Chapters 9, 17, 18, & 22
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| The body usually adapts to temp. of 59 F to 113 F and affects blood circulation because of what? | Heat & Cold
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| What happens to people when their bodies temperature goes below 59 F? | Experience pain and numbness
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| What happens to people when their bodies temperature goes above 113 F? | Experience burning and pain
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| Who is more sensitive to cold and may need more covering to maintain warmth? | Older adults/young children
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| What do you need to evaluate more frequently with hot/cold therapies with older adults/young children? | Skin
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| Why are older adults more susceptible to burns/frost bite? | Have a reduced sensitivity to pain
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| 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.
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| What does heat therapy provide and to what areas of the body? | Comfort; good for musculoskeletal, joint, and back pain
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| 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
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| Explain benefits of cold therapy | Causes vasoconstriction, decreases swelling and pressure on nerves, and decreases pain
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| When is cold therapy used? | Sprains, strains, and fractures
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| If cold therapy is left in place too long, what can it interfere with? | Circulation which can cause tissue damage
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| What are adverse reactions to cold therapy? | Numbness or pale skin
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| 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.
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| Who do you monitor closely with heat/cold therapy? | Children, elderly, diabetics, and Peripheral Vascular Disease (PVD)
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| What are the types of heat/cold therapy? | Hot, moist compress, warm soaks, paraffin bath, Aquathermia Pad, dry heat, and ice bags
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| What are the benefits of a hot, moist compress? | Improves circulation, relieves edema, and consolidates exudate
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| How do you apply a warm soak? | Immerse affected body part
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| 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
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| 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)
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| What is important to teach patients when using a heating pad? | Never use a setting over medium
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| 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
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| 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
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| Describe a cool water bath | Relieves tension and can reduce body temperature, water temperature is 98.6 degrees
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| Describe a warm water bath | Reduces muscle tension, water temperature is 109.4 degrees
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| Describe a hot water bath | Relieves soreness and muscle spasms, water temperature ranges from 113 degrees - 115 degrees
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| Describe a sitz bath | Cleanses and aids in reducing inflammation in perineal and anal areas. Duration of sitz bath is 20-30mins
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| What is orthostatic hypotension? | When blood pressure drops very low and very fast when you stand up. Signs are dizziness or light headedness
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| What do you do if a patient experiences orthostatic hypotension? | Stop bath and lay them back in bed
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| What is the temperature for a tepid sponge bath and what is it used for? | 98.6 degrees; lowering body temperature
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| What are complimentary therapies used in addition to and who recommends them? | Conventional treatment; patients health care provider
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| What do complimentary therapies compliment? | Conventional treatment
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| 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
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| What do complimentary therapies give to patients? | More control
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| What may alternative therapies include the same of as complimentary therapies? | Interventions
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| Alternative therapies frequently become the ___________ treatment modality that replaces traditional or conventional medicine | Primary
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| Define allopathic | Traditional medicine
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| Many alternative therapies do not _______________ with those therapies prescribed by a physician, but some have ____________ reactions | Interfere; serious
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| 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
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| What is chiropractic therapy? | Chiropractic doctor adjust the joints of the body through gentle manipulation to restore the area to proper alignment
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| 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)
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| 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
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| What is acupressure? | Involves the use of gentle pressure at certain points on the body
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| Describe therapeutic massage | Performed by trained professionals to manipulate soft tissues of the body and assist with healing
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| When is therapeutic massage contraindicated? | When the patient has phlebitis, thrombosis, and infectious skin disease
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| What is aromatherapy? | Pure essential oils produced from plants that are used to provide health benefits
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| What can essential oils be used for? | Inhalation or applied topically
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| 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
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| What is relaxation therapy? | State of generalized decreased cognitive, physiologic, or behavioral arousal
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| What can yoga do? | Tone the muscles that balance all parts of the body, including internal organs, heart, lungs, glands, and nerves
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| What is one of the greatest challenges a nurse faces with a patient in pain? | Providing comfort to the patient
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| Define comfort | To give strength and hope, cheer, and to ease the grief or trouble of another
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| What is a vital role of a nurse to promote? | Physical and psychological comfort to a patient
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| What are some of the factors that are a result of "lack of comfort"? | Respiratory dysfunction, irritability, depression, and decreased GI motility
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| What is nature of pain? | Complex, abstract, and a personal experience
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| Pain is what? | Subjective
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| What is the nurses major role with a patient in pain? | Conduct pain assessments
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| When does a nurse assess pain in a patient? | During initial assessment and 30 mins after pain medications are given
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| 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
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| 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
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| What are the different types of pain? | Mild, severe, chronic, acute, intermittent, intractable, burning, dull, sharp, precisely or poorly localized, and referred
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| Define acute pain | Intense and typically short in duration (> 6mos)
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| What does acute pain flood the body with | Epinephrine, which gives the person the "fight or flight" response
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| Define chronic pain | Continuous or intermittent, can be as intense as acute pain. Is longer in duration (<6 mos)
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| Chronic pain does not serve as a warning sign for what? | Tissue damage, may be due to damage that has already occurred
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| 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
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| Define the gate control theory | Suggest that pain impulses can be regulated or even blocked by gating mechanisms located along the central nervous system
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| What happens with the brain in gate control? | Can not acknowledge the pain while it is interpreting the other stimuli
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| 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
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| 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
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| What is the fifth vital sign? | Pain
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| Why is pain included with other vital signs? | Ensures that pain is monitored on a regular basis
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| What does appropriate pain management bring about? | Quicker recoveries, shorter hospital stays, fewer readmissions, and improved quality of life
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| What are noninvasive pain relief techniques? | TENS unit, distraction, relaxation, guided imagery, hypnosis, and biofeedback
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| What are invasive pain relief techniques? | Nerve blocks, epidural analgesics, neurosurgical procedures, and acupuncture
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| What is the most widely & frequently used analgesic group? | NSAIDS or non-opioids
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| What are examples of NSAIDS? | Acetaminophen, aspirin, ibeprophen, and naproxen sodium
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| How do opioids work? | Act on higher centers of the brain to modify perception and reaction to pain
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| What are examples of opioids? | Morphine, codeine, and meperdine (Demerol)
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| What are adverse affects of opioids? | Decreased respiratory rate, slow bowel motility, and decreased peristalsis
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| What percentage of patients actually become addicted to opioids? | One
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| What are the administration routes for analgesics? | Oral, IV, IM, PCA, and epidural
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| What is the route of choice for opioid analgesics after major surgery? | IV
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| Why are opioid analgesics not given IM? | Painful & traumatic for patients
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| 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
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| 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
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| What is a PCA pump? | Drug delivery system that allows patients to administer pain medication whenever needed
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| What are the requirements for a patient to have a PCA pump? | Must be able alert, oriented, and able to follow simple directions
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| Why can't a patient over dose while using a PCA? | It is on a timer
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| 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
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| What are the two ways to collect data with regards to pain? | Subjectively and Objectively
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| 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
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| 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
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| 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
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| 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
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| What is important to encourage the patient to do? | Try pain relief therapy more than one time before giving up
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| 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
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| 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)
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| Define neuropathic pain? | Complex, chronic state that is usually accompanied by tissue injury (phantom limb syndrome)
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| Define somatic pain? | Pain in bones, joints, muscles, skin, or connective tissues (musculoskeletal pain)
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