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PVCC NUR151
Exam #4
| Question | Answer |
|---|---|
| Component of pain: Affective | The emotions related to pain...i.e. anger and anxiety |
| Component of pain: Behavioral | The behavioral response to the pain |
| Component of pain: Cognitive | The beliefs, attitudes, and evaluations about the pain and pain control. |
| Phase of nociception: Transduction | noxious stimulus which takes place in the periphery |
| Phase of nociception: Transmission | Pain impulse from periphery to brain |
| Phase of nociception: Perception | Conscious awareness of painful sensation |
| Phase of nociception: Modulation | Analgesic effect from neurotransmitters that slow down pain impulse. |
| Nociceptors | Pain sensors |
| Chemicals that increase pain sensation | Begin inflammatory process: Sustance P, Prostaglandins, Bradykinin, K, histamine |
| Chemicals that modulate pain sensation | Endorphins: morphine-like compounds that impact opiate receptor sites. |
| JC standards re: pain assessment. | ALL patients nature and intensity of pain must be assessed and follow-up given. Education re: pain must be completed. Document! |
| After surgery/procedures, pain needs to be assessed every... | Four hours. |
| Pain documentation includes | Pre-assessment, medication given, post-assessment, comfort measures given, subjective and objective data, education, and emotional support. |
| Gating mechanisms along CNS | Like a switchboard that is overloaded, gates can be blocked, which alters perception of pain. Most non-pharmacological methods work on this principle. |
| Time for PO meds to take effect | 50-60 minutes |
| Time for IV meds to take effect | 15 minutes |
| Time for IM meds to take effect | 30 minutes |
| Pain threshold | The lowest intensity of stimulation that causes pain to be recognized by the patient. |
| Pain tolerance | The level of pain an individual is willing to "put up with" |
| Pain in elders: | Often undertreated, they are often stoic, non-verbal assessment is important. |
| Physiological response to moderate pain | Fight or flight response stimulated, some change in vital signs |
| Physiological response to severe pain | Body begins to show signs of shock. |
| Signs of shock | Tachycardia, elevated BP, N/V |
| Chronic pain can lead to: | Personal suffering, depression, suicide |
| Idiopathic pain | Chronic, no identifiable physical or psychological cause |
| Somatic pain | General term for pain with an EVIDENT physical cause. Does not radiate. |
| Cutaneous pain | Superficial, sharp, short, localized. Does not radiate. |
| Deep somatic pain | Body structures - muscles, bones, tendons, joints. Aching throbbing localized. Does not radiate. |
| Visceral pain | Organs, diffuse, may radiate |
| Psychogenic pain | no explanation, but very real |
| Neuropathic pain | Altered processing or damaged nerves, phantom pain, peripheral neuropathic pain |
| Referred pain | Felt in another location, but related to the same spinal segment |
| Intractable Pain | Doesn't respond to treatment, constant. |
| Tolerance | The need for increased opioid dose to maintain the same degree of analgesia. |
| Physical dependence | normal physiologic response. Withdrawal symptoms when the drug is abruptly decreased. Patient put on a tapering schedule. |
| Addiction | Abnormal response. Drive to obtain and take substances for other than prescribed therapeutic value. |
| Major concerns for narcotic analgesics | side effects (CNS depression), tolerance, and addiction |
| narcotics are often given with what other meds? | antiemetics to decrease nausea (especially after anesthesia) |
| PCA pumps | patient controls when med is given. Usually results in decreased anxiety and decreased total amount of drug given. |
| Dosage for PCA pump | Checked by 2 RNs. Set at max for x mins. i.e. 1 mg morphine q 10 min. |
| Key to alternative therapies... | Complementary. |
| Advantages of alternative therapies | Does not require physician referral or prescription. Provides sense of control, most useful for chronic conditions, provides quality of life when conventional therapies fail. |
| Dangers of alternative therapies | lack of reliable info(esp side effects), delay or avoid needed medical treatment. |
| Acupuncture | insertion of tiny needles, most widely used for pain relief and many other problems, licensing exams required for practitioners |
| Naturopathy | emphasis on wellness and prevention |
| Homeopathy | Illness treated with highly diluted amounts of compounds that would cause the symptoms in concentrated form. Recognized and regulated by the FDA. |
| Chiropractic | Focuses on relationship between the spinal column and the nervous system |
Created by:
crna2b
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