is inevitable, and desire to be a ‘good’ patient.
Nurse’s role in pain management.
Educate patients and assess pain effectively.
Impact of untreated pain on recovery.
Delays healing and rehabilitation.
Biopsychosocial effects of pain.
Affects emotional well-being and social interactions.
Alternative pain scales for non-verbal patients.
Use scales like the Face scale and CPOT.
Utilization of the CPOT scale.
Used in ICUs for non-verbal pain assessment.
Behavioral indicators for assessing pain in cognitively impaired patients.
Includes vocalizations and facial expressions.
Key indicators of pain in non-verbal patients.
Vocalizations, facial expressions, and body movements.
Do pain scales differ for cognitively impaired patients?
Yes, based on observable behaviors rather than self-report.
Importance of assessing pain in non-verbal patients.
Crucial for providing appropriate care and comfort.
Two main types of pain and their characteristics.
Nociceptive pain is from tissue damage; neuropathic pain is from nerve damage.
Function of the thalamus in pain perception.
The thalamus relays and interprets pain information.
