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pain management

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Question
Answer
How to define pain?   whatever the person experiencing the pain says it is, existing wherever the person says it does  
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What is a definition of pain?   an unpleasant sensory & emotional experience associated with actual or potential tissue damage, or described in terms of such damage  
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How is pain described?   Subjective, its the patients experience and self report  
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Some populations may have problems with self report so what must you do?   observe non verbal cues too to help assist in pain assessment  
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The neural mechanism by which pain is perceived consists of 4 physiological processes. What are they?   transduction, transmission, perception, modulation  
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What interrupts the pain pathway during transduction?   nsaids, local anesthetics, anti-seizure agents, corticosteroids  
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what interrupts the pain pathway during transmission?   opioids  
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what interrupts the pain pathway during perception?   opioids, nsaids, adjuvants  
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What interrupts the pain pathway during modulation?   tricyclic antidepressants  
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what are the two ways pain is classified if based on underlying pathology?   Nociceptive pain, neuropathic pain  
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what are the two ways pain is classified is based on duration?   acute, chronic  
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what is nociceptive pain?   pain caused by damage to somatic or visceral tissue  
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what are examples of nociceptive pain?   pain from surgical incision, arthritis, cardiac ischemia  
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what are the two types of nociceptive pain?   somatic pain and visceral pain  
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what is somatic pain?   aching or throbbing pain, very well localized... it arises from bones, joints, muscles, skin, or connective tissue  
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what is visceral pain?   pain which results from stimuli (ex. tumor involvement or obstruction).. it arises from internal organs such as intestine or bladder  
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what is neuropathic pain?   caused by damage to nerve cells or abnormal processing of sensory input.. described as burning, shooting, stabbing or electric in nature  
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does acute pain last long? is it sudden?   No it is of short duration, and it has a sudden onset  
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what is acute pain?   course of pain decreases over time and goes away as recovery occurs. includes postop pain, labor pain, trauma pain.  
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how do you treat acute pain?   analgesics for symtom control, and also treat underlying cause  
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how do you treat neuropathic pain?   antidepressants  
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how do you treat nociceptive pain?   nonopioids or opioids  
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how does acute pain activate manifestations that reflect sympathetic ns?   increase heart rate, increase respiratory rate, increase bp  
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what can unresolved acute pain cause?   prolonged hospitalization, increase complications of immobility, delay rehab, decrease a patients focus on goal in get better  
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what is chronic pain?   last longer than expected, any pain that last more than 3 months  
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do you always know the cause of chronic pain?   no  
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how is chronic pain characterized?   by periods of waxing and waning  
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what are the two types of chronic pain?   non-cancer, cancer  
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what is chronic non-cancer pain?   long term pain, 25% population, considered non-life threatening but causes psychosocial distress  
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what are examples of chronic non-cancer pain?   R.A., lupus, headache, low back pain, arthritis, myofacial pain, peripheral neuropathy  
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what is chronic cancer pain?   2/3 of patients with advanced cancer have it, treat with oral opioids, from cancer bone mets, and nerve compression  
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