Chronic Pain and Alzheimers Flashcards
(31 cards)
What is dementia?
Often occurs in older adults. Umbrella term to describe range of conditions which cause damage/change to brain. Caused by treatable/non treatable diseases. Not curable.
Risk factors for dementia?
Smoking, cardiac dysrhythmia, HTN, diabetes, CAD, hypercholesterolemia, genetics, older age, hx of depression, head injury, lack of intellectual stimulation.
What are amyloid plaques and neurofibrillary tangles?
These disrupt brain function. NT- twisted protein threads that can damage neuron’s
Amyloid plaques- aggregates of misfolded proteins that form in spaces between nerve cells
Early signs of dementia?
Memory loss that affects job skills, difficulty performing familiar tasks, problems with language. Disorientation to place/time, poor judgement, change in mood/personality.
Moderate stages of dementia?
Increasing memory loss, may start to not recognize family, can’t continue to drive, difficulty with speech, challenges with ADLs, require supervision for safety, may become impulsive, purposeful walking (wandering), cues for tasks.
Late stage of dementia?
Significant memory loss, unable to communicate, can’t perform ADLs, may be unresponsive, require total care, refuse food (sign of end stage), meds aren’t useful at this point.
What does diagnosis of exclusion mean?
Rule out other possible disease to diagnose dementia, exclude other things that mimic symptoms that someone has.
How else to diagnose dementia?
Brain imaging test to assess dementia, patient history (blood work, cognitive screening, any depression). Only autopsy provides a definitive diagnosis.
Drug therapy treatment for dementia?
Doesn’t cure but slows down cognition changes (donepezil, memantine), behaviour meds, and can use anti-depressants. Shouldn’t be our initial treatment though.
Non pharmacological care interventions for dementia?
Moderate exercise, music, pets (calming), light therapy (helps with sleep/wake cycles).
What is the most common reason people seek healthcare?
Pain
What are the problems with pain?
Lack of knowledge, lack of services, misconceptions, failure to manage pain, lack of inter professional collaboration.
Physiological impact of pain?
Prolonged stress, increased HR/BP/O2, decreased GI functions, delayed healing, physical immobility.
Psychosocial effects of pain and financial?
Poor sleep, inability to work, anxiety, fear, depression, impaired sense of self
Financial- loss of income
What is chronic pain and types?
Persistent pain that lasts beyond acute illness/injury. More than 3-6 months. Described as invisible condition (doesn’t show up on X rays). Primary CP- pain is disease itself. Secondary CP- pain is secondary to disease. Can be things like headaches, migraines, low back pain, arthritis…
Pain assessment?
Ask person their story, use open ended questions, OPQRSTUV, assess impact on quality of life/mood/sleep.
What is nociceptive pain?
Arises from actual/threatened damage to non neural tissue due to activation of nociceptors. Can be somatic (originates in skin, muscles, bone, tissue) or visceral (stimulation of pain receptors in organs- feel sore/dull/tender/cramps).
What is neuropathic pain?
Injury to nerves b/c of lesions/disease of CNS or PNS. Could be stroke, spinal cord injury, diabetes, genetic abnormalities. Described as burning, tingling, numbness, prickling, stab, pins/needles, sensitivity to touch.
What is nociplastic pain?
Arises from altered nociception despite no clear evidence of actual/threatened tissue damage. Causes activation of peripheral nociceptors/evidence disease of somatosesnory system is causing pain. Persists after tissue has healed and results in sensitization (NS plasticity recognized with individuality of pain perception.
What is hyperalgesia and allodynia?
H- increased response to stimulus that normally provokes pain
A- stimulus that doesn’t normally provoke pain
4 P’s of pain management?
Prevention, psychological, physical, and pharmaceutical.
Opioid analgesics and adverse effects?
Morphine/codeine/fentanyl. Not first line recommendation for chronic pain. AE are respiratory depression/sedation/constipation/nausea/vomit/pruritus/urinary retention.
NSAIDS use for pain?
Avoid in 3rd trimester of pregnancy, GI side effects so take with food.
What does pseaudoaddiction mean?
Drug seeking behaviour due to untreated pain. Improves with proper treatment.
