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1- nursing Fundamentals > exam 3 presentations > Flashcards

exam 3 presentations Flashcards

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1
Q

acute pain

A

Rapid onset but resolves

Vital, physiological response

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2
Q

chronic pain

A

Constant or recurring pain

Normal vital signs, impacts mental well-being

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3
Q

nociceptive pain

A

Damage to body tissues

Throbbing, sharp, achy

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4
Q

Neuropathic pain

A

Damage to nerves

Stabbing, burning, shooting, pins/needle

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5
Q

intractable pain

A

Does not respond to therapy or interventions

Focus is reducing discomfort

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6
Q

phantom pain

A

Removal of limb

Burning, fiery, crushing, cramping

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7
Q

cutaneous classification pain

A

Superficial, involves skin or subcutaneous
tissue

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8
Q

somatic pain classification

A

Diffuse or scattered
*

Originates in tendons, ligaments, bones, blood
vessels and nerve

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9
Q

visceral pain classification

A

Poorly localized
*

Originates in the thorax, cranium and
abdomen

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10
Q

referred pain classifaictoin

A

Originates in one part of the body by is
perceived in a distant location

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11
Q

malignant/cancer pain classification

A

Results from direct effects of the disease and
its treatment

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12
Q

factors affecting pain

A

Past Experience / Background

Culture / Religion

Age

Family

Anxiety / Stressors

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13
Q

LOPQRST pain assess

when is it used
what does it do

A

used in beginning of assessment

Location (Where is the pain? If unable to answer, can you point?)

Onset (When did the pain start?)

Provocation (What makes it better or worse?)

Quality (How would you describe your pain?)

Radiation (Does the pain go from one place to another? Can you point to it?)

Severity (Can you rate your pain 0/10?)

Time (How long does the pain last?)

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14
Q

Numeric Scale pain assess

when is it used
what does it do

A

Used in patients above 9 who are able to use numbers correctly

give a number that correlates to pain currently

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15
Q

Wong- Baker FACES pain assess

when is it used
what does it do

A

used in patients above 3 years old that cannot use numbers

children rate pain based on :) to :( that correlates to a specific number

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16
Q

Verbal Descriptors pain assess

when is it used
what does it do

A

used in adults and children when they can process/talk through pain

used in all patients if they can, they will describe pain based on key words to narrow down how they feel

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17
Q

COMFORT Scale pain assess

when is it used
what does it do

A

children,adults/childern with cognitive impairments, ICU

each rated 1-5
alrtness
calmness
respitoary distress
crying
physical movement
muscle tone
facial tension
bp/hr

determine level on analgesic needed to adequately relieve pain in patient

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18
Q

FLACC Scale pain assess

when is it used
what does it do

A

used in infants/children from 2mon-7year who are unable to validate pain

Faces,legs,activity,cry,consalabiltiy
rate each on 0-2 scale

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19
Q

PAIN AD pain assess

when is it used
what does it do

A

Used in patients whose dementia is so far advanced that they cannot verbally communnicate

relies on: breathing, vocalization, facial expression, body language, consalability

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20
Q

non pharmelogical pain interventions

A

TENS unit
* Heat / Ice
* Repositioning
* Toileting
* Quiet Environment / Hypnosis
* Guided Imagery
* Massage / Acupuncture
* Distraction

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21
Q

phatmaolgical pain management

A

Non-Opioid Analgesics / NSAIDs
* Opioids
* Adjuvant or Co-Analgesics
* PCA Pump

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22
Q

factor affecting pain management

A

Pain Threshold

Pain Tolerance

Medication Tolerance

Breakthrough Pain

Dependence Addiction

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23
Q

Factors Affecting Sensory Function

A

AGE
CULTURE
MEDICATIONS
STRESS / ILLNESS
LIFESTYLE

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24
Q

disturbed sensory perception

A

Sensory Deprivation
Sensory Overload
Visual Impairment
Hearing Impairment
Olfactory Impairment
Tactile Impairment
Delirium
Dementia
Unconscious Patient

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25
Pain Pathophysiology
The body gets the noxious signal from the stimuli (hot stove), sends an impulse to the spinal cord which relays the information to the brain. The brain interprets this as pain (ouch), localizes it and sends the instructions back to the body (removing hand from hot stove)
26
What does pain determine?
Warns the body of potential or actual injuries or diseases
27
acute pain (long)
Rapid onset and varies in intensity from mild to severe --After underlying cause is resolved, pain disappears -Body’s Response – Increased HR/BP (fight of flight), diaphoretic (sweating), pupils normal or dilated, restlessness
28
chronic pain long
Pain that lasts beyond the normal healing period -Anywhere between 1 and 6 months but commonly 3 months in practice- Can be constant, episodic (remission with exacerbation), or recurring Body’s Response – Normal vital signs, restlessness w/ exacerbation, pupils normal or dilated, poorly localized, varies from person to person, commonly impacts mental well-being (depression, anger, frustration, sleep/appetite disturbance)
29
Nociceptive Pain long
Caused by damage of body tissues External injury: hitting elbow, falling or scrapping knee, twisting ankle, stubbing toe Representative of the normal pain process (acute) Locations can be visceral or somatic pain Described as throbbing, sharp, or achy pain
30
Neuropathic Pain long
Caused by damage to the nerves Peripheral (hands/feet) & central neuropathic pain (anything impacting central nervous system) Cancer, alcoholism, stroke, limb amputation, chemotherapy drugs, radiation, or diabetes Described as stabbing, burning, shooting, pins and needles, or sharp pain (electric shock) Does not generally respond to conventional analgesics
31
Intractable Pain long
Does not respond to therapy or interventions Degenerative spinal disease, chronic regional pain syndrome (CRPS), neuropathy, osteoporosis Focus is reducing discomfort
32
phantom pain long
Caused when limb is removed No nerve endings are present but patient still feels pain in their limb Described as burning, fiery sensation, crushing, cramping VERY REAL and needs to be treated Treatment: NSAIDs, pain relievers, antidepressants, beta blockers, antiseizure medications, muscle relaxers, injections, neurostimulators, spinal cord stimulators, TENS units
33
Cutaneous Pain long
Superficial, involves the skin or subcutaneous tissue (burning). Example: Papercut
34
Somatic Pain long
Diffuse (spread out) or scattered. Originates in tendons, ligaments, bones, blood vessels, and nerves (bone/joint pain) Example: Ankle sprain
35
Visceral Pain long
Poorly localized. Originates in the thorax, cranium, and abdomen (aching/squeezing). Example: Bladder pain
36
Referred Pain long
Originates from one part in the body but is perceived in an area distant from its point of origin. Example: Heart attack – pain is felt in the neck, shoulder, chest, or arms (usually left)
37
Malignant /Cancer Pain long
Results from the direct effects of the disease and its treatment
38
control gate theory
This is the concept that non-painful input, such as a TENS unit, massage, heat, ice, or acupuncture CLOSES the gate to painful input, preventing the pain sensation from traveling to the central nervous system
39
Factors that Affect Pain
Past experience with pain/ background Cultural / Religious considerations age family anxiety/stressors
40
communication do
Use open ended questions Active listening Seeking clarification Summarizing Reflecting
41
communication dont
Ask “why” Use clichés (you’ll be just fine) Stereotype / Judge Give advice Use “elderspeak” or baby talk
42
How Do We Assess Pain?
Location (Where is the pain? If unable to answer, can you point?) Onset (When did the pain start?) Provocation (What makes it better or worse?) Quality (How would you describe your pain?) Radiation (Does the pain go from one place to another? Can you point to it?) Severity (Can you rate your pain 0/10?) Time (How long does the pain last?)
43
Non-pharmacological Interventions
TENS unit Heat/Ice Toileting / Making Comfortable Quiet Environment / Hypnosis Guided Imagery Massage / Acupuncture Exercise or Repositioning Distraction (laughter, music, TV)
44
Pharmacological Interventions
Non-opioid Analgesics or NSAIDs Tylenol or Ibuprofen Opioid Analgesics Mild (Tramadol) Strong (Hydromorphone/Morphine) Adjuvant or Co-analgesics Medications with a primary purpose other than pain relief (antidepressants, anticonvulsants, steroids)
45
pca pump
Patient-Controlled Analgesia Set to administer scheduled and/or on-demand dosing Patient must press the button Assess who is appropriate!!! Assess patient AT MINIMUM every 4 hours Continuous pulse-ox d/t increased risk for respiratory depression Two RNs must check the settings!!!
46
Priority Assessments w/ Opioid Administration
REMEMBER, ABC!!!!! Level of Consciousness (LOC) Respiratory Status (rate/quality) Side effects (nausea/constipation) Level of pain Vital signs
47
Pain Threshold
Lowest intensity at which pain is experienced
48
Pain Tolerance
Point when a patient can no longer endure the pain
49
Medication Tolerance
Body becomes accustomed and needs a larger dose for pain relief
50
Breakthrough Pain
Pain that occurs in-spite of medical intervention / flare-up, often use PRN medications to treat
51
Dependence
Body becomes accustomed to opioid therapy and experiences withdrawal when stopped
52
Addiction
Inability to stop using a substance even though it causes physical harm – used for euphoric aspect in spite of pain resolving
53
Sensory Perception MOA
Stimuli Stimuli is sensed and converted to nerve impulse nerve impulsed conducted through nervous system brain receives impulse and translate it into sensation
54
Factors affecting sensory function
Developmental age * Culture * Stress * Medications * Illness * Lifestyle
55
Sensory Deprivation
Drowsiness or Excessive Yawning “Escape Behaviors” Unusual body sensations, Illusions & Hallucinations Decreased attention span,problem-solving & ability to concentrate Crying or irritability Confusion Depression & panic
56
Sensory Overload
Fatigue Insomnia Sleeplessness Anxiety Racing thoughts Disorientation Increased muscle tension Difficulty with problem solving
57
Visual sensory deficit/ impairment interventions
Eye patches / surgery * Presbyopia, Cataracts, Glaucoma, Macular Degeneration bright colors, larger everything,enlarged text, clear pathways glasses
58
Hearing Impairment interventions
Other senses enhanced Amplification of devices Hearing aids, FM systems, Cochlear implant read lips, decrease background noise, check batteries, talk slower
59
Olfactory Impairment
Taught the dangers of working with chemicals Carefully inspect food for freshness
60
tactile impairment
May not be aware of heat/cold May not be aware for repositioning on bony prominences = pressure ulcer complete rom, reposition, ambulate frequently, use moisturizers
61
Delirium
Sudden Onset Either quiet, sleepy and disorientated, or restless and very distressed. Sleep may be disturbed May hallucinate Communicate using reality orientation Cause: Medications, nutritional deficiency, illness, circulatory or metabolic problems – one specific cause Interventions: Reorient frequently and immediately after surgery, structured environment, using aids (hearing/glasses) to minimize isolation and confusion, reduce the use of antipsychotics as they exacerbate the problem
62
Dementia stages what does causes interventions
Slow Onset Forgetfulness (early AD) Increased confusion (middle AD) Trouble speaking with difficulty understanding others (advanced AD) Alzheimer’s Disease is irreversible and progressive –impacts memory and advances to inability to self-care Communicate using validation Causes: Alzheimer’s Disease, stroke, or vascular event Interventions: Safety, decreased stimuli, frequent or constant supervision and care, emotional support/education/empathy with family
63
Unconscious Client who risks nursing considerations
Coma, Ventilated patient, Medication induced coma Risk for sensory deprivation,uti Hearing is the last sense lost Assume the patient can hear you Speak before touching
64
kinesthesia
awareness of position of body parts/movements
65
visceral
awareness of inner organs

1- nursing Fundamentals (10 decks)

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