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FUN 7 &16

Chapters 9, 17, 18, & 22

The body usually adapts to temp. of 59 F to 113 F and affects blood circulation because of what? Heat & Cold
What happens to people when their bodies temperature goes below 59 F? Experience pain and numbness
What happens to people when their bodies temperature goes above 113 F? Experience burning and pain
Who is more sensitive to cold and may need more covering to maintain warmth? Older adults/young children
What do you need to evaluate more frequently with hot/cold therapies with older adults/young children? Skin
Why are older adults more susceptible to burns/frost bite? Have a reduced sensitivity to pain
Explain benefits of heat therapy Causes vasodilation and increased blood flow to that area of the body, which brings more nutrients to that area and speeds healing.
What does heat therapy provide and to what areas of the body? Comfort; good for musculoskeletal, joint, and back pain
What happens if heat therapy application is extended over 1 hour? Causes decreased blood flow to the area and can cause damage to epithelial cells. Can also cause tenderness and blistering
Explain benefits of cold therapy Causes vasoconstriction, decreases swelling and pressure on nerves, and decreases pain
When is cold therapy used? Sprains, strains, and fractures
If cold therapy is left in place too long, what can it interfere with? Circulation which can cause tissue damage
What are adverse reactions to cold therapy? Numbness or pale skin
What are contraindications to heat/cold therapy? Do not use on abscessed tooth, appendix, etc., or with a confused or unconscious patient, open wounds, broken skin, or bleeding.
Who do you monitor closely with heat/cold therapy? Children, elderly, diabetics, and Peripheral Vascular Disease (PVD)
What are the types of heat/cold therapy? Hot, moist compress, warm soaks, paraffin bath, Aquathermia Pad, dry heat, and ice bags
What are the benefits of a hot, moist compress? Improves circulation, relieves edema, and consolidates exudate
How do you apply a warm soak? Immerse affected body part
Why is the aquathermia pad (K Pad, ) safer than heating pads? Precise temperature is set between 105-110 degrees. The warm water circulates thru-out for 20-30 minutes
What are examples of dry heat? Hot packs, electric heating pad, and hot water bottles (hot water bottles are never used in a hospital setting)
What is important to teach patients when using a heating pad? Never use a setting over medium
What are the benefits of using ice bags for cold therapy and what do you place between ice bag and patient? Reduce pain and edema; place a cloth
What are the different types of therapeutic baths? Cool water, warm water, hot water, sitz bath, complete bed bath, partial bed bath, medicated bath, and tepid sponge bath
Describe a cool water bath Relieves tension and can reduce body temperature, water temperature is 98.6 degrees
Describe a warm water bath Reduces muscle tension, water temperature is 109.4 degrees
Describe a hot water bath Relieves soreness and muscle spasms, water temperature ranges from 113 degrees - 115 degrees
Describe a sitz bath Cleanses and aids in reducing inflammation in perineal and anal areas. Duration of sitz bath is 20-30mins
What is orthostatic hypotension? When blood pressure drops very low and very fast when you stand up. Signs are dizziness or light headedness
What do you do if a patient experiences orthostatic hypotension? Stop bath and lay them back in bed
What is the temperature for a tepid sponge bath and what is it used for? 98.6 degrees; lowering body temperature
What are complimentary therapies used in addition to and who recommends them? Conventional treatment; patients health care provider
What do complimentary therapies compliment? Conventional treatment
What are examples of complimentary therapies? Exercise, massage, reflexology, prayer, biofeedback, creative therapies, guided imagery, acupuncture, acupressure, relaxation strategies, chiropractic therapy, therapeutic touch, and herbalism
What do complimentary therapies give to patients? More control
What may alternative therapies include the same of as complimentary therapies? Interventions
Alternative therapies frequently become the ___________ treatment modality that replaces traditional or conventional medicine Primary
Define allopathic Traditional medicine
Many alternative therapies do not _______________ with those therapies prescribed by a physician, but some have ____________ reactions Interfere; serious
What are the nursing interventions to alternatives therapies? Keep an open, non-judgmental attitude when obtaining health history. This allows patient to feel comfortable in providing all information about any therapies he/she is currently receiving
What is chiropractic therapy? Chiropractic doctor adjust the joints of the body through gentle manipulation to restore the area to proper alignment
What are acupuncture and acupressure therapies based on? Belief that there is a form of energy, or Qi (life force), that flows through the body along meridians (channels of energy)
What is acupuncture? Method of stimulating certain points on the body by insertion of special needles to modify the perception of pain, normalize physiologic functions, or treat/prevent disease
What is acupressure? Involves the use of gentle pressure at certain points on the body
Describe therapeutic massage Performed by trained professionals to manipulate soft tissues of the body and assist with healing
When is therapeutic massage contraindicated? When the patient has phlebitis, thrombosis, and infectious skin disease
What is aromatherapy? Pure essential oils produced from plants that are used to provide health benefits
What can essential oils be used for? Inhalation or applied topically
What does imagery therapy? The conscious mind creates mental images to evoke physical changes in the body, improve perceived well-being, and enhance self-awareness
What is relaxation therapy? State of generalized decreased cognitive, physiologic, or behavioral arousal
What can yoga do? Tone the muscles that balance all parts of the body, including internal organs, heart, lungs, glands, and nerves
What is one of the greatest challenges a nurse faces with a patient in pain? Providing comfort to the patient
Define comfort To give strength and hope, cheer, and to ease the grief or trouble of another
What is a vital role of a nurse to promote? Physical and psychological comfort to a patient
What are some of the factors that are a result of "lack of comfort"? Respiratory dysfunction, irritability, depression, and decreased GI motility
What is nature of pain? Complex, abstract, and a personal experience
Pain is what? Subjective
What is the nurses major role with a patient in pain? Conduct pain assessments
When does a nurse assess pain in a patient? During initial assessment and 30 mins after pain medications are given
What is the definition of pain? Unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
What is the ultimate goal of pain management? Provide pain relief and enable the patient to carry on with ADL in as comfortable manner as possible
What are the different types of pain? Mild, severe, chronic, acute, intermittent, intractable, burning, dull, sharp, precisely or poorly localized, and referred
Define acute pain Intense and typically short in duration (> 6mos)
What does acute pain flood the body with Epinephrine, which gives the person the "fight or flight" response
Define chronic pain Continuous or intermittent, can be as intense as acute pain. Is longer in duration (<6 mos)
Chronic pain does not serve as a warning sign for what? Tissue damage, may be due to damage that has already occurred
What is a patient with chronic pain as risk of developing? Low self-esteem, change in social identity, changes in role & social interaction, fatigue, sleep disturbances, and depression
Define the gate control theory Suggest that pain impulses can be regulated or even blocked by gating mechanisms located along the central nervous system
What happens with the brain in gate control? Can not acknowledge the pain while it is interpreting the other stimuli
What are the results of analgesia? Certain endorphins attach to opioid receptor sites in the brain and prevent the release of neurotransmitters, thereby inhibiting the transmission of pain impulses
Under TJC, healthcare providers are expected to be knowledgeable about what? Pain assessment & management, and facilities are expected to develop policies & procedures supporting the appropriate use of analgesics & other pain control therapies
What is the fifth vital sign? Pain
Why is pain included with other vital signs? Ensures that pain is monitored on a regular basis
What does appropriate pain management bring about? Quicker recoveries, shorter hospital stays, fewer readmissions, and improved quality of life
What are noninvasive pain relief techniques? TENS unit, distraction, relaxation, guided imagery, hypnosis, and biofeedback
What are invasive pain relief techniques? Nerve blocks, epidural analgesics, neurosurgical procedures, and acupuncture
What is the most widely & frequently used analgesic group? NSAIDS or non-opioids
What are examples of NSAIDS? Acetaminophen, aspirin, ibeprophen, and naproxen sodium
How do opioids work? Act on higher centers of the brain to modify perception and reaction to pain
What are examples of opioids? Morphine, codeine, and meperdine (Demerol)
What are adverse affects of opioids? Decreased respiratory rate, slow bowel motility, and decreased peristalsis
What percentage of patients actually become addicted to opioids? One
What are the administration routes for analgesics? Oral, IV, IM, PCA, and epidural
What is the route of choice for opioid analgesics after major surgery? IV
Why are opioid analgesics not given IM? Painful & traumatic for patients
What is the optimal opioid route for patients with chronic pain and why? Orally; because it is convenient, flexible, and helps keep relatively steady blood levels
When is oral pain medications appropriate to use and for what patients? As soon as the patient can tolerate oral intake; is the mainstay of pain management for ambulatory surgical patients
What is a PCA pump? Drug delivery system that allows patients to administer pain medication whenever needed
What are the requirements for a patient to have a PCA pump? Must be able alert, oriented, and able to follow simple directions
Why can't a patient over dose while using a PCA? It is on a timer
What is the responsibility of the nurse in pain control? Advocate for the patient by clarifying concerns, answering all questions, supplying all the information the patient needs to make decisions about care, and supporting the patients decisions
What are the two ways to collect data with regards to pain? Subjectively and Objectively
What are the subjective characteristics of pain? Assess site, severity, duration, and location of pain. Ask the patient what relieves the pain, what makes it worse, and identify usual coping mechanisms
What are the objective characteristics of pain? Tachycardia, increased rate & depth of respirations, diaphoresis (sweating), increased systolic/diastolic BP, pallor, dilated pupils, increased muscle tension, nausea, and weakness
What are the physical signs that a patient may be in pain? Changes in facial expressions, gritting teeth, clenched fist, withdrawal, crying, moaning, or tossing in bed, fetal position, clutching at affected body part, and pacing
What are the guidelines for individualized pain therapy? To use different types of pain relief measures, provide pain relief measures before pain becomes severe, use measures the patient believes are effective, choose pain relief measures appropriate for the severity of the pain as reflected by the Pt behavior
What is important to encourage the patient to do? Try pain relief therapy more than one time before giving up
What is important to do when a patient is in pain? Lift, not pull, patient up in bed, handle them gently, prevent urinary retention by ensuring patency of Foley catheter, prevent constipation by encouraging fluid intake, diet, exercise, and by administering prescribed stool softeners
What is a synergistic relationship? Actions of two or more substances or organs achieve an effect that can not be achieved by an individual substance or organ (ex: two medications that work together to obtain pain relief)
Define neuropathic pain? Complex, chronic state that is usually accompanied by tissue injury (phantom limb syndrome)
Define somatic pain? Pain in bones, joints, muscles, skin, or connective tissues (musculoskeletal pain)
Created by: tandkhopkins