Pain Flashcards Preview

M.H.R School Of Nursing > Pain > Flashcards

Flashcards in Pain Deck (37):
1

Carry Pain 

Small Diameter Fibers

2

Inhibit Transmission of Pain Impulses

Carry non-painful stimuli

Large Fibers

3

NOCICEPTION

Physiological processes related to pain perception 

4

4 parts of Nociception

1. Transduction
2. Transmission
3. Perception
4. Modulation

5

Transduction

1st step in experience of pain

  • Nociceptors activated by exposure to noxious stimuli (mechanical, chemical, or thermal)
  • Nociceptors spark electrical impulse that is conducted along nerve

6

3 segments of Transmission

1. Pain impulse travels from peripheral nerve to spinal cord


2. Transmission from spinal cord and ascension to brain stem and thalamus


3. Transmission of signal between thalamus to somatic sensory cortex, where pain perception occurs

7

2 parts of the pain assessment

  1. Pain History (Subjective)
  2. Observation (Objective)

8

unpleasant sensory and emotional experience associated with actual or potential tissue damage, or it is described in terms of such damage

 International Association for the Study of Pain

(def of pain)

9

drug injected into nerve pathway

blocks transmission of impulse

Nerve block 

10

Cordotomy

last resort for intractable pain

11

usually on cervical nerve roots

Rhizotomy 

12

used to reverse effects of narcotics

 NARCAN

13

Rectal

  • Suppository
  • Good for patients with nausea/vomiting

14

Common Side Effects of Opioids

  • Constipation 
  • N/V
  • Sedation
  • Respiratory depression
  • Pruritus
  • Urinary retention

15

Pain

  • complex phenomena with NO simple definition
  • Highly subjective –Individual & Personal
  • difficult to assess 

16

4 Categories of Pain

  1. Location
  2. Duration
  3. Intensity
  4. Underlying mechanism

most patients do not fit neatly in single category 

17

Acute Pain

  • Begins suddenly
  • Usually sharp
  • mild to severe
  • moment to 6 months
  • Relieved when underlying cause eliminate

 

If unrelieved, may become chronic

18

Chronic Pain

• Prolonged duration
• Interferes with functioning
• Recurrent/ longer than 6 months
• Persists when injury has healed
• May have w/o injury or evidence of damage

19

Intractable pain 

  • Resistant to relief
  • Difficult to relieve
  • Try multiple interventions
  • Affects quality of life

can’t treat on own…. Interferes with ADL

20

Nociceptive Pain 

Most pt’s, manageable

  • Intact, functioning nervous system
  • signal that tissues are damaged
  • Requires attention and proper care

21

Subcategories of Nociceptive Pain

  1. Somatic Pain
  2. Visceral Pain 

22

Somatic Pain

 

intensity and location match type and extent of injury

  • Originates in skin, muscles, bone
  • Highly organized

23

Visceral Pain 

• Activation of nerve fibers from organs or hollow viscera
• Poorly localized

• Cramping, throbbing, aching
• Associated with diaphoresis or nausea

24

Neuropathic Pain

  • Damaged/ malfunctioning nerves
  • Difficult to treat
  • Burning, electric shock, tingling, dull, aching

 

25

3 Types of Neuropathic Pain

  1. Peripheral 
  2. Central
  3. Sympathetically Maintained

26

 Peripheral Neuropathy

– Pain felt along peripheral nerves
– Diabetic neuropathy Peripheral Neuropathy

27

Central Neuropathic Pain

  • Caused by lesion or dysfunction of CNS
  • Post-stroke pain
  • MS

28

 Sympathetically Maintained Pain

Abnormal connections between pain fibers and sympathetic nervous system

Becomes chronic and neuropathic

Phantom limb pain

29

Hyperalgesia

heightened response to painful stimuli

Severe pain from paper cut

30

Allodynia

nonpainful stimuli produce pain

Contact with wind, linens

31

Dysesthesia

unpleasant abnormal sensation, there are bugs under my skin, my skin is on fire

32

5 dimensions of pain

  1. Physiologic
  2. Sensory
  3. Affective
  4. Behavioral
  5. Cognitive

33

Transmission

3 segments

  1. Pain impulse travels from peripheral nerve to spinal cord
  2. Transmission from spinal cord and ascension to brain stem and thalamus
  3. Transmission of signal between thalamus to somatic sensory cortex, where pain perception occurs

34

Perception

  • become conscious of pain
  • Opiates work well here
  • shapes character, intensity, and meaning of pain to individual

35

Three key factors of preception

1. Threshold: point which identifies pain
2. Distractibility: degree can ignore pain
3. Tolerance: point at which act to stop pain

36

Modulation

  • Descending system
  • Neurons in thalamus and brainstem send signals down spinal cord
  • Neurons release substances (Endogenous opioids) inhibit pain impulses 

37

Endogenous opioids

serotonin, norepinephrine