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Professional Nursing

Transduction: is the conversion of painful stimuli to an electrical impulse through peripheral nerve fibers (nociceptors).
Transmission: occurs as the electrical impulse travels along the nerve fibers and is regulated by neurotransmitters.
Pain Threshold: is the point at which a person feels pain.
Pain Tolerance: is the amount of pain a person is willing to bear.
Nociceptive Pain: arises from damage to or inflammation of tissue. Three types (cutaneous, somatic, visceral)
Cutaneous: (papercut) in the skin or subcutaneous tissue.
Somatic: (bone, joint pain) in bones, joints, muscles, skin, or connective tissue.
Visceral: (organ pain) in internal organs such as the stomach or intestines.
Neuropathic Pain: arises from abnormal or damaged pain nerves. It includes phantom limb pain, pain below. Pain is intense, shooting, burning, or described as "pins and needles."
Psychogenic Pain: pain that results from a mental event can be just as intense as pain that results from a physical event.
Physical Pain: cause of pain can be identified.
Psychogenic: cause of pain cannot be identified.
Referred Pain: pain is perceived in an area distant from its point of origin.
Phantom Limb Pain = Neuropathic
Referred Pain: Visceral
Fracture Pain: Somatic
Burning, "pins and needles" pain: Neuropathic
Sharp, aching pain: Somatic
Transduction: activation of pain receptors.
Transmission: conduction along pathways (A-delta and C-delta fibers)
Modulation: initiation of the protective reflex response. pain reflex causes muscle contraction and movement away from pain source.
Perception of Pain: awareness of the characteristics of pain. (how you perceive pain)
Stimulators of Nociceptors or Pain Receptors: Bradykinin, prostaglandins, substance P
Gate Control Theory of Pain: relationship between pain and emotions, small and large diameter nerve fibers conduct and inhibit pain stimuli, gating mechanism determine impulses that reach the brain.
Gate Theory: (cant take in too much at once) small diameter nerve fibers - pain stimuli toward the brain. Large diameter nerve fibers inhibit the transmission. A gating mechanism located in substantia gelatinosa cells in the dorsal horn of the spinal cord. The gate controls what reaches the brain.
Perception of Pain: pain threshold, adaptation, modulation of pain - neuromodulators, endorphins, dynorphins, enkephalins
Endorphins: released when certain measures are used to relieve pain produced at neural synapses powerful pain-blocking chemicals that have prolonged analgesic effects and produce euphoria.
Dynorphin: released when certain measures are used to relieve pain the endorphin which has the most potent analgesic effect.
Enkephalins: considered less potent than endorphins. Inhibit release of substance P. Are thought to reduce pain by inhibiting the release of substance P from the terminals of afferent neurons.
Behavioral (Voluntary Responses): moving away from painful stimuli, grimacing, moaning, and crying (emotions), restlessness, protecting the painful area and refusing to move.
Physiologic (Involuntary) Responses: Typical Sympathetic Responses When Pain is Moderate and Superficial: Increased blood pressure, increased pulse and respiratory rates, pupil dilation, muscle tension and rigidity, pallor (peripheral vasoconstriction), increased adrenaline output, increased blood glucose.
Physiologic (Involuntary) Responses: Typical Parasympathetic Responses When Pain is Severe and Deep: Nausea, and vomiting, fainting or unconsciousness, decreased blood pressure, decreased pulse rate, prostration, rapid and irregular breathing.
Affective (Psychological) Responses: exaggerated weeping and restlessness, withdrawal, stoicism, anxiety, depression, fear, anger anorexia, fatigue, hopelessness, powerlessness
Assessment Parameters for Pain: Psychological, Emotional, Sociologic, Physiologic
Psychological: patient perceives pain as worse than it is.
Emotional: patient is crying - pain medication does not relieve pain because of intense emotions.
Sociologic: patient cannot afford hospital visit, does not have insurance and therefore is treated late.
Physiologic: can the pain be treated
Pain Assessment Tools: McGill-Melzack pain questionnaire, Pain scale, McCaggery method, WILDA pain measurement scale
Wong-Baker FACES: pain rating scale that asks children to compare their pain to a series of faces ranging from a broad smile to a tearful grimace. This scale is visual and easy to interpret for young children and for older adults.
WILDA Scale: W=words that describe pain, I=intensity of pain, L=location of pain, D=duration of pain, A=aggravating or alleviating factors.
Manipulating Pain Experience Factors: remove or alter cause of pain, alter factors affecting pain tolerance, initiate nonpharmacologic relief measures.
Nonpharmacologic Pain Relief Measures: distraction, humor, music, imagery, relaxation, cutaneous stimulation, acupuncture, hypnosis, biofeedback, therapeutic touch.
Pharmacologic Pain Relief Measures: analgesic administration, non-opioid analgesics, opioids or narcotic analgesics, adjuvant drugs.
Pain Management Regimens for Cancer or Chronic Pain: give medications orally if possible, administer medications ATC rather than prn, adjust the dose to achieve maximum benefit with minimum side effects, allow patients as much control as possible over the regimen.
Created by: mr209368