PAIN

Question 1

NOCICEPTIVE PAIN

Answer 1

Pain caused by non neurological sources

Question 2

DEFINITION OF PAIN

Answer 2

Pain is defined as whatever the person that is experiencing it says it is , whenever he says it is

Question 3

Concept of pain

Answer 3

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

Question 4

GATE THEORY

Answer 4

A fibers close the gate and prevent transmission to the brain
C fibers open the gate
Gate is in dorsal horn of spinal cord
Opioid receptors on the fibers

Question 5

ACUTE PAIN

Answer 5

Sudden onset
Short lived
Sharp
Localized
Responds to treatment

Question 6

CHRONIC PAIN

Answer 6

Dull
Recurrent
Harder to treat
Long lasting

Question 7

PAIN THRESHOLD

Answer 7

Level of stimulus needed to produce perception of pain

Question 8

PAIN TOLERANCE

Answer 8

Amount of pain a patient can endure without it interfering with normal function

Question 9

POPULATIONS MOST AT RISK

Answer 9

Older adults

Question 10

INDIVIDUAL RISK FACTORS

Answer 10

Chronic conditions
Acute or traumatic injury
Medical procedures
Breakthrough pain

Question 11

BREAKTHROUGH PAIN

Answer 11

Pain flare

Patient is on long acting pain med and uses short acting drug for this pain

Question 12

SIGNS OF PAIN

Answer 12

Sweating
Fast respiration
Restlessness
Crying
Guarding

Question 13

ELEMENTS OF PAIN ASSESSMENT

Answer 13

Location
Intensity
Quality
Onset and duration
Relieving factors( what helps?)
Effect on quality of life
Goal

Question 14

HIERACHY OF PAIN MEASURES

Answer 14

Self report
Patient condition
Observe behavioral signs
Evaluate physiological indicators
Analgesic trial

Question 15

NURSING INTERVENTIONS FOR PAIN

Answer 15

Alternative

Drug therapy

Question 16

ALTERNATIVE PAIN THERAPY

Answer 16

Positioning
Massage
Relaxation
Splinting
Thermal(hot or cold)
Yoga
Meditation
Tai chi

Question 17

CYP450 ENZYMES

Answer 17

Causes decreased metabolism of pain medications in some Caucasian’s and Asians

Question 18

INTRAVENOUS TYLENOL

Answer 18

Given 1 gram in 15 minute infusion.
No more than 4 grams in 24 hours
Many opioids have acetaminophen in them
MUCOMIST (acetocysteine) is used to counteract overdose orally

Question 19

NURSING IMPLICATIONS OF ANALGESICS

Answer 19

Perform thorough hx regarding allergies and other meds
Baseline vitals and I/O
Assess for potential interactions and respiratory depression
Monitor respiration rate( hold if under 10)
Increase fiber and fluids during therapy
Drowsiness and dizziness
Do not drive or operate machinery

Question 20

PATIENT TEACHING

Answer 20

Take med before pain is severe
Do not take with alcohol or CNS depressants
Less than 1% of hospitalized patients become addicted
Taper narcotics

Question 21

NON OPIOID PAIN RELIEVERS

Answer 21

Acetaminophen
Tramadol
NSAIDs

Question 22

TRAMADOL

Answer 22

Opioid synthetic
Inhibits reuptake of both norepinephrine and serotonin 
Non-narcotic
Controlled
Morphine-like

Question 23

ACETAMINOPHEN

Answer 23

Monitor closely for overdose

Limit is 4000mg per 24 hours

Question 24

OPIOIDS

Answer 24

Morphine
Norco (hydrocodone)
Dilaudid (hydromorphone)
Oxycodone

Question 25

NARCAN

Answer 25

Naxalone Used for opioid overdose Opioid antagonist

Question 26

OPIOID NURSING IMPLICATIONS

Answer 26

``` Check vitals, allergies, respiratory function I/O Must have Narcan on hand Increase fiber Give before pain reaches maximum Manage fall risk Taper dose May cause dependency ```