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med surg pain manage
| Question | Answer |
|---|---|
| What are the two subdivisions of nociceptive pain | somatic and visceral |
| what is speculated to be released with some non-drug methods of pain relief such as endorphins and enkephalins with your natural morphine like substances in the body that modulate pain transmission by blocking receptors for substance P | GABA |
| What is a pain management technique that delivers bursts of electricity to the skin and underline nerves | tens |
| what is a discomfort that has a short duration from a few seconds to less than 6 months that is associated with tissue trauma or some other recent identifiable etiology | acute pain |
| what meals may help maximize intake in clients with drug related or pain related anorexia | small frequent |
| the conscious experience of discomfort | perception |
| the point at which the pain transmitting neurochemicals reach the brain causing conscious awareness | pain threshold |
| discomfort that lasts longer than 6 months | chronic pain |
| the amount of pain a person in doors after the threshold has been reached | pain tolerance |
| a term used to describe discomfort that is perceived in the general area of the body but not in the exact site where an organ atatomically located | Referred pain |
| the face during which peripheral nerve fibers from synapses with neurons in the spinal cord the pain impulses moved from the spinal cord to subsequently higher levels in the brain | transmission |
| the phase of pain impulse transmission during which the brain interacts with the spinal nerves in a downward fashion to alter the pain experience | modulation |
| the conversion of chemical information in the cellular environment to electrical impulses that moved to ward the spinal cord this phase is initiated by cellular disruption during which affected cells release various chemical mediators | transduction |
| the face of impulse transmission during which the brain experiences pain at a conscious level | perception |
| why is the Wong Baker faces scale assessment tool best for specific types of clients | if easier for children and cognitively impaired people or people from other cultures |
| why is risk for injury a concern for the client who is receiving narcotic analgesics | the danger is loss of consciousness safety is the biggest so always ambulate |
| why do older adults avoid taking opioid medication | for fear of addiction and also fear of constipation |
| why do some nurses fear giving larger doses of narcotic analgesics when the client experience is tolerance | falsely labeled addictive fear of respiratory issues |
| why are drugs that are known to cause physical dependence discontinued gradually | to avoid withdrawal symptoms |
| a client requires an increased amount of opioid analgesic to achieve pain relief and fears addiction how would the nurse explain the difference between addiction and tolerance | addicted people do not use opioids for paying the using to get high tolerance is the body getting used to the medication so that you need more only about 1% of people that are using the narcotics for pain will wind up addicted |
| what are the Joint Commission standards on pain assessment and pain management | Assess on admission use the tools and respect client choices |
| Identify nursing responsibilities for pain management | comprehensive assessment on administration provide alternative pain methods |
| identify non-drug interventions used to help manage pain | heat and cold acupuncture Pen ten |
| Why do people with acute pain cope better than people with chronic pain | pain diminishes with healing |
| what is an essential action by the nurse throughout care when dealing with pain | Giving asurance that pain management is a nursing and agency priority |
| when a client is receiving frequent administration of anOpiate what is most important for the nurse to closely monitor | respiratory rate |
| To achieve a similar level of pain relief what is the nurses most accurate understanding when a parental dose of an analgesic is switched to an oral form | To achieve a similar level of pain relief what is the nurses most accurate understanding when a parental dose of an analgesic is switched to an oral form the oral dose will be higher than the parental those |
| When non-steroidal anti-inflammatory drugs NSAIDs is prescribed for an older adult what teaching is most appropriate for the nurse to provide | Take the medication when eating food |
| What is the nursing standard performing a pain assessment | Perform a pain assessment when vitals are taken |
| what is the appropriate assessment tool to use when accessing the pain of a pediatric client | Wong Baker faces scale |
| the nurse is correct in identifying which of the following client at greatest risk for an adverse effect when administering opioid analgesia | but client with chronic obstructive lung disease |
| the following are nonverbal behaviors that suggest to the nurse that a client is in pain | eating poorly Moan frequently emotionally irritable resists repositioning |
| The emotional component of pain is | suffering |
| noxious stimuli that are transmitted from the point of cellular injury / peripheral sensory nerves to pathways between the spinal cord and thalamus and from the thalamus to the cerebral cortex of the brain | nociceptive pain |
| Nociceptive pain is divided into two divisions | somatic and visceral |
| Caused by mechanical chemical thermal or electrical injuries or disorders affecting bones joints muscles skin and other structures composed of connective tissue | somatic pain |
| insect bite or papercut perceived as sharp or burning discomfort falls under somatic pain | superficial somatic pain |
| this is caused by trauma produces sensations that are sharp throbbing and intense dull aching diffuse discomfort with long-term disorders such as arthritis | deeper somatic pain |
| this pain arises from internal organs such as the heart kidneys and intestines that are deceived or injured | visceral pain |
| Discomfort in a general area of the body but not in the exact site where the organ is located an example would be in MI pain goes down the arm | referred pain |
| pain processed abnormally by the nervous system | neuropathic pain often described as pins and needles |
| phantom limb pain spinal cord injuries strokes diabetes and herpes zoster are all examples of | neuropathic pain |
| cancer pain can be either | nociceptive or neuropathic |
| what kind of pain is less than 6 months and has a purpose | acute pain its protective |
| these carry pain impulses rapidly get sharp acute initial pain a type of nociceptors | a delta fibers |
| this type of nociceptors throbbing aching or burning after initial pain | C fibers |
| chemicals that increased pain transmission | Substance P prostaglandin bradykinin histamine |
| chemicals that decrease pain transmission | serotonin endorphins |
| NSAIDs inhibit | prostaglandins |
| the four phases of pain transmission | transduction transmission perception modulation |
| conversion of chemical information in this cellular environment to electrical impulses that move to ward the spinal cord initiated by cellular distribution | transduction |
| specialized pain receptors located in the free nerve endings of peripheral sensory nerves | nociceptors |
| peripheral nerve fibers form synapses is with neurons in the spinal cord impulses moved from the spinal cord to the brain | transmission |
| brain experiences pain at a conscious level locate Spain its intensity and what it means and gives emotional response | perception |
| under perception the point at which the pain transmitting neurochemicals reach the brain causing conscious awareness | pain threshold |
| decreased pain threshold pain signals are intensified | hyperalgesia |
| under perception the amount of pain a person and doors once the threshold has been reached | pain tolerance |
| variables to pain tolerance | age gender fatigue culture anticipatory fear |
| the action of pulling the finger back the brain transmits a response down the spinal nerves to the point where the pain transmission originated to alter the pain experience causes muscle to contract reflectively moving the body away from the pain stimuli | modulation |
| endogenous opioids neurochemical painful sensation is reduced | serotonin endorphins |
| patients have the right to adequate assessment and management of pain nurses are accountable for the assessment of pain the nurse's role is that of an | advocate and educator for effective pain management |
| pain is v | vital signs |
| pain is | whatever the patient says it is it is a private thing the patient is the only reliable source for quantifying pain |
| aggravated pain response | allodynia |
| vital signs acute pain will temporarily increase blood pressure pulse respirations but will eventually | levelized so not an accurate indicator of pain |
| pain assessment tools quantify pain intensity these are objective | numeric scale word scale linear scale faces scale |
| this assessment tool is for pediatric people of different cultures and the mentally challenged | Wong Baker faces scale |
| a technique for pain management blocking brain | opioids |
| Interrupting transmitting chemicals | Interrupting pain by giving NSAIDs to interrupt transmitting chemicals |
| An example of this would be given an opioid and a non opioid for pain management | combining analgesics |
| another pain management technique is to substitute | sensory stimuli and altering pain transmission |
| What does the World Health Organization recommend | a three-tier approach for pain management |
| A narcotic that interfere with pain perception centrally at the brain used for moderate severe pain as in post op mi and cancer pain | opioids |
| examples of opioids | oxycodone morphine sulfate fentanyl and codeine |
| Opioid side effects | sedation nausea vomiting constipation respiratory depression Brady Pena urinary retention hypotension and physical dependence |
| Opioid contraindications and precautions | lactation pregnancy patients with head injury CNS depression COPD liver and kidney disease use with caution with elderly children suicidal patients and those with addiction issues |
| Opioid nursing considerations | have narcan on hand naloxone monitor respiratory rate don't administer a respiratory is less than 12 per minute encourage TcdB turn Cough and take a deep breath to prevent collapsed or partially collapsed lung |
| more nursing considerations for opioids | monitor bowel activity you stool softeners laxative and animals when necessary monitor for urinary retention eyes a nose bladder distention may need to capitalize maintain safety bed and low position called lighting reach |
| And nursing consideration for Duragesic fentanyl | patches need changed every 72 hours |
| Nursing consideration for meperidine Demerol | Use minimal amount restrict use to 48 hours not recommended for older adults |
| this IV opioid is frequently given post Op | Duragesic fentanyl |
| not narcotics alternar o transmission at the peripheral level or the side of injury used for mild to moderate pain acetaminophen NSAIDs ibuprofen and stalactites | non opioid analgesics |
| non opioid analgesic side effects | nausea gastritis increased bleeding time GI bleeding rash liver toxicity especially with acetaminophen tinnitus decreased hearing especially aspirin |
| non opioid analgesic contraindications and precautions | select equal asthma bleeding disorders lactation and pregnancy vitamin K deficiency acetaminophen equals alcohol abuse liver disease and now malnutrition NSAIDs equals active GI bleed CV disease liver disease pregnancy ulcers in renal disease |
| nursing considerations non opioid analgesics | antidote is Acetylcysteine Mucomyst administer with food to protect gi inform of side effects Kush and patient only use one inside at a time report any bruising or bleeding |
| these enhance the effects of non opioids help alleviate other symptoms that aggravate pain like depression seizures and information and are useful treatment of neuropathic pain | adjuvant analgesics |
| examples of adjuvant analgesics | anticonvulsant like Carcamazepine tegretol anti-anxiety agents like diazepam valium tricyclic antidepressants like any triptyline elavil antihistamines like hydroxyzine vistaril |
| Routes of pain medication administration | Analgesic drugs oral rectal transdermal or parental patient controlled analgesia PCA inter spinal intrathecal analgesia |
| The oral dosage that provides same pain relief as the IV med is called | Equianalgesic |
| relieving intractable pain experienced by dying client this aims to administer the date of med at the minimum dose is necessary to decrease consciousness and relieve the pain | palliative sedation client and family included in decision 24 hour wait one to two nurses are available at clients bed side at all times and physician must be Assessablethroughout administration |
| repetitive pattern of drug seeking and drug use to satisfy a craving for a drug's mind-altering or mood-altering affects fewer than 1% of clients who need drugs for pain relief ever reach this | addiction |
| Performing a comprehensive assessment of each client's pain on admission determined | Onset quality intensity location and duration of pain |
| Joint Commission administration of analgesics every 3 hours rather than | PRN |
| acknowledge patients pain in respond | quickly |
| collaborating with the client and informing of pain relief options assist patients pain goals including the patient in pain interventions gives the patient a sense of control which contributes to achieving |
Created by:
bekaleyce