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Flashcards in chronic exam 1-pain Deck (45):
1

type A delta fibers

carry rapid, sharp, pricking sensation
quick transmission
found in skin, muscles
may be localized

2

C fibers

carry dull, burning, aching sensation
slow transmission
found in muscle, periosteum, viscera (organs)
more continuous and constant pain

3

pain threshold

Amount of a pain stimulus required to perceive as pain

4

Pain tolerance

amount of pain a person is willing to endure

5

Intractable

pain not responsive to conventional treatment

6

psychogenic

Pain for which no pathologic condition can be found

7

Radiating pain

Diffuse pain around the site of origin, not well localized

8

Localized pain

Confined to the site of origin

9

Projected pain

Pain along the specific nerve or nerves

10

Acute pain

Short duration of less than six months
Identifiable onset
Often has useful function
Accompanied by sympathetic responses

11

Chronic pain

Longer duration of more than six months
Persistent, recurrent
No foreseeable end
Observable pain expression often absent

12

Characteristics of acute pain

Physiologic changes in vital signs
Limited lifestyle impact
Treatment usually has high success

13

Characteristics of chronic pain

Low or no physiologic changes
Impacts behavior, cognitive, social roles and lifestyle
Treatment is more difficult

14

nocioceptive pain

Normal processing of stimuli that damages normal tissue or has the potential to do so

15

Neuropathic pain

Abnormal processing of sensory input by peripheral or central nervous system

16

nocioceptive pain arises from three major types of structures

Cutaneous (somatic)
Deep somatic (bones, muscles, skin joints, connective tissue)
Visceral (organs)

17

cutaneous pain

Superficial structures of skin and subcutaneous tissue
Well defined, localized

18

Deep somatic pain

Originates in bone, blood vessels, nerves, muscles, and other tissues
Dull, poorly localized

19

Visceral pain

Arises from body organs
Known for referred pain

20

Referred pain

Felt in an area distant from the site of origin

21

Centrally generated pain

Injury to either peripheral or central nervous system or dysregulation of the autonomic nervous system

22

Peripherally generated pain

Pain along one or more peripheral nerves

23

Nonmalignant chronic pain

Rheumatoid arthritis rightists (non-cancerous)

24

Intermittent chronic pain

Occurs at specific intervals (migraines)

25

Malignant chronic pain

May have elements of both acute and chronic (tumor)

26

Pain behaviors as assessment tool

Facial expression
Vocal behavior
Aggressive behavior
Increase in body movements
Changes in ADLs
Irritability, confusion, withdrawn, agitated

27

Clinical signs of pain

Increased pulse, blood pressure, respiratory rate-often not present with chronic pain
Dilated pupils
Increased perspiration
Guarding
Muscle rigidity

28

Assessment of factors which influence the pain experience

Situation
Race culture ethnicity
Age
Gender
Anxiety
Past experiences with pain

29

Nonnarcotic analgesics

Aspirin (ASA)
Acetaminophen (Tylenol)
Cox two inhibitors (Celebrex, Bextra)
NSAIDs (Ibuprofen, Indocin) nonsteroidal anti-inflammatory drugs
Utram

30

Narcotic analgesics

Opioid agonists (morphine sulfate, Dilaudid, codeine, oxycodone, hydrocodone)
Methadone
Propoxyphene
Fentanyl
Meperidine

31

Action of opioid analgesics

Bind with opiate receptors in the CNS to alter the perception of pain

32

Adverse affects of opioid analgesics

Constipation, nausea and vomiting, respiratory depression, urinary retention

33

Opioid antagonist

Blocks opiate receptors, used to treat overdoses
Narcan (naloxone)

34

Action of non-opioid analgesics

Inhibit prostaglandin synthesis

35

Adverse affects of non-opioid analgesics

G.I. upset
G.I. bleeding
Tinnitus-tingling in ears
Liver or kidney toxicity

36

Routes of administration for opioid analgesics

Oral/rectal
IM and subQ
IV
Transdermal and transmucosal
Intraspinal
Nerve blocks
Epidural

37

Patient controlled analgesia

Patient controls frequency of pain medication
Dr. order includes: drug, amount, block out time interval and route is IV

38

Capnography monitoring

To monitor CO2 levels which will rise with hypoventilation
Use Narcan to treat respiratory depression

39

Epidural catheters

Local anesthetic or narcotic medication into the epidural space
Medication is Duramorph
Often used in labor and delivery, also orthopedics
Side effects similar to morphine sulfate
Complication of possible infection

40

Tens unit

Transcutaneous electrical nerve stimulation
It's electric current to skin and tissue, adjustable voltage; portable

41

Guided imagery

Envision something pleasant; can include music and aromatherapy

42

Oral morphine

Three times the IV dose

43

Antidepressants

Alter serotonin levels and block receptors and spinalthalamic tract that transmit pain parentheses neuropathic pain

44

Anticonvulsants

Use for neuropathic pain

45

Anxiolytics

Xanax Valium thorazine Ativan