Pain

Question 1

What causes perception of pain

Answer 1

nociceptor stimulation
by cell wall destruction, inflammation, infection, nerve injury, extravasation of fluid, pressure, distention, occlusion, obstruction

Question 2

what are conceptors mediated by

Answer 2

bradykins, prostaglanids, substance p, histamine, seratonin, leukotrienes, H, nerve growth factor

Question 3

pain tolerance

Answer 3

the amount of pain you can endure

Question 4

pain threshold

Answer 4

when pain is percieved as pain
based on past expirences

Question 5

Nociceptive pain

Answer 5

caused by direct tissue damage
sharp, stabbing, is localized and acute

Question 6

cutaneous pain

Answer 6

nociceptive pain of the skin, very localized, high amount og nocicpetive receptors

Question 7

somatic pain

Answer 7

nociceptive- deeper, dull, muscle, bone ligament

Question 8

visceral pain

Answer 8

organ pain, dull, diffuse, vague, may present as referred pain

Question 9

neuropathic pain

Answer 9

of the nerves, more tingling/numb
like phantom limb pain or diabetic neuropathy

Question 10

treatment of nociceptive pain

Answer 10

gabapentin, lyrica, anti-depressants

Question 11

diabetic neuropathy

Answer 11

from damage to vascular system, pain/tingling/pins and needles

Question 12

chronic pain

Answer 12

must separate acute and chronic pain
chronic pain may not present as normally because of adjustment to it. especially with vital signs

Question 13

elderly pain

Answer 13

felt just as intensely, but may present more atypically
more concerns with drugs bc lower kidney and liver function
use appropriate tools when diagnosing pain- dementia pain scales based on behavior

Question 14

goals of pain managment

Answer 14

able to participate in activities that will help in preventing complications

Question 15

addiction

Answer 15

psychological, diagnosed by a specialist

Question 16

placebo

Answer 16

saying something is a drug when it is not, can only be done consually in trials

Question 17

steps in pain management

Answer 17

find cause, know how pt percieves it, identify charactersitcs, implement plan

Question 18

when should pain meds be given

Answer 18

before pain in severe, start with minimal dosing and titrate up

Question 19

pain assessment

Answer 19

location, intensity, character, onset/duration, constant/intermittent, aggravating/relieving factors, associated symptoms, vital signs

Question 20

vital signs with pain

Answer 20

increased everything, although not always 100% reliable

Question 21

common post op pain

Answer 21

from incision site, sore throat from intubation, musculoskeletal pain based on positioning

Question 22

ceiling effect

Answer 22

increased dose will not give more pain relief
happens w/ non- narcotics, aspirin, tylenol, NSAIDs
opioids do not have a ceiling effect

Question 23

rescue dose

Answer 23

for breakthrough pain
higher dose of IV push, morphine, dilaudid

Question 24

analgesic ladder

Answer 24

way of thinking for treating pain, starting low and going higher
it tylenol, codeine, stronger IV med

Question 25

tylenol dose lim per day

Answer 25

3-4 g

Question 26

opioid crisis with med

Answer 26

has changed go to use of dilaudid and morphine into trying alternative methods like ice, lidocaine, nerve blocks

Question 27

are IV meds stronger

Answer 27

no, but they are faster and may take less time, however therapeutic effects end faster as well

Question 28

opioids in pain treatment

Answer 28

CNS depressant, no ceiling, yes dependance/ tolerance keep naloxone/ narcan near by with resp depression, pt may be in pain/ agitated causes urinary/GI retention- stool softners, ambulation Itching- helped with benadryl

Question 29

NSAIDS with pain

Answer 29

ibuprophen. Cotorolac/ torodol in IV, especially good for inflammation yes ceiling effect, no tolerance/dependance take with food to reduce ulcer risk need good renal system

Question 30

sallicylates with pain

Answer 30

aspirin avoid with other anticoagulents/ chances of bleeding

Question 31

tylenol with pain

Answer 31

does not effect pain as much because no inflammation effect best with fever

Question 32

multimodal pain treatment

Answer 32

blockin paintransduction with hot/cold, that block perception with med or distraction

Question 33

Baclofen

Answer 33

for muscle spasms can be through a pump

Question 34

Clonidine

Answer 34

for BP, but also used for migraines/ headaches

Question 35

anxiolytics

Answer 35

muscle spasms, anxiety

Question 36

coritcosteroids

Answer 36

decrease inflammation

Question 37

anti-seizure durgs

Answer 37

neuropathic pain

Question 38

Non-pharmacological therapies

Answer 38

music, relaxation, massage, TENS, exercise, cold/hot, acupuncture, distration

Question 39

Fentanyl patches

Answer 39

good for 3 days, chronic pain get lost easily need to be flushed when disposed

Question 40

injections with pain

Answer 40

quicker than PO, slower than IV good for acute, not chronic

Question 41

PCA pumps

Answer 41

patient controlled analgesia typcially small dose every 10 min-1hr can only be controlled by pt explain and remind pt of pump

Question 42

loading dose

Answer 42

high bolus of pain medictation to releive pain quickly

Question 43

continuous basel pump

Answer 43

continuous small amount of pain med

Question 44

Evaluation

Answer 44

pain level, vital signs, activity level minimize adverse effects like consitpation, lethargy, urniary retention, hypoventilation, hypotension, itching, GI bleeding, renal damage, nausea, vomiting

Question 45

Meds causing GI bleeding

Answer 45

NSAIDS, Aspirin