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Fundies > Pain > Flashcards

Pain Flashcards

1
Q

Pain is a…

A

universal, but individual subjective experience that is often misunderstood and inadequately treated

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2
Q

Pain definition

A

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

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3
Q

Nurse’s job in pain

A

assess; improve systems; provide patient-centered care

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4
Q

nociception

A

observable activity in NS in response to adequate stimuli

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5
Q

4 steps of NS pain activity

A

transduction, transmission, perception, modulation

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6
Q

acute pain

A

protective; short duration and limited tissue damage; can threaten recovery if untreated and can progress to chronic

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7
Q

Chronic pain

A

no outward sx; over 3-6 months; cause psych and phys disability (anorexia, depression, suicide, hopelessness); goal is it improve functional status

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8
Q

cancer pain

A

damage from tumors, chemo, infection, all cancer related

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9
Q

how does pain change wth time

A

observable signs decrease; acute pain is more observable (inc BP, pulse, RR, dilated pupils, sweat)

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10
Q

acute pain response

A

tachy, HTN, anxiety, muscle tension, diaphoresis

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11
Q

behavioral response

A

grimace, guarding

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12
Q

chronic pain response

A

physiologic response is uncommon; more fatigue, depression, decreased functioning

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13
Q

subjective opinions of pain

A

believe the patient, acknowledge own prejudice, think safety when deciding what meds to give–eval patient first

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14
Q

factors influencing pain

A

age, fatigue, genes, cog/neuro (problems communicating), previous pain experience, support system/coping, spirituality, anxiety/fear

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15
Q

cultural aspects of pain

A

may not acknowledge pain if threatens lifestyle; some cultures more demonstrative, some more stoic, assess pain in native language bc may translate differently

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16
Q

what does pain impact

A

QoL, self-care, work, social support

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17
Q

who is the authority on pain?

A

the patient

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18
Q

Measures of pain

A

visual analog scale, simple descriptive, visual pain assessment or word bank, subjective and objective, PQRSTU, Baker face scale

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19
Q

who establishes acceptable level of pain goal

A

patient and care team; 0 pain might not be a reasonable goal

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20
Q

NC for pain treatment

A

multidimensional, inc functional status, use multiple methods, include cultural beliefs, be open-minded, pain may not be eliminated; include all patient concerns

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21
Q

relaxation and guided imagery

A

alters cognitive and affective perception; dec physiological response to pain

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22
Q

distraction

A

reticular system inhibits pain stimuli if person gets sufficient sensory input; best for SHORT, INTENSE pain

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23
Q

music

A

ACUTE/CHRONIC pain—Dec SNS response, distract, positive mood and emo

24
Q

cutaneous stim

A

stim skin with massage, temp, TENS (acute); unknown MOA but may be gate control, watch out for hot temperatures

25
Q

What temperature to use for acute and chronic pain?

A

heat for chronic, cold for acute

26
Q

adjuvants

A

enhance or have analgesic properties (ex: sleep meds)

27
Q

pharmacological tx of pain; nurse responsibility

A

assess, give med, reasses

28
Q

NSAID SE

A

Gi bleed especially in old

29
Q

non-opioids what they are and function

A

Acetaminophen and NSAIDs; mild-moderate pain; can have ceiling effect, give up to 800 mg

30
Q

Tylenol limit

A

4g/24h

31
Q

opioids function and SE

A

moderate to severe pain; GI SE, memory, thought change, respiratory depression

32
Q

opioids NC

A

don’t do edu immediately after getting; know pt baseline neuro status; start low and try to keep use temporary

33
Q

Respiratory depression/overdose NC; when do you see it

A

have oxygen and open airway; assess breathing and give Narcan (check after 15 minutes and reassess); common with opioid naive and around the clock dosing; often seen with BDZs

34
Q

around the clock dosing

A

max pain relief and potentially dec opioids use; give meds at a regular interval to prevent pain from coming back; might end up giving unneeded meds

35
Q

range-order meds

A

med orders where the dose is flexible (ex: 2-6mg morphine q2h); know your patient and count TYLENOL if given like this

36
Q

Patient controlled analgesia (PCA)

A

nurses program IV machine and pt pushes button to get bolus when needed; start with a higher loading dose to get pain under control then decrease; programmed frequency and lockout (limit)

37
Q

epidural anesthetic

A

regional anesthesia; must be preservative free; PCA or continuous

38
Q

SE of epidural

A

hypotension, N/V, urinary retention, constipation, respiratory depression, pruritis–itchy

39
Q

nursing care for epidural

A

monitor site placement, monitor infection/bleed, urinary retention/cath need, fall risk depending on location, monitor coagulation

40
Q

tolerance

A

Caused by repeated drug exposure long-term; associated with chronic opioid use but not a sign of addiction

41
Q

dependence

A

withdrawal symptoms occur after long-term opioid use; need to withdraw drug gradually; not a sign of addiction

42
Q

addiction

A

psychological dependence; use of drugs FOR mind-altering effects; “drug-seeking” behaviors

43
Q

Nociceptive pain and what helps it

A

Arises from pain receptors and usually response to opioids/analgesia; ache/pound/gnaw

44
Q

Neuropathic pain and tx

A

Injury to nerves or abnormal processes of sensory input; tx with adjuvant analgesics; burning, shooting, electrical, abnormal sensation; phantom limb, neuropathy, spinal cord

45
Q

Somatic pain

A

Type of nociceptive pain In bones, joints, muscles, skin or connective tissue; well-localized

46
Q

Visceral pain

A

Type of nociceptive pain in internal organs, often associated with referred pain (non-specific); often poorly localized

47
Q

Cutaneous pain

A

A type of nociceptive pain in skin or SQ tissue; well localized

48
Q

Idiopathic pain

A

Chronic pain w/o known cause

49
Q

When to give IV acetaminophen

A

Post-surgery

50
Q

Big complication of acetaminophen use

A

Liver failure esp with over 4g/24 hours

51
Q

Goal of non-pharm/alt/complementary

A

Inc QoL, inc functioning

52
Q

How does a support system/coping affect pain

A

Presence of these decrease pain sensitivity

53
Q

How does anxiety and fear impact pain?

A

May increase pain perception which causes more anxiety and fear

54
Q

How do genes impact pain?

A

May increase or decrease pain sensitivity

55
Q

Should you use non-pharm interventions if your patient is having moderate to severe pain?

A

You can, but use pharmacological interventions first

56
Q

What drug can cross the blood-brain barrier?

A

IV tylenol

Fundies (8 decks)

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