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Nature of pain: Only the client knows Subjective,highly individualized
Pain is the leading cause of: disability
The Joint Commission standard requires that pain be assessed on a regular basis; has become known as.. 5th vital sign
Cellular damage causes the release of neurotransmitters (3 types) thermal, mechanical,chemical
Neurotransmitters Prostagladins, bradykinin,potassium, histamine, substance P
Neurotransmitters surround the pain fibers, spreading the pain message and causing an: inflammatory response
How do nerve impluses travel? along the afferent (sensory) nerve fibers to the spinal cord
Pain impulses ascend the spinal cord to the: thalamus
The thalamus transmits the pain information to: higher brain centers that perceive pain
2 types of sensory nerves fibers: A Delta fibers and C fibers
A Delta Fibers Fast myelinated: send sharp, localized, distinct sensations (Sharp)
C Fibers Slow, smal, unmyelinated: send poorly localized, burning, persistant pain (chronic)
Conversion of stimulus into electical energy (thermal, mechanical, Chemical) Transduction
Sending of impluse across a sensory pain nerve fiber (nociceptor) Transmission
The patient's experience of pain Perception
Inhibition of pain/release of inhibitory neurtransmitters Modulation
Pain has emotional and cognitive components, in addition to: a physical sensation
Gating mechanisms in the CNs: regulate/block pain impluses
The basis for nonpharmacological pain relief interventions Closing the gate
Motor impulse is controled by: Motor neuron
Sensory impluse is controlled by: Sensory neuron
Types of Pain: Protective, identifiable, short duration; limited emotional response Acute/Transient pain (threat unless realeaved)
Types of Pain: Is not protective, has no purpose, may or may not have an identifiable cause Chronic/persistent (non cancer)
Types of Pain: Occurs sporadically over an extended duration Chronic episode (GERD, migraine, sickle cell)
Types of Pain: can be acute or chronic Cancer
Types of Pain: Musculoskeletal, visceal or neuropathic Inferred pathological (bone, joint, muscle aching)
Types of Pain: Chronic pain without identifiable physical or psycholgical cause Idiopathic (complex regional pain center- physical/psychological)
Approach to pain "A" Ask about the pain regularly, be systematic
Approach to pain "B" Beleive the patient and family
Approach to pain "c" Choose pain control options appropriate for the patient
Approach to pain "d" Deliver interventions in a timely manner
Approach to pain "e" Empower patient and their families to control their pain and course of action
Nursing Assessment: Patients expression of pain, characteristics, onset and duration, location, intensity/severity (0-10), quality/description, pattern
Nonpharmological interventions: relaxation/guided imagery, distraction, music, cutaneous stimulation, herbals, reducing pain perception
what do you need a physician order for? Heat/Cold, TENS, Meds, herbal
Analgesic acute pain management: narcotics (Opiods), non-narcotics (non opiods), Anjuvants/coanalgesics (combo drugs)
Delivery systems of pharmacological pain control: PCA, Local/regional analgesics (edpideral), topical agens/transdermal patches (lidocaine)
Fentanyl patch: For cancer patients, lowers respiratory rate, lasts 48-72hrs, 100x more potent than morphine. Causes drowsiness, constipation
What is the antidote for a narcotic OD? Narcan
Barriers to effective pain management... Physical dependence, addiction, drug tolerance, placebos, jaded RN, family, bais experience
Goal of pallative care: to learn how to live life fully with an incurable condition
Hospice programs for end-of-life care
ANA support aggresive treatment of pain and suffering
Evaluating the appropriateness of pain medication will require nurses to: evaluate clients 15-30mins ager administration
Created by: aeponton
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