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PAIN & SKIN LEWIS
study guide for my test!
| Question | Answer |
|---|---|
| Physiological signs of acute pain? | Increased HR, increase respiratory rate, increased BP, diaphoresis/pallor, anxiety, agitation, confusion, urine retention |
| Physiological signs of chronic pain? | Flat effect, decreased movement/activity, fatigue, withdrawal from others and social interaction, waxing and waning, anxiety and depression |
| referred pain | must consider when interpreting location of pain |
| Somatic pain | superficial or deep |
| superficial pain | skin, mucous membranes, subQ tissue sharp, burning, or prickly well localized ex) sunburn |
| deep pain | bone, joint, muscle, skin, or connective tissue deep, aching, or throbbing diffuse or radiating EX) arthritis, tendonitis, myofascial pain |
| neuropathic pain | arise from abnormal processing of stimuli by nervous system damage to peripheral nerve or structures in CNS numbing, hot-burning, shooting, stabbing, electric-shock like sudden, intense, short lived, lingering |
| causes of neuropathic pain? | trauma, inflammation, metabolic diseases, alcoholism, infections, tumors, toxins, neurological diseases |
| central pain | primary lesion or dysfunction in CNS ex) poststroke pain, pain with MS |
| Peripheral neuropathies | pain felt along the distribution of one or many peripheral nerves caused by damage to the nerve ex) diabetic neuropathy, trigmenial neuralgia, postherpetic neuralgia |
| differentiation pain | pain resulting from loss of afferent input ex) phantom limb pain, postmastectomy pain |
| sympathetically maintained pain | pain that persists secondary to sympathetic nervous system activity ex) phantom limb pain, complex regional pain syndromes |
| Complex regional pain syndrome | dramatic changes in color and temperature of the skin over the affected limb or body part intense burning pain, skin sensitivity, sweating and swelling |
| CRPS type 1 | triggered by tissue injury no underlying nerve damage |
| CRPS type 2 | diverse sympathetic dysfunction |
| Treatment for neuropathic pain | tricyclic antidepressants (Elavil, Pamelor, Norpramin) SNRIs (Effexor, Cymbaltha, Wellbutrin, Zyban) antiseizure drugs (Neurontin, Lyrica) A2 - adrenergic agonists (Catapres) NMDA (ketamine) |
| Visceral Pain | internal organs and lining of the body cavities cutaneous sites ex) appendicitis, pancreatitis, cancer affecting internal organs |
| stretching of hollow viscera in the intestines and bladder that occur from tumor involvement or obstruction produces? | intense cramping pain |
| types of visceral pain causes | surgical incision, broken bone, arthritis, pancreatitis, inflammatory bowel disease |
| Nociceptive pain treatment (somatic and visceral) | nonopiods (NSAIDs) and opiods |
| Phantom limb pain | deafferentiation pain - loss of afferent input secondary to either the peripheral nerve damage or CNS disease Sympathetically maintained pain - associated with dysregulation of the autonomic nervous system |
| chronic pain | severity and function is disproportionate to objective findings |
| acute pain | functions as a signal, warning person of potential or actual tissue damage |
| Chronic pain | longer than 3 months, persistent |
| chronic pain | disabling accompanied by anxiety and depression |
| acute pain leading to chronic pain | central sensitization |
| central sensitization | enhanced excitability of spinal neurons peripheral tissue damage or nerve injury some people experience pain from touch or tactile stimulation |
| similar to neuropathic pain | chronic pain |
| breakthrough pain | transient, moderate to severe pain that occurs in patients with otherwise controlled pain. typically with cancer pain |
| end-of-dose failure | breakthrough pain that occurs before the duration of pain relief that is expected |
| acute pain treatment | analgesics for symptom control and treatment of the underlying cause |
| acute pain to chronic pain example | pain associated with herpes zoster subsides as the acute infection resolves, usually within a month. However, sometimes the pain persists and develops into a chronic pain state called postherpetic neuralgia |
| Early response withdrawal symptoms (6-12 hrs) | anxiety, lacrimation, rhinorrhea, diaphoresis, yawning, piloerection, shaking chills, dilated pupils, anorexia, tremors |
| Late response withdrawal symptoms (48-72 hrs) | excitation, diarrhea, restlessness, fever, nausea/vomiting, abdominal cramping pain, hypertension, tachycadia, insomnia |
| ibuprofen (Motrin, Nuprin, Advil) | use lowest effective dose for shortest possible duration. Increase risk of GI adverse events may increase risk of serous CV thromotic events, MI and stroke |
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