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N158 Nursing Therapeutics > Pain > Flashcards

Pain Flashcards

1
Q

Specificity theory

A

Neurons and pathways are specific

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2
Q

How are Specificity and Pattern theory lacking?

A

does not account for differences in perception

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3
Q

Pattern theory

A

rapid and slow firing of fibers form pain and non-pain patterns

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4
Q

Gate control theory

A

non-painful input closes the nerve “gates” to painful input

only noxious input is able to suppress pain

large fibers and small fibers

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5
Q

large fibers

(gate control theory)

A

inhibit the small pain fibers

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6
Q

what kind of behavior can pain illicit?

A

escape or immobilization

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7
Q

the most common reason people seek healthcare

A

they are in pain

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8
Q

acute pain

A

temporary

sudden onset

easily localized

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9
Q

pain with a biologic purpose

A

acute pain

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10
Q

ex: postoperative pain

A

acute

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11
Q

ex: trauma

A

acute

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12
Q

ex: burns

A

acute

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13
Q

ex: procedural pain

A

acute

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14
Q

ex: obstetric pain

A

acute

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15
Q

chronic pain

A

usually longer than 3-6 months

persistant and irritable

can involve peripheral or central nerves

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16
Q

involves an issue with modulization

A

chronic pain

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17
Q

describe neuropathic pain

A

shooting/burning

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18
Q

describe phantom pain

A

squeezing or crushing

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19
Q

describe cancer pain

A

tumors pressing on nerve treatment

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20
Q

3 physiologic sources of pain

A
  1. Somatic
  2. Visceral
  3. Neuropathic
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21
Q

somatic pain

A

skin and subcutaneous tissues

bone, muscle, blood vessels, connective tissue

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22
Q

describe the quality of somatic pain

A

sharp, dull, burning, aching

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23
Q

visceral pain

A

organs and linings of body cavities

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24
Q

describe the quality of visceral pain

A

stabbing, deep, diffuse

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25
Q

pain threshold

A

the lowest intensity of a stimulus that causes the recognition of pain

26
Q

pain tolerance

A

the ability/willingness to endure pain before something is done

27
Q

breakthrough pain

A

not controlled at that period of time

28
Q

intractable pain

A

resistant to therapy

29
Q

Hierarchy of pain sources

A
  1. Patient reporting
  2. Consideration of treatment
  3. Behavior (may need surrogate)
  4. Physiologic response (least sensitive)
30
Q

collaborative problems

A

problems commonly associated or happen at the same time

31
Q

what level of progress indicates effective pain treatment?

A

+2 pts or 30%

32
Q

nociceptor

A

sensory receptors of pain

33
Q

A-delta fibers

A

fast, well localized, myelinated

34
Q

C fibers

A

slow, diffuse, visceral

35
Q

Chemicals released with painful peripheral stimuli

A

bradykinin

prostaglandins

36
Q

bradykinin

A

released from leaking plasma in the tissue

37
Q

where do afferent nerve fibers travel

A

spinal cord

38
Q

where do secondary neurons travel

A

through the dorsal horn of the spinal cord

39
Q

types of secondary neurons

A

excitatory and inhibitory

40
Q

what is released between secondary neurons and the anterior/lateral spinothalamic tract

A

Substance P and glutamate

41
Q

where is pain perceived in the brain

A

thalamus

42
Q

where do pain impulses ultimately reach in the brain

A

thalamus and cerebral cortex

43
Q

neurotransmitters that slow down or speed up the pain process

A

substance P

dopamine

serotonin

prostaglandins

44
Q

2 neuromodulators

A

endogenous opiates

encephalins

45
Q

what do the descending pathways (efferent fibers) do

A

take info from the brain back to spinal dorsal horn

46
Q

where are mu opiate receptors located

A

between dorsal horn and brain

also located in bowels

47
Q

where do endogeneous and prescription opioids work

A

mu receptors

48
Q

What types of drugs work at the peripheral nociceptors

A

local anethetics

anti-inflammatory drugs

49
Q

what types of drugs work at the peripheral nerve?

A

local anesthetics

50
Q

what types of drugs work at the secondary neurons in the dorsal root ganglion

A

local anesthetics

opiods

alpha2 agonists

51
Q

what type of drugs work at the site of pain in the brain?

A

opiods

alpha2 agonists

52
Q

what is the mechanism of NSAIDs and aspirin

A

inhibit prostaglandin release

53
Q

what is the mechanism of local anesthetics?

A

inhibits transport of ions across neural membranes

54
Q

what type of local anesthetic might be used at the dorsal horn?

A

epidural

55
Q

example of an alpha2 agonist

A

clonidine

56
Q

what is the best rule for administering opioids

A

use the smallest possible dose, then titrate accordingly

57
Q

order of the 2 most concerning conditions in patients on opiods

A

sedation precedes respiratory depression

58
Q

top 4 adverse effects of opiods in order

A
  1. constipation
  2. nausea/vomiting
  3. sedation
  4. respiratory depression
59
Q

important info concerning opiods and older adults

A

dosing should be decreased 25 - 50%

60
Q

important info concerning opiods and addictions

A

focus should be on treating pain

61
Q

important info concerning opiods and obesity

A

increased pain

increased risk for respiratory depression and inflammation

N158 Nursing Therapeutics (8 decks)

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