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PAIN & SKIN LEWIS

study guide for my test!

QuestionAnswer
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
Created by: 1359653975