PAIN

Question 1

transduction

Answer 1

convert noxious stimuli to electrical impulses. ex. mechanical (skim knee) thermal (burns) chemical (chemical reaction)

Question 2

histamine

Answer 2

inflammatory response

Question 3

lactic acid

Answer 3

nociceptor activation

Question 4

bradykinin

Answer 4

vasodilator. Important with mediating pain response at the site before the signal gets to the central nervous system.

Question 5

prostaglandins

Answer 5

send pain stimuli to the CNS

Question 6

substance P

Answer 6

synthesized receptors to feel pain. Makes nerves more sensitive and quick to respond

Question 7

serotonin

Answer 7

smooth muscles and promote vasoconstriction

Question 8

transmission

Answer 8

a- fibers: acute localized pain is sent to the CNS
ex. stub a toe
c- fibers: defuse aching burning type pain
reflex arc: reflex from the pain

Question 9

perception

Answer 9

Individual interpretation of stimuli.
Increased Sensitivity to Thermal Pain and Reduced Subcutaneous Lidocaine Efficacy in Redheads

Question 10

threshold

Answer 10

lowest intensity of stimulus that causes recognition of pain

Question 11

modulation

Answer 11

Regulation or inhibition of pain sensation

Question 12

neuromodulators

Answer 12

they inhibit the production of pain-transmitting nerves. Both pain and stress activate these modulators. (endogenous opioid compounds)

Question 13

endorphins

Answer 13

produced at neuro synapsis. Released when things like relaxation techniques are used.
ex. Pain medicine (morphine) through IM injection then IV. causes a distraction which will improve pain response.

Question 14

enkephalins

Answer 14

less potent and thought to reduce pain by inhibiting substance P. (what our body produces to help manage pain.)

Question 15

gate control theory

Answer 15

Provides ideas for pain relief emphasizing multiple dimensions of pain and; relationship between pain and emotions. The motor receptor will be accepted first.
ex. sensory, emotional, behavioral, cognitive

Question 16

cutaneous: superficial

Answer 16

paper cut

Question 17

somatic: diffuse/ scattered

Answer 17

sprained ankle

Question 18

visceral: body organs due to stretch/ spasm

Answer 18

cholangitis –> Often guard/ splinting and when you touch them their muscles contract because they are protecting themselves

Question 19

Nociceptive pain

Answer 19

feels sharp, aching, or throbbing. normally external injury
ex. stubbing toe, sport injury, dental procedure

Question 20

neuropathic pain

Answer 20

Abnormal function of peripheral nervous system or central nervous system
ex. Burning, electric, tingling, stabbing

Question 21

Allodynia

Answer 21

pain after non-painful stimuli
touch and it shouldn’t hurt but it does. The majority is feet and fingers

Question 22

phantom pain

Answer 22

amputation but still experience pain even though its not there.

Question 23

psychogenic

Answer 23

Physical cause of the pain can not be identified. Results from a mental event may be more severe than a physical event.
ex. Think of ‘Never have I ever. Devi dad died, ended up in wheelchair

Question 24

intractable pain

Answer 24

intractable. cause cannot be removed.
ex. headaches, migraines

Question 25

PQRST PAIN ASSESSMENT

Answer 25

P: provokes Q: quality R: radiates S: severity T: time

Question 26

Interventions

Answer 26

Remove or alter the source of pain. Alter factors that contribute to pain tolerance Fatigue Misunderstanding of cause of pain Fear Establish trusting relationship

Question 27

Nonpharmacologic Interventions

Answer 27

Establish trusting relationship & acceptable pain level Distraction/ Humor Music/ Imagery/Relaxation Cutaneous stimulation Acupuncture/ Massage/therapeutic touch Heat/Cold Elevation Pet therapy

Question 28

Pharmacologic Interventions

Answer 28

giving meds to relieve pain

Question 29

non-opioids: more local reaction to pain. scheduled

Answer 29

Aspirin (ASA) Analgesic Anti-inflammatory NSAIDs Analgesic Anti-inflammatory Acetaminophen Analgesic Corticosteroids Anti-inflammatory

Question 30

Adjuvant Analgesics

Answer 30

Tricyclic antidepressants Antihistamines Caffeine Muscle relaxants Anticonvulsants Antiemetic

Question 31

opioid analgesics: alter perception of pain

Answer 31

morphine, codeine, oxycodone, meperidine, fentanyl, hydromorphone

Question 32

hydromorphone

Answer 32

1 mg of hydromorphone ≈ 7-10 mg of morphine! So, your ordered dose of hydromorphone should be 7-10 times less than that of morphine

Question 33

opioid antagonist

Answer 33

naloxone

Question 34

INVASIVE pain management

Answer 34

PCA: patient controlled analgesia IV: nerve block, epidural, intrathecal used to control post-op pain, chronic pain, severe cancer pain

Question 35

Opioid Side effects

Answer 35

Most Serious: Respiratory Depression Apnea Respiratory Arrest Circulatory Depression Hypotension/ Shock Common: Constipation ↓ peristalsis ↓ intestinal secretions Nausea & Vomiting Sedation Dizziness Pruritus Headache Dry Mouth

Question 36

Numeric Sedation Scale POSS

Answer 36

S: sleep, easy to arouse: no action necessary 1: awake and alert; no action necessary 2: occasionally drowsy, but easy to arouse; no action necessary 3: frequently drowsy, drifts off to sleep during conversation; reduce dosage 4: somnolent with minimal or no response to stimuli; discontinue opioid, consider use of naloxone

Question 37

break through pain

Answer 37

need another intervention to break through pain.

Question 38

opioid concerns

Answer 38

reluctant to take pain medication r/t fear of addiction

Question 39

physical dependence

Answer 39

withdrawal syndrome arises if drug discontinued, dose substantially reduced, or antagonist administered

Question 40

tolerance

Answer 40

greater amount of drug needed to maintain therapeutic effect, or less of effect over time

Question 41

pseudoaddiction

Answer 41

behavior suggestive of addiction; caused by undertreatment of pain

Question 42

addiction( psychological dependence)

Answer 42

a psychiatric disorder characterized by continued compulsive use of substance despite harm