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Mosby's > Ch 7 Pain > Flashcards

Ch 7 Pain Flashcards

1
Q

How do we deal with pain?

A

we assess and treat all patients

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2
Q

What is this:
sudden onset
short duration
associated w/ injury?

A

acute pain

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3
Q

What does acute pain travel on?

A

a-delta fibers

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4
Q

What fibers send sharp pain info, have quick transmission, large fibers, and are myelinated?

A

a-delta fibers

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5
Q

What is this:

persistent pain greater than 6 months and associated with long disease processes.

A

chronic pain

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6
Q

What does chronic pain travel on?

A

C-polymodal fibers

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7
Q

What fibers send dull pain info, have slow transmission, small fibers and are unmyelinated?

A

C-fibers

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8
Q

What does bradykinin, substance P, prostaglandins, leukotriens, seritonine, histamine and catecholamines do in terms of pain?

A

help move pain impulse from pain receptors to dorsal horn up to the anterolateral spinothalamic tract up to the cerebral cortex

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9
Q

Do neonates feel pain?

A

yes, process pain early in life

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10
Q

In neonates, how does pain travel?

A

typically on C-fibers w/ short transmission distance and inability to process pain resulting in increased sensitivity to pain stimulus, due to developmental immaturity

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11
Q

Who are more likely to be more sensitive to pain, preterm and full term newborns, or infants and children.

A

preterm and newborns

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12
Q

Why might pregnant women experience back pain?

A

lax ligaments, weight gain, anterior tilt of pelvis, hyperlordosis

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13
Q

Why might pregnant women experience epigastric pain?

A

gravid uterus

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14
Q

What kind of pain might pregnant women feel if their ligaments are stretched due to enlarged uterus?

A

round ligament pain

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15
Q

What are the causes of labor pain?

A

dilation of cervix
stretching of uterus
pressure on structures
hypoxia of uterine muscle cells

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16
Q

Do older adults have diminished perception of pain?

A

no evidence to support this

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17
Q

What kind of pain do elderly feel?

A

osteoporosis, arthritis, diabetic neuropathy, fractures

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18
Q

Why dont the elderly tell people they are hurting?

A

stigmas

think its normal part of aging, dont want to bother you, dont want to pay for tests, dont want to take meds

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19
Q

If elderly individual is cognitively impaired how do you assess pain?

A

ask family member, use nonverbal pain indicators, ask them

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20
Q

What takes precedent, subjective or objective pain assessment?

A

SUBJECTIVE!

21
Q

How do you rate a patients pain?

A

you ask them, then you make that level of pain the gold standard for that patient to compare against for other visits

22
Q

What is the fifth vital sign?

Why is it so important?

A

pain

can assess tissue damage, assess emotional state of mind, and pathophysiological effect of pain on body

23
Q

How to choose the correct pain scale?

A

continuity is key

24
Q

If you have large change in vital signs what kind of pain are you showing?
few changes?

A

acute

chronic

25
Q

What are some behavioral signs of pain?

A 
distorted face
inability to sit still
clenched eyes
silence in a talkative patient
groaning
26
Q

What kind of pain is this associated with:

tender, deep, aching

A

bone and soft tissue pain

27
Q

What kind of pain is this:

heavy, throbbing, and aching pain

A

tumor pressing on a cavity

28
Q

What kind of pain is this:

burning, shocklike

A

nerve tissue damage

29
Q

What is this a sign of:

clenched fist over chest with diaphoresis and grimacing

A

myocardial infarction

30
Q

What is this a sign of:

cramping or spasm

A

visceral or colic pain

31
Q

How do you assess pain in neonates (28-40 weeks)?

A

PIPP (premature Infant Pain Profile)

uses gestational age, behavioral state, heart rate, oxygen saturation, brow bulge, eye squeeze, nasolabial furrow

32
Q

How do you assess pain in infants?

A

facial expressions, cries, breathing patterns, extremeties, state of arousal in procedural pain

33
Q

The (blank) scale uses crying, oxygen saturation, heart rate, blood pressure, expression, and sleeplessness to assess procedure and surgical pain in newborns and infants

A

CRIES

34
Q

Physiological measures and behaviors are combined for pain behavior scales that dont rate pain but are used for ….?

A

identify presence of pain and treatment

35
Q

How do you reduce pain in neonates?

A

give them sugar water -> it promotes opoids :)

36
Q

At what age do kids start being able to verbalize pain levels? What pain scale should you use?

A

3

Wong/Baker FACES rating scale (the ones with the sad to happy face) and Oucher scale (different faces too)

37
Q

Should you look at a childs facial expression and use an oucher scale or a wong/baker faces scale and figure out for yourself what they are feeling?

A

NOOOOOOO

38
Q

Following the surgery of 2months-7 year olds, what pain scale is good to assess pain in nonverbal patients?

A

FLACC

face, legs, activity, cry and consolability

39
Q

Explain the FLACC pain scale?

A

0 is no problem, 2 is the greatest problem

40
Q

For the FLACC scale, After scoring all the points tell me what they mean?

A

0=relaxed
1-3=mild discomfort
4-6=moderate pain
7-10= severe pain/discomfort

41
Q

Why can FLACC be useful for parents to use?

A

for cognitively impaired children

42
Q

What is a good predictor of amount of pain a particular woman may experience in labor?

A

socioeconomic status and prior menstrual difficulties

43
Q

If patients have dementia or cognitive impairment can you still give them a pain scale?

A

if they can verbalize then yes

if not, use the Checklist of Nonverbal Indicators

44
Q

Explain how the Checklist of Nonverbal Indicators works

A

Gives a sign, if observed, then 1 point, if not observed then no points.
Total score 0-5

45
Q

What are the signs in the Checklist of Nonverbal Indicators?

A 
Vocal complaints (moans, grunts)
Facial Grimaces/Winces
Bracing
Restlessness
Rubbing
Vocal complaints(ouch, that hurts, curse words)
46
Q

What is a form of chronic pain caused by a primary lesion or dysfunction of the CNS that persists beyond expected healing?

A

Neuropathic pain

47
Q

What is the presence of regional pain (beyond site of nerve damage) with motor, sensory, and autonomic changes following a predominantly traumatic noxious event with or without specific nerve injury?

A

Complex regional pain syndrome

48
Q

What all goes into sensing pain?

A

behavior, physiology, and emotion

49
Q

State the key components of the history when pain is part of the present problem

A

Onset, Quality, Intensity, Location, Associated symptoms, What the patient thinks is causing the pain, Effect of pain on daily activities, Effect of pain on psyche, Pain control measures, Medications

Mosby's (7 decks)

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