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LCC nursing
jdannels LCC nursing unit 6 notes
| Question | Answer |
|---|---|
| Pain Threshold | the level of stimulus needed to produce the perception of pain |
| pain tolerance | the amount of pain a Pt can endure w/o it interfering with normal function |
| physical dependence | the physical adaptation of the body to the presence of an opiod or other substance |
| psychologic dependece(addiction) | a pattern of compulsive opiod use characterized by a continuous craving for the substance and the need to use it for effects other than pain relief |
| drug tolerance and drug dependence are | involontary behaviors that involve physiologic changes |
| drug abuse and drug addiction are | voluntary behaviors that invole active drug seeking |
| Pain is | whatever the person experiencing it says it is and exsits whenever they say it does. |
| physiology of pain | reception, perception, reaction |
| reception | transmission from nerve fibers to brain. A-delta fibers and C-fibers, transmit implulses from periphery to dorsal horn, substance P released |
| Protective Reflex Response | cause withdrawl from painful stimuli |
| Neurotransmitters | substance P, serotonin, prostaglandins |
| neuromodulators | endorphins and dynorphins, bradykinin |
| what decreases endorphins | prolonged stress, prolonged pain, alcohol |
| what increases endorphins | brief pain/stress, laughter, exercise, acupuncture, TENS, massive trauma, sexual activity |
| Gate control theroy | if the gate is closed pain cant travel to the brain. if the gate is open pain passes through to the brain. |
| what can open the gate | fear of pain, tissue damage, monotony |
| what can close the gate | massage, postion change, heat/cold, guided imagery, distraction |
| perception | point at which person is aware of the pain |
| reaction | physiological and behavioral |
| physiological reaction | react with fight or flight or PSNS or SNS |
| behavioral reaction | anticipatory, sensation, aftermath |
| acute and chronic pain can be | chronic malignant, chronic nonmalignant, and chronic intermittent pain |
| acute pain | short duration, usually well defined cause, decreases with healing, reversible, mild to severe, may be accomp. by anxiety. |
| chronic pain | usually greater than 3 months, may or may not have a defined cause, begins gradually/persists, exhausting and useless, mild to severe, may be accomp. by depression and fatigue. |
| somatic pain | skeletal muscle and joints |
| visceral | organs and smooth muscle |
| superficial | skin and muscous membranes |
| vascular | vascular tissue |
| referred | visceral nerve fibers |
| neuropathic | patho of damaged CNS |
| nocieptive | pain from chemical or noxious stimuli |
| somatic pain characteristics | sharp, aching, localized, throbing |
| viseral pain characteristics | dull cramping colicy |
| neuropathic pain characteristics | shooting buring electric like |
| factors influencing pain | age/gender, culture/religion, meaning of pain, attention, anxiety, fatigue, past experience, coping style, family and social support, NS integrity |
| Role of nurse | Pt advocate/attitude, establish trust and rapport, assess for/identify pain, coordinate/collaborate with team, educate self and others |
| assessment ABC's | ask, believe, choose, deliver, empower/enable |
| characteristics of pain | onset and duration, location, severity, quality, pain pattern |
| measures of pain relief | non-pharmacological and pharmacological |
| Gas exchange is either | neural or chemical |
| cardiac output | amount of blood ejected from left ventricle/min |
| stroke volume | amount of blood ejected form the ventricle with each contraction |
| factors affecting oxygenation | decrease o2 carrying capacity, decreased inspired o2 concentration, hypovolemia, increase metabolic rate, conditions that affect chest wall movement |
| alterations in cardiac function | disturbances in conduction, altered cardiac output, myocardial ischemia, left sided heart failure, right sided heart failure, impaired valvular function |
| alterations in respiratory fuctioning | hyperventilation, hypoventilation, hypoxia |
| developmental factors affecting oxygenation | premee infants, infants and toddlers, school age kids, young middle aged adults, older adults |
| lifestyle factors affecting oxygenation | nutrition, exercise, smoking, substance abuse, anxiety |
| assessment of oxygentation | risk factors, fatigue, pain, breathing patterns(dyspnea, orthopnea, wheezing)cough (productive), respiratory infections, medication use. |
| implementation of oxygenation | health promotions, acute care, restorative care. |
Created by:
jdannels
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