Comfort Flashcards

1
Q

pain can be

A

psychological and emotional stressors

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2
Q

decreased sleep =

A

increased perception of pain

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3
Q

if we manage pain we have

A

decrease suffering
decrease hospital readmission for pain
prevent acute from turning into chronic pain syndromes

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4
Q

pain is

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage

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5
Q

pain is what the

A

person says it is, existing whenever they say it does

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6
Q

if past experience of pain is bad/untreated

A

increased anxiety

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7
Q

people respond to pain based on

A

ability to tolerate pain and past experiences with pain

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8
Q

what affect pain

A

gender and culture

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9
Q

pain is accompanied by

A

suffering

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10
Q

inadequate pain refief hastens

A

death

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11
Q

how does inadequate pain relief hasten death

A

increase psychologic stress
decrease mobility
- pnumonia
- thromboemboli
- increase work of breathing
- increase oxygen demand of myocardium

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12
Q

HCAPs survery

A

answer call light
treat pain

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13
Q

sickle cell crisis

A

fluid
oxygen
pain meds

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14
Q

as nurses we need to removed what surrounding pain

A

biases and judgements

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15
Q

when are opiods good

A

post op
- allows to get up and move
- reverse anestheitcs
- reflexes return
- bowels move
- lung expansion
- eat and drink
- healing
- decrease PONV
- decreases pain

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16
Q

who thinks they will get additvcted

A

older adults

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17
Q

why do we not want to wait to use an opiod until it is really needed

A

it will take longer to get pain controlled if it is a 10/10 rather than a 3/10

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18
Q

when do we treat pain

A

as soon as patient says they are in pain

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19
Q

what should we educate patients about unpleasant side efefcts

A

we have meds to treat that

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20
Q

what is one opioid that isn’t a shot

A

fentynal
patch

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21
Q

with the opioid crisis what is happening

A

prescribed less
decrease treatment of pain

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22
Q

transduction

A

activation od pain receptors

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23
Q

what is converted to electrical impulse in transduction

A

stimulus

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24
Q

what are peripheral pain receptors

A

nocieptors

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25
Q

transmission

A

impulse traveling up spinal cord to higher center

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26
Q

perception

A

awareness of the characteristics of pain

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27
Q

pain threshold

A

lowest intensity of a stimulus that causes you to recognize pain

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28
Q

is threshold same or different in people

A

same

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29
Q

pain tolerance

A

greatest level of pain that a subject is ale to endure

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30
Q

is tolerance the same or different

A

different

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31
Q

modulation

A

inhibition or modification of pain

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32
Q

gate control theory explains why

A

different people interpret similar painful stimuli differently

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33
Q

gate open

A

allow sensations to be felt

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34
Q

gate closed

A

less transmission up to brain

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35
Q

gating mechanisms determines the impulse

A

that reaches the brain

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36
Q

what are some things that close the gate

A

music
back rub
warm compress

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37
Q

duration of pain

A

acute
chronic

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38
Q

acute pain

A

sudden onset
result of clearly defined cause
heals when underlying cause heals

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39
Q

chronic

A

any pain that lasts beyond normal healing peroid

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40
Q

patients with chronic pain have difficultly

A

describing pain because it is poorly localized

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41
Q

3 responses to pain

A

physiologic
behavioral
affective

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42
Q

physiologic

A

increase in pulse, BP, RR

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43
Q

who might not have a physiologic response

A

chronic pain because they have adapted to pain

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44
Q

is physiologic response always present

A

no

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45
Q

behavioral is voluntary or involuntary

A

voluntary

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46
Q

examples of behavioral responses

A

protecting, grimacing, moaning

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47
Q

affective response

A

pain causes fear, anger, depression

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48
Q

anxiety does what to pain

A

aggravate pain

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49
Q

is pain a part of aging

A

no

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50
Q

do babies feel pain

A

yes

51
Q

if past experience with pain is poor (untreated) how will the person feel now

A

increase anxiety

52
Q

pain assessment is

A

asking and believing the patient

53
Q

non verbal pain indicators is what response

A

behavioral
voluntary

54
Q

examples of nonverbal pain indicators

A

moaning
crying
grimacing
guarded position
reduced social interactions
difficulty concentration
changes in eating

55
Q

when should pain be assessed

A

regular intervals
new report of pain
after pharm and non pharm intervention

56
Q

what do we assess with pain

A

sedation

57
Q

why do we assess after pharm and non pharm

A

if it worked
evaluation

58
Q

why is it important to asses sedation

A

because it helps us decide best intervention because if the patient is sedated we do not want to give a opioid because they are depressors

59
Q

steps of pain assessment

A

intesnity
location
quality
aggravating and alleviating factors
goals

60
Q

FLACC

A

faces, legs, arms, cry, consoability

61
Q

1-10

A

numerical used in patient who can talk

62
Q

PAINAD

A

advanced dementia

63
Q

baker wong faces

A

peds

64
Q

somatic means

A

body

65
Q

somatic descriptors

A

aching, deep, dull, gnawing, throbbing, sharp, stabbing

66
Q

examples of somatic

A

muscle, tendon, bone

67
Q

visceral means

A

organ

68
Q

visceral discriptors

A

cramping, squeezing, pressure, referred

69
Q

visceral examples

A

gallstones, kidney stones, pancreatitis

70
Q

referred pain

A

perceived at another location other than site of painful stimulis

71
Q

neuropathic descriptor

A

burning, numbness, radiating, shooting, tingling, touch, sensitive

72
Q

neuropathic examples

A

herpes zoster, peripheral neuropathy

73
Q

cutaneous

A

superficial, skin, subq, sharp with a burning sensation

74
Q

phantom limb pain

A

perception of sensations that occur following partial or complete amputation

75
Q

atractable pain

A

severe constant, relentless, debilitating pain, uncurable

76
Q

atractable pain leads to

A

boedbound/house bound
early death

77
Q

how does phantom limb pain resolve

A

with time

78
Q

aggravating/alleviating factors

A

what makes it worse
better
affected by movement or postion
does nonpharm help

79
Q

do we rely on vital sign change

A

no

80
Q

we need to educate patient to tell us

A

when pain starts

81
Q

non pharm relief

A

complementary alternative therapies

82
Q

can nonpharm be used with pharm

A

yes or alone

83
Q

are non pharm orders

A

no they are independent nursing interventions

84
Q

what are some examples of nonpharm

A

distractors
humor
music
imagery
relaxation
cutaenous
acupuncture
hypnosis
biofeedback
touch
animal

85
Q

acetaminophen over max does affects

A

renal

86
Q

NSAIDS do not work on

A

GI irritation/stomach bleeding

87
Q

common opiods

A

morphine, codeine, fentynal

88
Q

what is adjuvant

A

used for other reasons but enhances the affect of opoids

89
Q

level one of pyramid

A

nonopoid and adjuvant

90
Q

level 2 of pyramid

A

opioid
nonopioid
adjuvant

91
Q

level 3 of pyramid

A

increased does or frequency of opoiod, nonopoid, adjuvant

92
Q

goal of pyrimid

A

freedom of pain

93
Q

morphine

A

gold standard

94
Q

common side affect with morphine

A

nausea and vomiting, morphien itch

95
Q

codeine can have what issues

A

stomach

96
Q

hydromophone

A

deluded

97
Q

methadone

A

dolaphine

98
Q

fentnyal takes how long

A

12 hours
- give meds until reaches 12 hours

99
Q

how much stronger is fentynal than morphine

A

8-10

100
Q

how long does fentynal last

A

3 days

101
Q

adjuvant drugs

A

anticonvulsants, tricyclic antidepressants, steroids, anti anxiety

102
Q

PCA

A

patient controlled anesthesia

103
Q

what does the pateint have to be for PCA

A

alert and oriented

104
Q

what does PCA inhibit

A

overdose

105
Q

PCA can be incombination with

A

continuous infusion

106
Q

what is the common drugs for PCA

A

morphine, fentynal, hydromorphone

107
Q

PCA has what settings

A

lock out

108
Q

break through pain

A

flare up of moderate to severe pain that occurs even when the patient is taking around the clock meds

109
Q

what should we have ordered for break through pain

A

PRN

110
Q

physical dependence

A

the body physiologically adapts to the presence of an opioid and suffers withdrawal symptoms if the opioid is suddenly stops

111
Q

is physical dependence addiction

A

no

112
Q

psychological dependence

A

pattern of compulsive drug use characterized by continued craving for an opioid and the need to sue the opioid for effects other than pain relief

113
Q

is psychological dependence addiction

A

yes

114
Q

tolerance

A

common physiological result of chronic opioid use, a larger dose of opioid is required to maintain the same level of analgesia

115
Q

placebo

A

harmless pill prescribed for for the psychological benefit of the patient than the physiological

116
Q

is placebo ethical

A

no

117
Q

is pain a process of aging

A

no

118
Q

pain is often unreported in elderly which leads to

A

higher risk for patient experiencing pain

119
Q

are adverse effects of pain meds more dramatic in elderly

A

yes

120
Q

why do elderly have more dramatic affects to pain meds

A

decreased liver and renal

121
Q

elderly have more

A

prolonged effect and we need to watch for cumulative affect

122
Q

metabolized

A

liver

123
Q

excreted

A

kidney